QUALIFICATION_SUBMITTAL_FORM_6.26rev.pdf

PDF 150 KB Posted

Attached to
South Cross Bayou Electrical Switchgear Replacement (TPA & TPB) PID 004906A
Solicitation number
26-0401-ITB-C
Issued by
Pinellas County, Clewiston City, Florida

About this file

This is a Qualification Submittal Form for Pinellas County, Florida's solicitation for electrical switchgear replacement at the South Cross Bayou Advanced Wastewater Reclamation Facility (PID 004906A). The project involves the removal and replacement of two 3200-ampere drawout generator circuit breakers and four 1600-ampere drawout feeder circuit breakers within a 277/480-volt, three-phase, four-wire switchgear line-up rated at 6000 amperes main bus capacity. Additional work includes replacement of the generator/engine master control cabinet components, modification of switchgear cells as needed, and removal and replacement of two switchboard line-ups (TPA and TPB) with utility and generator circuit breakers, group-mounted devices, and automatic failover systems. All equipment, materials, and work must result in complete, fully tested, and operational systems at the facility. Proposals were due August 25, 2026, with Technical Specifications and Final Plans updated August 10, 2026. Addendum #1 was posted on August 10, 2026.

Vendors must demonstrate successful completion of a minimum of three contracts of similar size and scope within the past seven years for public or private entities and submit four professional contract references prior to award, with all references and experience to be validated by a County Designee. The submittal form requires vendors to provide detailed information for each reference project, including owner contact information, project manager contact details, total contract amounts, and completion dates. Performance and payment bonds are required for the contract award. The solicitation includes an SBE (Small Business Enterprise) set-aside, with compliance forms and supporting documentation required. Vendors must complete the Officers Form section identifying corporate officers or business owners and provide their Florida contractor registration or certification number, with all submissions notarized and signed by authorized representatives.

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Other files

File Type Posted
South_Cross_Bayou_Electrical_Switchgear_Replacement_(TPA_&_TPB)_PID_004906A_(Addendum_#1_Revision).pdf PDF
Technical_Specifications_Add1.pdf PDF
Final_Plans_S&S_Add1.pdf PDF
QUALIFICATION_SUBMITTAL_FORM_6.26rev.pdf PDF
QUALIFICATION_SUBMITTAL_FORM_8-25_non-FDOT.pdf PDF
Technical_Specifications.pdf PDF
Pricing_Proposal26-0401(reference_only).pdf PDF
Sample_Performance_and_Payment_Bonds.pdf PDF
Performance_and_Payment_Bonds.pdf PDF
Common_Carrier_Attestation_02.05.2025.pdf PDF
Human_Trafficking_Affidavit_02.05.2025_(3).pdf PDF
Foreign_Countries_of_Concern_Affidavit_02.05.2025_(1).pdf PDF
QUALIFICATION_SUBMITTAL_FORM_8-25.pdf PDF
Sample_Agreement-26-0401.pdf PDF
APPENDIX_1-Permits.pdf PDF
Project_Location_Map.pdf PDF
Preliminary_Staff_Report.pdf PDF
SBE_Memo.pdf PDF
004906A_FY25_SCBSwitchgear_PFO.pdf PDF
Engineers_Estimate.xlsx XLSX spreadsheet
OpenGov_Fillable-_Final.pdf PDF
Sample_Change_Order.pdf PDF
Bid_Submittal_Form-JOC.pdf PDF
Airport_Security_Program.pdf PDF
Florida_Trench_Safety_Form.pdf PDF
Sample_Application_for_Payment.pdf PDF
E-Verify_Affidavit.pdf PDF
Affdavit_of_Release_and_Guarantee.pdf PDF
SBE_Compliance_Form.pdf PDF
LD_Calculator_(Purchasing_Only).xlsx XLSX spreadsheet
Non-Competitive_Oversight_Committee_Justification_Form.docx DOCX document
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Text version

MINIMUM QUALIFICATION SUBMITTAL FORM

REFERENCES/PROJECTS OF SIMILAR SIZE AND SCOPE:

Vendor must demonstrate successful completion of a minimum of three (3) contracts of similar size and scope within the past seven (7) years performing work for a public or private entity. Vendor must submit prior to award a minimum of four (4) professional contract references from a public or private entity of a similar size and scope. All references and work experience will be validated by a County Designee.

Company Name:

Project 1 Description (of similar scope and size)

Owner of Project - Contact Information

Name

Address

Telephone Number and Email Address:

Project/Contract Manager - Contact Information

Total Contract Amount: $

Completion Date

Project 2 Description (of similar scope and size)

Project Manager - Contact Information

Project 3 Description (of similar scope and size)

Project Manager- Contact Information

Project 4 Description (of similar scope and size)

Project Manager- Contact Information

OFFICERS FORM

Each solicitation response 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. Responses must 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 intent to award.

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

Corporate Name:

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:

Printed Name

TREASURER ADDRESS:

Printed Name

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

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:

Printed Name

Name ADDRESS:

Printed Name

Name ADDRESS:

Printed Name

If said company or business entity is a sole proprietorship, partnership, or joint venture, list the following:

Company Name:

By:

Name of Firm or Qualifying Agent

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

STATE OF FLORIDA,

PINELLAS COUNTY

Sworn to and subscribed before me by means of physical presence or online notarization, this day of

, 20 , by , who is personally known to me, or has produced as identification.

Signature of Notary Public

Print, Type or Stamp Name of Notary Public

Project 1 Description (of similar scope and size)
Owner of Project - Contact Information
Project/Contract Manager - Contact Information
Completion Date
Project 2 Description (of similar scope and size)
Owner of Project - Contact Information
Project Manager - Contact Information
Completion Date
Project 3 Description (of similar scope and size)
Owner of Project - Contact Information
Project Manager- Contact Information
Completion Date
Project 4 Description (of similar scope and size)
Owner of Project - Contact Information
Project Manager- Contact Information
OFFICERS FORM
PRESIDENT ADDRESS:
SECRETARY ADDRESS:
TREASURER ADDRESS:
Name ADDRESS:
Name ADDRESS:
Name ADDRESS:
STATE OF FLORIDA, PINELLAS COUNTY
has produced as identification.
Signature of Notary Public
Company Name:
Project 1 Description of similar scope and size 1:
Project 1 Description of similar scope and size 2:
Project 1 Description of similar scope and size 3:
Owner of Project Contact Information:
Company Name_2:
Owner of Project Contact Information_2:
Total Contract Amount_2:
Company Name_3:
Owner of Project Contact Information_3:
Total Contract Amount_3:
Company Name_4:
Owner of Project Contact Information_4:
Said Corporation is qualified to do business in the State of Florida:
Company Name_5:
Name of Firm or Qualifying Agent:
Contractors Registration or Certification No issued by the State of Florida:
20:
as identification:
Print Type or Stamp Name of Notary Public:
Signature1_es_:signer:signature:
Owner name:
Owner address:
Project Manager Name:
Project Manager Address:
Owner name_2:
Owner address_2:
Project manager name_2:
Project manager address_2:
Completion date_2:
Owner name_3:
Owner address_3:
Project manager name_3:
Project manager address_3:
Owner name_4:
Owner address_4:
Project manager name_4:
Project manager address_4:
Total contract amount:
Completion date:
Completion date_4:
Project Manager Contact Information_4:
Project 4 Description of similar scope and size 1_4:
Project 4 Description of similar scope and size 2_4:
Project 4 Description of similar scope and size 3_4:
Completion Date_3:
Project Manager Contact Information_3:
Project 3 Description of similar scope and size 1_3:
Project 3 Description of similar scope and size 2_3:
Project 3 Description of similar scope and size 3_3:
Project 2 Description of similar scope and size 1_2:
Project 2 Description of similar scope and size 2_2:
Project 2 Description of similar scope and size 3_2:
Project Contract Manager Contact Information:
Project Manager Contact Information_2:
Contractors address line 1:
Contractors address line 2:
Contractors address line 3:
President printed Name:
Secretary printed Name:
Treasurer Printed Name:
Address line 1_1:
Address line 2_1:
Address line 1_2:
Address line 2_2:
Address line 1_3:
Address line 2_3:
Qualifying agent:
Contractor's registration or certificate number:
Owner address line 1_1:
Owner address line 2_1:
Owner printed Name_1:
Owner printed Name_2:
Owner printed Name_3:
Owner address line 1_2:
Owner address line 2_2:
Owner address line 1_3:
Owner address line 2_3:
Corporation name:
Check Box5: Off
year:
Check Box4: Off
identification_type:
day:

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