GS Vendor Bidder Data Sheet.docx

DOCX document 243 KB Posted

Attached to
T0845- Regulated Medical Waste, DEA Pharmaceutical, & RCRA Hazardous Waste Disposal- Statewide
Solicitation number
19DPP00422
Issued by
Camden County, Jersey City, New Jersey

About this file

This document is a Vendor (Bidder) Data Sheet issued by the State of New Jersey Department of the Treasury Division of Purchase and Property for Bid Solicitation #19DPP00422. The data sheet requires bidders to provide details on their prior contracts of similar size and scope to the work required by this bid solicitation, as well as any negative actions taken against the bidder by other contracting entities.

The related state and local contract opportunity is for Regulated Medical Waste, DEA Pharmaceutical, & RCRA Hazardous Waste Disposal services on a statewide basis, with Mercer County and the City of Trenton identified as the specific jurisdictions involved. The contract term, award date, and any renewal options are not provided in the information given.

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Text version

STATE OF NEW JERSEY

DEPARTMENT OF THE TREASURY

DIVISION OF PURCHASE AND PROPERTY

33 WEST STATE STREET, P.O. BOX 230

TRENTON, NEW JERSEY 08625-0230

VENDOR {BIDDER} DATA SHEET

BID SOLICITATION #:
19DPP00422
VENDOR {BIDDER}:

THIS FORM WILL BE USED IN EVALUATING THE VENDOR’S {BIDDER’S}

ABILITY TO COMPLETE THE SCOPE OF WORK.

PART I - CONTRACTS OF SIMILAR SIZE AND SCOPE

List prior contracts performed by the Vendor {Bidder}. Emphasis should be placed on contracts that are similar in size and scope to the work required by this Bid Solicitation as evidence of the Vendor’s {Bidder’s} ability to successfully complete the scope of work required by this Bid Solicitation. If the Vendor {Bidder} has not had any prior contracts, enter “None” below.

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Contract Scope of Work:

Contact Name:

Contact Phone No.:

Contact Email:

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Contract

Contact Name:

Contact Phone No.:

Contact Email:

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Contract

Contact Name:

Contact Phone No.:

Contact Email:

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Contract

Contact Name:

Contact Phone No.:

Contact Email:

Attach additional sheets if necessary.

PART II – NEGATIVE ACTIONS AGAINST THE VENDOR {BIDDER}

Provide a list of any negative actions taken by other contracting entities against the Vendor {Bidder} in the course of performing these projects including, but not limited to, receipt of letters of potential default, default, cure notices, termination of services for cause, or other similar notifications/processes. Additionally, the Vendor {Bidder} should provide details, including any negative audits, reports, or findings by any governmental agency for which the Vendor {Bidder} is/was the contractor on any contracts of similar scope. In the event a Vendor {Bidder} neglects to include this information in its Quote, the Vendor’s {Bidder’s} omission of necessary disclosure information may be cause for rejection of the Vendor’s {Bidder’s} Quote by the State. If no negative actions were taken against the Vendor {Bidder}, enter “None” below.

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Negative Action:

Contact Name:

Contact Phone No.:

Contact Email:

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Negative Action:

Contact Name:

Contact Phone No.:

Contact Email:

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Negative Action:

Contact Name:

Contact Phone No.:

Contact Email:

Contracting Agency / Entity:

Contract/Project Name:

Contract Number:

Contract Term:

Summary of Negative Action:

Contact Name:

Contact Phone No.:

Contact Email:

Attach additional sheets if necessary.

DPP Rev. 3.27.2018
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