Proposers_Qualification_Statement.pdf
PDF 97 KB Posted
- Solicitation number
- RFP026-12
- Issued by
- New Haven County, Connecticut
About this file
This document is a Proposer's Qualification Statement for the City of Meriden, designed to collect comprehensive information from potential contractors bidding on a project. The form requires detailed information about the proposing company, including its organizational structure, years in business, personnel, vehicles and equipment, subcontractors, and past project experience. The document specifically requests proposers to list five similar projects completed within the past five years, provide contact information for references, and disclose details about the company's business history, corporate status, and potential conflicts of interest.
The qualification statement includes several critical sections that assess the proposer's capability, such as inquiries about minority-owned business status, corporate structure, years of operation, and past contract performance. The form requires proposers to disclose whether they have ever defaulted on a contract, filed for bankruptcy, or failed to complete a contract, and mandates that all information be verified through a notarized statement. Proposers must also authorize the City of Meriden to request and verify any additional information about their business, demonstrating a commitment to transparency and accountability in the bidding process.
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Text version
PROPOSER’S QUALIFICATION STATEMENT
This Statement of Proposer’s Qualifications is to be submitted by the proposer at the time of the proposal opening. All questions must be answered and the data given must be clear and comprehensive. If necessary, questions must be answered on attached sheets. The proposer may submit any additional information they desire. It is understood that when the City has executed an Agreement, to which these General Conditions are a part, it is, in part, done upon the reliance of the answers provided herein by the proposer or the agent of the proposer .
Firm Name ________________________________________________________________________________
Address __________________________________________________________________________________
Telephone _________________________________ Fax____________________________________________
Officers: _____________________________________________ President
______________________________________________ Vice President
______________________________________________ Secretary
______________________________________________ Treasurer
Bank References: ___________________________________________________________________________
Bond surety Company: ______________________________________________________________________
If a partnership, give names of partners. If a sole proprietorship, give name and title of a least one responsible employee.
Experience: The Proposer shall be qualified by experience to perform work of this nature and shall list five (5) examples of similar projects completed within the past five (5) years, with the names of responsible parties as references.
TELEPHONE NUMBER
PROJECT OWNER CONTACT NAME COST
1. Minority owned business? ______________ yes ________________ no
2. Years organized. ________________
3. Is your company a corporation ______________yes ________________ no
If yes where incorporated? __________________
4. How many years have you been engaged in business under your present firm name? ________________
5. Former Firm Name (if any)______________________________________________________________
6. List total number of Personnel _________________________
7. Is any principal of your firm an employee or public official of the City of Meriden, or an immediate family member of an employee or public official of the City of Meriden? (Definition of immediate family includes: an individual’s spouse, fiancé or fiancée; the parent, brother or sister of such individual or spouse; and the child of such individual or the spouse of such child.)
______________ yes ________________ no
8. List Vehicles and Equipment that you will use to perform this work: (show age of vehicles and equipment, sizes, capacities, etc.
9. List the work to be performed by Subcontractors and summarize the dollar value of each subcontract.
10. List the name and address of the more important contracts recently completed by you, starting the approximate gross cost for each, and the month and year completed:
11. General character of work performed by you________________________________________________
12. Have you ever failed to complete any contract awarded to you? If so, where and why?
13. Have you ever defaulted on a contract? If so where and why?
14. Have you ever filed bankruptcy: __________Please explain:___________________________________
15. Will you, upon request, furnish any information that may be required by the City of Meriden?________
16. The undersigned hereby authorizes and request any person, firm or cooperation to furnish any information requested by the City of Meriden, in verification of the recitals comprising this Statement of
Bidder’s Qualifications.
Dated this ______________day of ____________________, 20__________ day month year
Name of Proposer
Title
State of _____________________________
County of __________________________
___________________________________________ being duly sworn deposes and says that they are
Name
____________________________________ of ____________________________________________ title name of organization and that the answers to the forgoing question and all statement therein contained are true and correct
Subscribed and sworn to before me this __________________ day of __________________ 20_________ day month year
Notary Public signature
My commission expires ____________________________
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