QUALIFICATION_SUBMITTAL_FORM_4.26.pdf

QUALIFICATION SUBMITTAL FORM

STEP ONE

FDOT pre-qualified requirements:

If you are currently a pre-qualified construction contractor with FDOT in all the applicable work classes, as required in the Special Conditions Section, please fill out/provide:

1. Please complete and return the OpenGov Fillable-Final.

2. Provide your experience on the Qualification Submittal Form outlining projects of a similar size and scope.

3. A bonding letter from your surety indicating the maximum amount your company can bond.

4. Provide a minimum of three reference letters dated within the past five years from companies that you have performed projects of a similar size and scope.

5. FDOT qualification letter/forms.

Non-FDOT pre-qualified requirements:

If you are not pre-qualified with FDOT in all the applicable work classes, as required in the Special Conditions Section, please fill out/provide:

1. Please complete and return the OpenGov Fillable-Final.

2. Provide your experience on the Qualification Submittal Form outlining projects of a similar size and scope.

3. A bonding letter from surety indicating the maximum amount your company can bond.

4. Provide a minimum of three reference letters dated within the past five years from companies that you have performed projects of a similar size and scope.

5. Provide your Florida Certified General Contractor license.

**If any of the above conditions are not met, your company will be disqualified from moving forward to Step Two. **

Applicable for all contractors. The invitation to bid for this project requires that this form be included with the bid and completed in its entirety.

Company Name: Please include below

Project 1 Description (of similar scope and size)

Owner of Project - Contact Information

Name

Address

Telephone Number and Email Address:

Project Manager - Contact Information

Project Award Amount: $

Final Project Total Amount: $

Design Professional/Engineer Estimate:

$ Change Orders $

Scheduled Completion Date

Actual Completion Date

QUALIFICATION SUBMITTAL FORM (continued)

Project 2 Description (of similar scope and size)

Project Manager - Contact Information

Final Project Total Amount: $

Design Professional/Engineer

Project 3 Description (of similar scope and size)

Project Manager- Contact Information

Final Project Total Amount: $

Design Professional/Engineer

Project 4 Description (of similar scope and size)

Project Manager- Contact Information

Final Project Total Amount: $

Design Professional/Engineer

Applicable only for contractors who are not pre-qualified with FDOT

Vendor Information Firm Name:

Street Address: City: State: ZIP:

Additional Info:

Officer/Director Information

Officer/Director/Member: Title: DOB:

Notes:

Officer/Director/Member: Title: DOB:

Notes:

Officer/Director/Member: Title: DOB:

Notes:

Officer/Director/Member: Title: DOB:

Notes:

Officer/Director/Member Title: DOB:

Notes:

Additional Information: (On Vendor or Contract Requirements)

BID SUBMITTAL OFFICERS FORM

Each Bid by an individual or firm shall state the name and address of each person who owns an interest therein, and, if it is a corporation, the name and address of its officers, or if an LLC, the name and address of its members. Bids shall be signed by the person or member of the firm making the same, and if a corporation, by an authorized officer or agent, subscribing the name of the corporation, together with his/her own name and the corporate seal.

The Bidder further agrees to execute the Agreement within 10 calendar days after receipt of notice of award, and within the time frame of the Agreement.

The Bidder further agrees to bear the full cost of maintaining all Work until final acceptance.

Accompanying the Bid is a Bid Guarantee, meeting the requirements described in the Instruction to Bidders.

The Contractor’s address and principal place of business is:

If Contractor is a Corporation, list the names, titles and business addresses of its President, Secretary and Treasurer.

PRESIDENT ADDRESS:

Printed Name

SECRETARY ADDRESS:

TREASURER ADDRESS:

Said Corporation is qualified to do business in the State of Florida.

Corporate Name:________ ___________________________________

By Title

***CORPORATE SEAL***

Qualifying Agent

Contractor's Registration or Certificate No.

issued by the State of Florida

If Contractor is not a corporation, list the name(s) and business address(es) of its owner(s), joint venturers or partners:

Name ADDRESS:

The said company or business entity is a sole proprietorship, partnership, or joint venture and is trading and doing business as

Company Name:___________________________________________________________

By: ________________________________________________________________________ Name of Firm or Qualifying Agent

Contractor’s Registration or Certification No. issued by the State of Florida