QUALIFICATION_SUBMITTAL_FORM_8-25.pdf

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Attached to
South Cross Bayou Replacement of Generator Controls and Switchgear (GEN2) (PID 004906A) - STEP 1
Solicitation number
26-0256-ITB-C
Issued by
Pinellas County, Clewiston City, Florida

About this file

This is a Qualification Submittal Form for the State of Florida Department of Transportation (FDOT) related to the South Cross Bayou Replacement of Generator Controls and Switchgear project at the Pinellas County South Cross Bayou Advanced Water Reclamation Facility. The project involves the removal and replacement of four 3200-ampere draw out generator circuit breakers and six 2000-ampere draw out feeder circuit breakers in two 277/480 volt, 3-phase, 4-wire switchgear lineups. The work also includes removal of six free-standing, floor-mounted generator/engine control cabinets and their internal control components, with all systems to be complete and fully tested upon completion. Bidders must submit completed qualification forms as part of their bid package for Step 1 of the procurement process.

The qualification requirements differ based on FDOT pre-qualification status. Contractors currently pre-qualified with FDOT in all applicable work classes must submit the OpenGov Fillable-Final form, outline experience with similar projects on the Qualification Submittal Form, provide FDOT qualification letters, and furnish a bonding letter indicating maximum bonding capacity. Non-FDOT pre-qualified contractors must submit the same documentation except the FDOT qualification letter but must instead provide a minimum of three reference letters from companies for which they have completed similar projects. All contractors must complete the Qualification Submittal Form in its entirety, documenting up to four previous projects of similar type and scope, including owner contact information, project manager details, award amounts, final project totals, design estimates, change orders, and completion dates. Failure to meet these qualification conditions results in disqualification from proceeding to Step Two. The bidder must execute the agreement within ten calendar days of notice of award and bear full costs of work maintenance until final acceptance.

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Text version

QUALIFICATION FORMS – BID SUMMARY

QUALIFICATION SUBMITTAL FORM

STEP 1

FDOT Pre-qualified requirements

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

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

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

3. FDOT qualification letter/forms

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

Non FDOT Pre-qualified requirements

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

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

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

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

4. Provide a minimum of three reference letters from companies that you have performed projects of a similar size and scope.

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

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

NOTE: BIDDER SHALL SUBMIT QUALIFICATION SUBMITTAL ON THE FORM PROVIDED HEREIN TO PROVIDE THE

QUALIFICATION REQUIREMENTS AS SPECIFIED IN

Company Name: Please include below

Project 1 (of similar type) Description

Owner of Project - Contact Information

Name

Address

Telephone Number and Email Address:

Project Manager - Contact Information

Name

Address

Telephone Number and Email Address:

Project Award Amount: $

Final Project Total Amount: $

Design Professional/Engineer Estimate:

$ Change Orders $

Scheduled Completion Date

Actual Completion Date

QUALIFICATION SUBMITTAL FORM (continued)

Company Name: Please include below

Project 2 (of similar type) Description

Owner of Project - Contact Information

Name

Address

Telephone Number and Email Address:

Project Manager - Contact Information

Name

Address

Telephone Number and Email Address:

Project Award Amount: $

Final Project Total Amount: $

Design Professional/Engineer Estimate:

$ Change Orders $

Project 3 (of similar type) Description

Owner of Project - Contact Information

Name

Address

Telephone Number and Email Address:

Project Manager- Contact Information

Name

Address

Telephone Number and Email Address:

Project Award Amount: $

Final Project Total Amount: $

Design Professional/Engineer Estimate:

$ Change Orders $

Project 4 (of similar type) Description

Owner of Project - Contact Information

Name

Address

Telephone Number and Email Address:

Project Manager- Contact Information

Name

Address

Telephone Number and Email Address:

Project Award Amount: $

Final Project Total Amount: $

Design Professional/Engineer Estimate:

$ Change Orders $

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

The invitation to bid for this Project requires that this qualification submittal be included with the proposal and completed in its entirety.

Vendor Information Firm Name:

Street Address:

City:

State:

ZIP:

Additional Info:

Officer/Director Information

Officer/Director/Member:

Title:

DOB:

Notes:

Officer/Director/Member

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 any corporation, the name and addresses 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 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 the 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.

By Corporation Name President

***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

By:

Name of Firm or Qualifying Agent

Contractor’s Registration or Certification No. issued by

PRESIDENT ADDRESS:
SECRETARY ADDRESS:
TREASURER ADDRESS:
Name ADDRESS:
Name ADDRESS:
Name ADDRESS:
QUALIFICATION REQUIREMENTS AS SPECIFIED IN:
Company Name Please include below 1:
Company Name Please include below 2:
Company Name Please include below 3:
Project 1 of similar type Description 1:
Project 1 of similar type Description 2:
Project 1 of similar type Description 3:
Owner of Project Contact Information:
Name:
Address:
Project Manager Contact Information:
Name_2:
Address_2:
1:
2:
3:
undefined:
Company Name Please include below 1_2:
Company Name Please include below 2_2:
Company Name Please include below 3_2:
Project 2 of similar type Description 1:
Project 2 of similar type Description 2:
Project 2 of similar type Description 3:
Owner of Project Contact Information_2:
Name_3:
Address_3:
Project Manager Contact Information_2:
Name_4:
Address_4:
1_2:
2_2:
3_2:
undefined_2:
QUALIFICATION SUBMITTAL FORM continued:
Company Name Please include below 1_3:
Company Name Please include below 2_3:
Company Name Please include below 3_3:
Project 3 of similar type Description 1:
Project 3 of similar type Description 2:
Project 3 of similar type Description 3:
Owner of Project Contact Information_3:
Name_5:
Address_5:
Project ManagerContact Information:
Name_6:
Address_6:
1_3:
2_3:
3_3:
undefined_3:
QUALIFICATION SUBMITTAL FORM continued_2:
Company Name Please include below 1_4:
Company Name Please include below 2_4:
Company Name Please include below 3_4:
Project 4 of similar type Description 1:
Project 4 of similar type Description 2:
Project 4 of similar type Description 3:
Owner of Project Contact Information_4:
Name_7:
Address_7:
Project ManagerContact Information_2:
Name_8:
Address_8:
1_4:
2_4:
3_4:
undefined_4:
Firm Name:
Street Address:
City:
State:
ZIP:
Additional Info:
OfficerDirectorMember:
Title:
DOB:
Notes:
OfficerDirectorMember_2:
Title_2:
DOB_2:
Notes_2:
OfficerDirectorMember_3:
Title_3:
DOB_3:
Notes_3:
OfficerDirectorMember_4:
Title_4:
DOB_4:
Notes_4:
OfficerDirectorMember_5:
Title_5:
DOB_5:
Notes_5:
Additional Information On Vendor or Contract Requirements:
The Contractors address and principal place of business is 1:
The Contractors address and principal place of business is 2:
The Contractors address and principal place of business is 3:
If Contractor is a Corporation list the names titles and business addresses of its President Secretary and Treasurer:
ADDRESS 1:
ADDRESS 2:
Printed Name:
ADDRESS 1_2:
ADDRESS 2_2:
Printed Name_2:
ADDRESS:
By:
Corporation Name:
Qualifying Agent:
Contractor:
s Registration or Certificate No:
Printed Name_3:
ADDRESS_2:
undefined_5:
Printed Name_4:
ADDRESS_3:
undefined_6:
Printed Name_5:
The said company or business entity is a sole proprietorship partnership or joint venture and:
Name of Firm or Qualifying Agent:
Contractors Registration or Certification No issued by:
Project Award Amount:
Final Project Total Amount:

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