ESBD_399417_1740750255255_PR-0002353-A Attachment G - Contractors Qualification Form.pdf

RFP PR-0002353-A

HVAC Maintenance Services in Houston, Waco, and Ft Worth, Texas

ATTACHMENT G -كCONTRACTOR’S QUALIFICATIONS

FORM

Respondent Instructions: Complete the form below and submit with response as per Attachment J

– RFP Submission Instructions and Guidelines. This form or a reasonable likeness must be returned with response. Failure to complete and submit Attachment G – Contractor’s Qualifications Form through the Bonfire online system will result in disqualification of submitted response.

COMPANY INFORMATION:

Company Name:

Federal EIN Number:

(Attach W9 to this form)

Company Description

Number of Years in Business:

(If less than 5 years, explain how company meets minimum requirements)

Office Presence in Houston, Waco, Ft. Worth, Area?

Primary Contact Name:

Primary Contact Phone:

Primary Contact Email:

FINANCIAL HISTORY

Indicate if your company or any of its subsidiaries filed or met criteria for bankruptcy within the past five years; (Yes or No, provide explanation)

Indicate if your firm is currently in default on any loan agreement or financial agreement institution, or other entity. If so, specify date(s), details, circumstances, and prospect resolution.

Identify if your company is currently for sale or involved in any transaction to expand or become acquired by another business entity. If so, explain the impact both in organization and company direction.

Indicate if your company has ever failed to complete a project or if a project was ever stopped in the middle of a project within the past five years. If so, why.

Indicate if your company has had a contract terminated for default or convenience within the past five years. Yes or No. If yes, provide explanation

MAIN/HOME OFFICE LOCATION INFORMATION:

Main Office Address:

# of Permanent, FT Employees:

# of Permanent, PT Employees:

OFFICE THAT WILL SERVICE THIS CONTRACT INFORMATION:

Servicing Office Address:

# of Permanent, FT Employees:

# of Permanent, PT Employees:

# of Service Technicians:

Geographic Service Area: Houston Fort Worth Waco

(Checked service area should have an Attachment E – Compensation and Fees filled in)

1. What certi�ications, licenses, or permits are required to perform preventative maintenance and repair services on HVAC and BAS equipment as required in Attachment A – Statement of Work and Attachment F

– Equipment List. (Attach additional sheet, if necessary)

2. Explain how you meet the requirements stated in question 1 above.

(Attach additional sheet, if necessary)

Provide the names and certi�ications/licenses held by Lead Service Technicians and Service Technician Helpers that will perform services, if awarded this contract. (Attach resumes and licenses/certi�ications to this document)

Name Certification/License (Include number if applicable)

City

List any specialized HVAC training provided to Lead Service Technicians and Service Technician Helpers relevant to the Statement of Work.

Name Training

RELEVANT EXPERIENCE AND QUALIFICATIONS

(Attach additional sheet if necessary) Describe how you propose to fulfill the requirements outlined in Attachment A – Statement of Work. Answer should include: Company experience in providing preventative maintenance and repair services on HVAC and BAS equipment and any other additional information we would need to know going into the contract.

PROPOSED METHODOLOGY

(Attach additional sheet if necessary. See Attachment F – Minimum Scoring Criteria)

Describe how you propose to fulfill the requirements outlined in Attachment A – Statement of Work. Answer should include: explain your process and techniques used to understand the services to be provided under this contract; diagnostics and troubleshooting techniques; how you meet maintenance schedules; communication to owners regarding results of findings and recommendations found during inspections, how your staffing size and their roles will fulfill these requirements; method of tracking for maintaining a schedule for how equipment will remain compliant; how services are scheduled; how services are requested as-needed; available service times; response times during normal working hours and emergency situations; availability 24/7; if parts used are OEM or off brand utilized for repairs; and any other additional information we would need to know going into the contract. (Attach additional sheet, if necessary)

QUALITY AND SAFETY

(Attach additional sheet if necessary) Describe safety training program provided to employees relevant to Statement of Work. Answer should include: quality assurance program, quality requirements and means of measurement to ensure high quality and response services. (Attach additional sheet, if necessary)

Describe the safety equipment issued to provide employees performing services relevant to Statement of Work.

(Attach additional sheet, if necessary)

Provide an insurance letterhead, the Worker’s Compensation Modification Rate for the past five (5) years.

(Attach as a separate document). Below, provide explanation for any rating above a value of one (1).

REFERENCES: Contractor shall submit three (3) references for which the contractor has provided services of similar size, scope and complexity within the last three (3) years. Additional information may be submitted or attached at Respondent’s discretion to provide a detailed summary of Qualifications & Experience of similar/relevant scope.

A. Client:

Point of Contact:

Telephone:

Email:

Facility Name:

Facility Address:

Start Date of Contract:

End Date of Contract:

Description of Scope of Work:

B. Client:

Telephone:

Email:

Facility Name:

Facility Address:

Start Date of Contract:

End Date of

C. Client:

Telephone:

Email:

Facility Name:

Facility Address:

Start Date of Contract:

End Date of

ATTACHMENT G - CONTRACTOR’S QUALIFICATIONS FORM