Offer Document 4 _ Proposer Information Form.pdf
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- Attached to
- Xpress Bus Wash Rehabilitation
- Solicitation number
- PE-99600-RFP-2027-000000004
- Issued by
- Clayton County, Georgia
About this file
This is a Proposer Information Form (Offer Document #4) for GTEA Solicitation No. 27-001 issued by the Georgia Transportation Efficiency Authority for the Xpress Bus Wash Rehabilitation project at the Xpress South Operations maintenance facility in Forest Park, Clayton County, Georgia. The form requires Design-Build proposer firms to provide comprehensive company information including legal name, mailing and physical addresses, contact details, and website information. Proposers must designate an authorized representative and an Atlanta-based contact, both with complete contact information. Additionally, proposers are required to submit five project references demonstrating similar scope and cost work completed within the past ten years, with each reference requiring the project name, address, contact person details, total contract amount, and completion date.
The form requires proposers to specify their business structure (corporation, partnership, sole proprietorship, or joint venture) and indicate their Disadvantaged Business Enterprise (DBE) certification status, including the certifying agency if applicable. For proposers that are wholly-owned subsidiaries, parent company information must be provided. The authorized representative must certify under penalty that all information provided is true and correct, with a signature and date required on the certification statement. This document serves as a standard qualification and eligibility verification mechanism for the solicitation process.
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Text version
OFFER DOCUMENT #4 - PROPOSER INFORMATION FORM
GTEA Solicitation No. 27-001
Contractor must provide all of the information requested below:
Legal Name
Mailing Address
Physical Address
(if different from above)
Phone # Fax #
Website Address
Authorized Representative Name
Title
Email Address
Atlanta-Based Contact Name
Title
Proposer is a (choose one):
Corporation State of Incorporation
Partnership Sole Proprietorship Joint Venture (attach names)
Proposer is a (choose one):
Not a Certified Disadvantaged Business Enterprise (DBE)
Certified Disadvantaged Business Enterprise (DBE)
Certifying Agency
Provide the following information for five (5) project references for which Proposer has provided products and services of similar scope and cost in the last ten (10) years:
Reference #1
Name
Address
Contact Person
Total Contract Amount
Date of Contract Completion
Reference #2
Reference #3
Reference #4
If Proposer is a wholly-owned subsidiary of a parent company, provide the legal name and form of the parent company.
Reference #5
The undersigned certifies that the information provided above is true and correct.
Authorized Representative Name
Title Date
Authorized Representative Signature
File details come from the government source that posted it. Updated .