MB-1686-A SPECIAL QUESTIONNAIRE.pdf
PDF 465 KB Posted
- Attached to
- CMF Bldg. 2 Restroom renovation
- Solicitation number
- MB-1686-A-R1
- Issued by
- Oklahoma
About this file
This is a Special Questionnaire Application for Contractors Prequalification form used by Oklahoma City for evaluating potential construction contractors. The three-page application requires contractors to provide comprehensive information about their business operations, including complete legal name, contact details, authorized agents, business addresses, contractor identification numbers, years in business, and categories of construction work performed both as primary contractor and subcontractor. The form requests detailed information about the construction experience of officers and principals, completed projects with owner contact information and contract amounts, any history of failed contracts or liquidated damages, and bonding company information including any limitations or instances where bonding companies completed the applicant's work.
The questionnaire emphasizes that all provided information will be considered in determining contract qualification and warns that unanswered questions could result in disqualification from contract awards. The form requires disclosure of any litigation with project owners in the past five years, including contract amounts and nature of disputes, and asks whether the applicant maintains quality assurance/quality control programs and health and safety programs, with attachments required if available. The document notes that the awarding public agency reserves the right to determine the lowest and best responsive bidder rather than being required to award to the low bidder, and incomplete applications may result in disqualification from contract consideration.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
1. APPLICANT (Show Complete Legal Name) AUTHORIZED AGENT
APPLICANT STREET ADDRESS
BUSINESS ADDRESS, IF DIFFERENT
CITY STATE ZIP PHONE #
APPLICATION SUBMITTED BY/CONTACT PERSON
CONTRACTOR I.D. NO./FEDERAL TAX I.D. NO.
E-MAIL ADDRESS
HOW MANY YEARS HAS THE APPLICANT BEEN IN
BUSINESS UNDER YOUR PRESENT BUSINESS NAME? YEARS
2. DESCRIBE CATEGORIES OF CONSTRUCTION WORK THIS APPLICANT PERFORMS AS A CONTRACTOR
3. DESCRIBE CATEGORIES OF CONSTRUCTION WORK THIS APPLICANT SUBCONTRACTS, IF ANY
4. HAS THIS APPLICANT EVER FAILED TO COMPLETE OR REFUSED TO ENTER INTO A CONSTRUCTION CONTRACT AWARDED TO SAID
APPLICANT? YES IF YES, WITH WHOM, WHERE WHEN AND WHY?
5. HAS ANY OFFICER OR PRINCIPAL OF THIS APPLICANT EVER FAILED TO COMPLETE A CONSTRUCTION CONTRACT IN THEIR
NAME? YES NO IF YES, STATE NAME OF INDIVIDUAL, AND REASON THEREFOR:
*All Information provided in this questionnaire may be considered in determining qualification for the Contract. Any questions left unanswered could result in the bidder to not be qualified or awarded the Contract.
SPECIAL QUESTIONNAIRE APPLICATION FOR
CONTRACTORS PREQUALFICATION OKLAHOMA CITY
NO
INDIVIDUAL'S NAME PRESENT POSITION YEARS EXPERIENCE LICENSES AND LICENSE NO.’s
7. LIST COMPLETED PROJECTS (SEE SPECIAL PROVISIONS TECHNICAL)
DESCRIPTION OF PROJECT-
LOCATION OF PROJECT
Including the name of the owner, and phone numbers
DATE
PROJECT
COMPLETED
CONTRACT
AMOUNT
8. DESCRIBE ANY BOND LIMITATIONS IMPOSED BY BONDING COMPANY BECAUSE OF ANTICIPATED CONSTRUCTION
DURATION.
9. NAME AND ADDRESS OF BONDING COMPANY:
10. HAS THIS APPLICANT BEEN CHARGED FOR LIQUIDATED DAMAGES IN THE PAST FIVE YEARS?
IF YES, WHEN WHERE AND WHY?
NO 11. HAS ANY BONDING COMPANY OR AGENT COMPLETED THIS APPLICANT'S WORK IN THE PAST FIVE YEARS? YES
IF YES, WHEN WHERE AND WHY
6. CONSTRUCTION EXPERIENCE OF THE OFFICER AND PRINCIPALS OF THIS APPLICANT. ( Include any )
YES NO
robert.witt Line
12. LIST ANY LITIGATION WITH THE OWNERS OF PROJECTS IN THE PAST FIVE YEARS
OWNER'S NAME ADDRESS/PHONE NUMBER CONTRACT
AMOUNT
NATURE OF LITIGATION
13. DOES THIS APPLICANT HAVE A QUALITY ASSURANCE /QUALITY CONTROL PROGRAM?
14. DOES THIS ORGANIZATION HAVE A HEALTH AND SAFETY PROGRAM?
YES NO
YES NO
NOTE:
*All Information provided in this questionnaire may be considered in determining qualification for the Contract.
Any questions left unanswered could result in the bidder to not be qualified or awarded the Contract.
*The Awarding Public Agency is not required to award the Contract for that Project to the low bidder and reserves the right to determine and award to the Bidder the Awarding Public Agency determines lowest and best responsive bidder.
IF YES, PLEASE ATTACH
IF YES, PLEASE ATTACH
| 1 APPLICANT Show Complete Legal Name: |
| STREET ADDRESS: |
| MAILING ADDRESS: |
| CITY: |
| CONTACT PERSON: |
| CONTRACTOR ID NOFEDERAL TAX ID NO: |
| YEARS: |
| 2 DESCRIBE CATEGORIES OF WORK THAT THIS ORGANIZATION TO PERFORM AS A CONTRACTOR 1: |
| 3 DESCRIBE CATEGORIES OF WORK THIS ORGANIZATION USUALLY SUBCONTRACTS IF ANY 1: |
| fill_14: |
| 7 1: |
| DESCRIPTION OF PROJECTRow1: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow1: |
| DATE PROJECT COMPLETEDRow1: |
| DESCRIPTION OF PROJECTRow2: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow2: |
| DATE PROJECT COMPLETEDRow2: |
| Row1: |
| DESCRIPTION OF PROJECTRow3: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow3: |
| DATE PROJECT COMPLETEDRow3: |
| Row2: |
| DESCRIPTION OF PROJECTRow4: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow4: |
| DATE PROJECT COMPLETEDRow4: |
| Row3: |
| DESCRIPTION OF PROJECTRow5: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow5: |
| DATE PROJECT COMPLETEDRow5: |
| Row4: |
| DESCRIPTION OF PROJECTRow6: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow6: |
| DATE PROJECT COMPLETEDRow6: |
| Row5: |
| DESCRIPTION OF PROJECTRow7: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow7: |
| DATE PROJECT COMPLETEDRow7: |
| Row6: |
| DESCRIPTION OF PROJECTRow8: |
| LOCATION OF PROJECT Including the name of the owner inspector their addresses phone numbersRow8: |
| DATE PROJECT COMPLETEDRow8: |
| Row7: |
| DESCRIBE ANY BOND LIMITATIONS IMPOSED BY BONDING COMPANY BECAUSE OF ANTICIPATED CONSTRUCTION: |
| DURATION: |
| 10 NAME AND ADDRESS OF BONDING COMPANY 1: |
| 10 NAME AND ADDRESS OF BONDING COMPANY 2: |
| IF YES WHEN WHERE AND WHY 1: |
| IF YES WHEN WHERE AND WHY 2: |
| IF YES WHEN WHERE AND WHY 3: |
| HAS ANY BONDING COMPANY OR AGENT OF ANY BONDING COMPANY EVER COMPLETED THIS ORGANIZATIONS WORK: |
| fill_11: |
| fill_12: |
| OWNER S NAMERow1: |
| ADDRESSPHONE NUMBERRow1: |
| CONTRACT AMOUNTRow1: |
| OWNER S NAMERow2: |
| ADDRESSPHONE NUMBERRow2: |
| CONTRACT AMOUNTRow2: |
| NATURE OF LITIGATION: |
| Text1: |
| Check Box5: Off |
| Check Box6: Off |
| Text9: |
| Text10: |
| Text11: |
| Text12: |
| Text13: |
| Text14: |
| Text15: |
| Text16: |
| Text17: |
| Text18: |
| Text19: |
| Text20: |
| Check Box1: Off |
| Check Box2: Off |
| Text4: |
| Text5: |
| Check Box7: Off |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
| Check Box3: Off |
| Check Box4: Off |
| Check Box11: Off |
| Check Box12: Off |
File details come from the government source that posted it. Updated .