Form_9.7_-_Statement_of_Respondent's_Qualification.pdf

FORM 9.7 STATEMENT OF RESPONDENT’S QUALIFICATIONS

The undersigned warrants that he or she is duly authorized to complete this document, and hereby affirms that the information contained in Form 9.7 is complete, true and correct to the best of his or her knowledge and belief. If necessary, questions may be answered on separate paper and attached with any additional information that may be pertinent.

A. Name of Respondent: _______________________________________________________________________________________________________

B. Permanent main office address: ________________________________________________________________________________________

C. Date organized: ___________________

D. If a corporation, where incorporated: ______________________________________________

E. How many years have you been engaged in the business under your present firm or trade name? _____________

F. Contracts on hand: (List these, showing amount of each contract and the approximate anticipated dates of completion.) USE SEPARATE SHEET & ATTACH TO SUBMITTAL.

G. Have you ever failed to complete any work awarded to you? If so, where and why?________________________________

H. Have you ever defaulted on a contract? If so, where and why? ______________________________________________________

I. List your major equipment currently owned or leased: USE SEPARATE SHEET & ATTACH TO SUBMITTAL.

J. List the more important projects recently completed by your company, stating the approximate cost for each and the month and year completed: USE SEPARATE SHEET & ATTACH TO SUBMITTAL.

K. Background and experience of the principal members of your organization, including the officers: USE

SEPARATE SHEET & ATTACH TO SUBMITTAL

L. Credit currently available: $____________________________

M. Give bank name, contact name and phone number: ___________________________________________________________________

Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the Owner? ☐Yes ☐No

The undersigned hereby authorizes and requests any person, firm or corporation to furnish any information requested by the Owner in verification of the recitals compromising the Statement of Respondent’s Qualifications.

Name of Business

STATE OF:_________________________ Authorized Signature

COUNTY OF: _______________________ ______________________________________________________ Printed Name and Title

The foregoing instrument was acknowledged before me by means of ☐physical presence or ☐online notarization, this _________ day of _______________________, 2025, by____________________________________________________________ and who:

☐Is personally known to me; or ☐ has produced __________________ as identification.

_________________________________________________________ Notary Public, State of ______________________________________ Printed, typed or stamped name, commission and expiration:

This document must be completed and returned with your Submittal