MB-1820 SPECIAL QUESTIONNAIRE.pdf

PDF 465 KB Posted

Attached to
Bricktown Ballpark Fence Improvements State and local contract opportunity
Solicitation number
MB-1820
Issued by
Oklahoma County, Oklahoma

About this file

This is a Special Questionnaire Application for Contractors Prequalification form for Oklahoma City. The document is a standard prequalification questionnaire that contractors must complete to be considered eligible for construction contracts with Oklahoma City, requiring comprehensive information about the applicant's business credentials, experience, and qualifications. The form does not specify particular projects, services, quantities, dates, or contract terms, as it serves as a general prequalification tool for multiple potential opportunities.

The questionnaire requests detailed information including the contractor's legal business information, construction work categories performed and subcontracted, project completion history, bonding company details and limitations, litigation history from the past five years, liquidated damages experience, and whether the contractor maintains quality assurance/quality control and health and safety programs. The form emphasizes that all information provided will be considered in determining contract qualification and that incomplete responses may result in disqualification, while also noting that the awarding public agency reserves the right to award contracts to the bidder they determine to be the lowest and best responsive bidder rather than automatically awarding to the low bidder.

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Anti Noncollusion Affidavit.pdf PDF
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Business Relationship Affidavit.pdf PDF
MB-1820 Bricktown ballpark fence NTB.pdf PDF

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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:
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Check Box5: Off
Check Box6: Off
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Text11:
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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 .