proc_dispute_disclosure_form_1.pdf
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- Attached to
- 2025 & 2026 Emergency Line Clearance
- Solicitation number
- PR8325
- Issued by
- Florida
About this file
The document is a Dispute Disclosure Form for the Orlando Utilities Commission (OUC) related to the 2025 & 2026 Emergency Line Clearance solicitation (RFP 25 8325). This form requires bidding firms to disclose any professional reprimands, contract defaults, suspensions, or litigation history within the past five years that might impact their qualification for the emergency line clearance contract. The form is designed to provide transparency about a firm's professional track record and potential risk factors before being considered for the contract.
The form requires firms to answer three key disclosure questions: whether they have received any regulatory reprimands, been terminated from previous contracts, or been involved in any contract-related litigation. Firms must answer "YES" or "NO" to each question, with an option to provide detailed explanations for affirmative responses. The document includes a certification statement that emphasizes the importance of truthful disclosure, warning that any misstatement or falsification could result in forfeiture of contract consideration rights. Signatories must provide their firm name, date, authorized signature, officer title, and printed name to complete the disclosure process.
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Text version
DISPUTE DISCLOSURE for Solicitation #:_____________
Answer the following questions by placing an "X" in the appropriate "YES" or "NO" box. If you answer "YES", please explain In the space provided, or via attachment.
Has your firm, or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulation or any other regulatory agency or professional association within the last five (5) years?
YES NO
Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years?
YES NO
Has your firm had filed against it or filed any requests for equitable adjustment, contract claims or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business?
YES NO
If yes, state the nature of the request for equitable adjustment, contract claim or litigation, a brief description of the case, the outcome or status of suit and the monetary amounts or extended contract time involved.
I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation or falsification of facts shall be cause for forfeiture of rights for further consideration of this project.
Firm Date
Authorized Signature Officer Title
Printed or Typed Name
Dispute Disclosure Form_v.1_160708
| DISPUTE DISCLOSURE for Solicitation: |
| association within the last five 5 years: Off |
| business within the last five 5 years: Off |
| regular course of business: Off |
| Firm: |
| Printed or Typed Name: |
| Date: |
| Officer Title: |
File details come from the government source that posted it. Updated .