Prequalification_Questionnaire_for_Substation_Transformer_Procurement.docx

CITY OF PALO ALTO

PRE-QUALIFICATION QUESTIONNAIRE

PQ197857 - Purchase (6 each) 20/26/34MVA, 115/60-12.47Y/7.2kV Substation Transformers

Directions: Complete all fields and questions as indicated and upload all required supporting documentation. Supporting documentation should be clearly labeled to cross-reference applicable Parts and Question numbers of the Questionnaire. If the City’s bid portal permits uploads by question, supporting documentation should be uploaded with the applicable question. If not, the proposer must submit one consolidated supporting documentation file with each document or section clearly cross-referenced to the applicable Parts and Question numbers. All responses must be legible. Execute as indicated, and create a PDF copy of the complete, signed Questionnaire, including supporting documentation, and submit via the City’s bid portal by the Pre-Qualification Deadline for the above-referenced project (“Project”).

PART A: SUPPLIER INFORMATION

Supplier Name:

Factory Location:

Electrical Design Location:

Mechanical Design Location:

FAT Test Laboratory Location:

Responsible Person for Questionnaire Completion :

Phone Number:

E-mail:

PART B: PREQUALIFICATION CRITERIA QUESTIONS

(a) core and magnetic-circuit design; (b) winding design; (c) insulation system and dielectric design; (d) thermal rating and cooling-system design; and (e) short-circuit/mechanical withstand design.

Provide Explanation:

NOTE: Omissions, misrepresentations and any failure to disclose associations with other firms or any prior history of alleged violations may lead to loss of your eligibility to register as a Public Works Contractor, disqualification of bids, and/or grounds for termination of a contract.

6056663

PART C: PROJECT REFERENCES

The City will use project references and supporting verification materials to verify Part B responses and identify material omissions or misrepresentations. Reference responses will not be separately scored unless the Scoring Directions identify the standardized questions, objective criteria, and how those responses will affect the bidder’s score or prequalification status.

Provide information about the firm’s three most recent completed transformers sold to a municipal utility in the United States. Names and references must be current and verifiable. Use separate sheets of paper that contain all of the following information*:

Transformer 1:

Project Name: ________________________________________________________________ Location: ____________________________________________________________________ Owner: ______________________________________________________________________ Owner Contact: (name and current phone number): ___________________________________ Engineering Contact (name and current phone number, if different from owner): ____________________________________________________________________________ Description of Project:

Date the Manufacturing of Transformer Commenced: __________________________________ Date of Manufacturing Completion: _________________________________________________ *In addition, you may also provide information about other projects that you have completed that are similar to the City’s project(s) for which you expect to bid using the same format.

Transformer 2:

Project Name: ________________________________________________________________ Location: ____________________________________________________________________ Owner: ______________________________________________________________________ Owner Contact: (name and current phone number): ___________________________________ Engineering Contact (name and current phone number, if different from owner): ____________________________________________________________________________ Description of Project:

Date the Manufacturing of Transformer Commenced: __________________________________ Date of Manufacturing Completion: _________________________________________________ *In addition, you may also provide information about other projects that you have completed that are similar to the City’s project(s) for which you expect to bid using the same format.

Transformer 3:

Project Name: ________________________________________________________________ Location: ____________________________________________________________________ Owner: ______________________________________________________________________ Owner Contact: (name and current phone number): ___________________________________ Engineering Contact (name and current phone number, if different from owner): ____________________________________________________________________________ Description of Project:

Date the Manufacturing of Transformer Commenced: __________________________________ Date of Manufacturing Completion: _________________________________________________ *In addition, you may also provide information about other projects that you have completed that are similar to the City’s project(s) for which you expect to bid using the same format.

PART D: CERTIFICATION

Questionnaires submitted by corporations must be signed with the legal name of the corporation, followed by the name of the state of incorporation and by the signature and designation of the chairman of the board, president or any vice president, and then followed by a second signature by the secretary, assistant secretary, the chief financial officer or assistant treasurer. All persons signing must be authorized to bind the corporation in the matter. The name of each person signing shall also be typed or printed below the signature. Satisfactory evidence of the authority of each officer signing on behalf of a corporation shall be furnished.

Questionnaires submitted by partnerships must furnish the full name of all partners and must be signed in the partnership name by a general partner with authority to bind the partnership in such matters, followed by the signature and designation of the person signing. The name of the person signing shall also be typed or printed below the signature.

Each person signing below makes the following representations under penalty of perjury:

The submitter of the foregoing answers to the questionnaire has read the same and the matters stated therein are true to the best of his or her own personal knowledge. This information is provided for the purpose of qualifying to bid on the Project, and any individual, company or other agency named herein is hereby authorized to supply the awarding body with any information necessary to verify the prospective bidder’s statements. By signing below, the submitter and the named contractor hereby grant permission to the City of Palo Alto, including its authorized staff or consultants, to contact any or all of the above listed persons or entities to confirm facts or otherwise investigate the above facts and issues.

The submitter understands that any statement which is proven to be false shall be grounds for immediate disqualification from bidding on the Project. The submitter whose signature appears below represents and warrants that he or she has authority to bind the named contractor.

I, (Name), the undersigned, am the (Title), with the authority to act for and on behalf of (Vendor Entity Name), declare under penalty of perjury under the laws of the State of California that the foregoing information provided in this Pre-qualification Questionnaire is true, full, and correct.

I understand that making a false statement may result in disqualification from bidding on City of Palo Alto procurements and may be grounds for termination of a contract.

Executed on this: day of at . (Date) (Month / Year) (City / State)

image1.jpeg