ESBD_383359_1732634922373_Exhibit D Contractor's Qualification Stmt.pdf

Magoffin Home State Historic Site HSD-2024-038 Visitor Center Structural Repairs RFP# 808-25-250510

EXHIBIT D

CONTRACTOR’S QUALIFICATIONS STATEMENT

COMPLETE AND SUBMIT WITH PROPOSAL

PROJECT NO.

HSD-2024-038 LOCATION:

Magoffin Home State Historic Site, El Paso

County, Texas

PROPOSAL

DATE:

FIRM

ADDRESS

CITY STATE ZIP

PHONE FAX

Individual Partnership Corporation

If incorporated, under the laws of the State of with principal place of business in

PRINCIPALS IN FIRM AND YEARS EXPERIENCE IN CONSTRUCTION:

NAME TITLE PHONE NO. OF

YEARS

FIRM HISTORY: List firm history below including any other business names used.

From to Firm Name

From to Firm Name

Has firm, under its current or former name(s) ever failed to complete a project, defaulted on a contract, or been engaged in litigation over a contract? Yes No. If so, state particulars of most recent occurrence on separate sheet(s) and attach to this form.

CONSTRUCTION CAPABILITIES:

FIRM’S AVERAGE ANNUAL CONSTRUCTION VOLUME FOR THE PAST THREE FISCAL YEARS $

Indicate below the work categories that your firm typically self-perform, and the percentage of your projects on which you do so (e.g. you self-perform the finish carpentry on 50% of your projects):

Demolition % Mechanical % Roofing % ____________ %

Electrical % Painting % Finish carpentry % ____________ %

Plumbing %

Masonry construction

/preservation % Waterproofing %

FINANCIAL CAPABILITIES:

FINANCIAL INFORMATION SUMMARIZED BELOW WAS PREPARED BY:

ACCOUNTING FIRM Address

City State Zip

Prepared by (name): Phone

FINANCIAL STATEMENT SUMMARY:

Current Assets Current Liabilities

Fixed Assets Net Worth

Total Assets Total Liab. & Net Worth

BONDING REFERENCES: Indicate agency/surety through which bonding will be obtained.

AGENCY Address

City State Zip

Phone Fax

Agent’s Name

Agent’s

Phone

Name of Power of Attorney from Bond Company

Expiration

Date

BONDING COMPANY

Address

Phone Fax

Name of Representative Phone

BANKING REFERENCES:

BANK Address

Bank Contact Name Phone

Checking Acct. Numbers

Loan Acct. Numbers

CD/MM Acct. Numbers

EXPERIENCE RECORD:

List minimum of three (3) projects and a maximum of six (6) that are at least 80% completed or have been completed within the last five (5) years by your organization. Projects similar to the one being bid are preferred. Describe how your experience on these past projects is relevant to your ability to execute this project.

• List the projects in order of relevance, with the projects that best demonstrate your ability to complete this project listed first.

• For each project, provide all information requested on the form. If a particular piece of information is not applicable for a particular project (e.g. a project that did not have an architect or engineer) note “N/A” in that box.

1.

Project Name and location

Project Type (e.g. new bldg., addition, restoration, etc.):

Bldg. orig.

construction date:

Primary building use (e.g. office, school, residence, etc.)

Bldg. square footage,# of stories:

Primary exterior materials (e.g.

wood siding, brick, stone)

Name of site superintendent:

Roof type/material (e.g. comp.

shingle, wood shake, membrane) Contract Amount Beginning $ Ending: $

Describe the project and your scope of work, and how it relates to your ability to execute this project:

Project Owner (company) Address

Project Owner’s Rep (familiar with project) Phone Fax

Project percent complete If completed, date

Project A/E Name (firm and individual) A/E Phone

2.

Project Name and location

Project Type (e.g. new bldg., addition, restoration, etc.):

Bldg. orig.

construction date:

Primary building use (e.g. office, school, residence, etc.)

Bldg. square footage,# of stories:

Primary exterior materials (e.g.

wood siding, brick, stone)

Name of site superintendent:

Roof type/material (e.g. comp.

shingle, wood shake, membrane) Contract Amount Beginning $ Ending: $

Describe the project and your

EXPERIENCE RECORD: (CONTINUED)

3.

Project Name and location

Project Type (e.g. new bldg., addition, restoration, etc.):

Bldg. orig.

construction date:

Primary building use (e.g. office, school, residence, etc.)

Bldg. square footage,# of stories:

Primary exterior materials (e.g.

wood siding, brick, stone)

Name of site superintendent:

Roof type/material (e.g. comp.

shingle, wood shake, membrane) Contract Amount Beginning $ Ending: $

Describe the project and your

4.

Project Name and location

Project Type (e.g. new bldg., addition, restoration, etc.):

Bldg. orig.

construction date:

Primary building use (e.g. office, school, residence, etc.)

Bldg. square footage,# of stories:

Primary exterior materials (e.g.

wood siding, brick, stone)

Name of site superintendent:

EXPERIENCE RECORD: (CONTINUED)

5.

Project Name and location

Project Type (e.g. new bldg., addition, restoration, etc.):

Bldg. orig.

construction date:

Primary building use (e.g. office, school, residence, etc.)

Bldg. square footage,# of stories:

Primary exterior materials (e.g.

wood siding, brick, stone)

Name of site superintendent:

6.

Project Name and location

Project Type (e.g. new bldg., addition, restoration, etc.):

Bldg. orig.

construction date:

Primary building use (e.g. office, school, residence, etc.)

Bldg. square footage,# of stories:

Primary exterior materials (e.g.

wood siding, brick, stone)

Name of site superintendent:

I hereby certify that all information provided above and attached is true and correct. Furthermore, I hereby authorize you to contact the references listed above and authorize release of information from such references to Texas Historical Commission. I hereby certify that my firm is not debarred or suspended from performing work for the U.S.A. or the State of Texas.

Name of Firm Signature of Owner or Officer

Date Date

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