EXHIBIT E-Emergency Response Form (1).pdf
PDF 193 KB Posted
- Attached to
- Traffic Signals Replacement
- Solicitation number
- 147530
- Issued by
- Polk County, Florida
About this file
This is an Emergency Response Capability Form (Exhibit E) for a Traffic Signals Replacement contract opportunity in Florida. The form requires bidders to provide emergency contact information, including a primary emergency contact, secondary emergency contact, and a 24-hour hotline (if applicable), with all contacts required to be available continuously throughout the year. Bidders must certify their capability to respond to emergency service requests within two hours as specified in the solicitation, and must provide their operations location address along with the distance in miles from the District. The form requires bidders to attest under signature that they possess the necessary personnel, equipment, and operational capability to meet the emergency response requirements, with failure to meet the required response time constituting a potential material breach of contract.
The form does not contain pricing information, set-asides, incumbency details, or funding source information. The document is a certification and qualification form that bidders must complete and submit with their bid response to demonstrate their emergency response readiness for the Traffic Signals Replacement project in Florida.
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Text version
Exhibit E Emergency Response Capability Form
Bid Number:
Bid Title:
List Emergency Contact Information
Contact Type Name Phone Number Email Address Primary Emergency Contact Secondary Emergency Contact 24-Hour Hotline, if applicable
NOTE: Emergency contacts must be available 24 hours per day, 7 days per week, for 365 days a year.
Emergency Response Capability The Bidder certifies the capability of responding to emergency service requests within the timeframe specified within the solicitation.
Required Response Time:
Two (2) Hours Other:____________
Operations Location
Address: __________________________________________________________
City/State/Zip: ______________________________________________________
Approximately ________ miles away from the District.
Business Information and Signature:
By signing below, the Bidder certifies they possess the personnel, equipment, and operational capability necessary to meet the emergency response requirements specified in the solicitation. Failure to meet the required response time may constitute a material breach of contract.
Business Name:
Signature:
Submit completed form with your bid response.
v.03.26
| Bid Number: |
| Bid Title: |
| NamePrimary Emergency Contact: |
| Phone NumberPrimary Emergency Contact: |
| Email AddressPrimary Emergency Contact: |
| NameSecondary Emergency Contact: |
| Phone NumberSecondary Emergency Contact: |
| Email AddressSecondary Emergency Contact: |
| Name24Hour Hotline if applicable: |
| Phone Number24Hour Hotline if applicable: |
| Email Address24Hour Hotline if applicable: |
| Other: |
| Address: |
| CityStateZip: |
| Approximately: |
| Business Name: |
| Check Box1: Off |
| Check Box2: Off |
File details come from the government source that posted it. Updated .