QUALIFICATION_SUBMITTAL_FORM.pdf
PDF 249 KB Posted
- Solicitation number
- 24-0692-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
The Qualification Submittal Form is a document for the ARPA Stormwater Starkey Facility M10 Modification project issued by the Florida Department of Transportation (FDOT). The form is designed for contractors to demonstrate their qualifications to bid on the project, with two primary paths: pre-qualified FDOT contractors (Part A) and non-pre-qualified contractors (Part B). Contractors must provide documentation including a bonding letter indicating their maximum bonding capacity, complete an OpenGov Fillable-Final form, outline project experience with at least three similar projects, and submit reference letters. Failure to meet these requirements will result in disqualification from proceeding to Step Two of the bidding process.
The form requires detailed information about the bidding company, including vendor information, officer/director details, and corporate structure. For non-pre-qualified contractors, additional documentation is required to verify the company's capabilities and experience. The bid submittal requires listing corporate officers, addresses, and registration details. Contractors must be qualified to do business in Florida and provide information about their business entity type, whether a corporation, sole proprietorship, partnership, or joint venture. The documentation aims to comprehensively assess the contractor's financial stability, past performance, and capacity to successfully complete the Starkey Watershed stormwater management facility modification project.
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Text version
QUALIFICATION SUBMITTAL FORM
STEP 1
PART A
If you are currently a pre-qualified construction contractor with FDOT in the applicable work type found in the Special Conditions Section, please check box and fill out OpenGov Fillable-Final and return with signed PART A and provide a bonding letter from surety indicating the maximum amount your company can bond for.
I am Pre-qualified with FDOT in one or more of the work class(s) as referenced in the Special Conditions Section.
Signature by Contractor for PART A Only: __________________________________________________
Please print name and email address: _____________________________________________________
If you are not pre-qualified with FDOT, please complete PART B and include all Qualification Forms.
PART B
The invitation to bid for this Project requires that this qualification submittal be included with the bid and completed in its entirety.
A component of the Pre-Qualification of Bidder process is background check and review. If you are not currently pre-qualified with FDOT please provide the following documentation and include with Qualification Submittal Forms by Step One due date referenced in the Notice Section.
1. Provide a bonding letter from surety indicating the maximum amount your company can bond for.
2. Please complete and return the OpenGov Fillable-Final.
3. Provide your experience on Qualification Submittal Forms below outlining projects of a similar size and scope.
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 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 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
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)
Project 2 (of similar type) Description
Project Manager - Contact Information
Address
Telephone Number and Email Address:
Project Award Amount: $
Final Project Total Amount: $
Design Professional/Engineer
Project 3 (of similar type) Description
Project Manager- Contact Information
Address
Telephone Number and Email Address:
Project Award Amount: $
Final Project Total Amount: $
Design Professional/Engineer
Project 4 (of similar type) Description
Project Manager- Contact Information
Address
Telephone Number and Email Address:
Project Award Amount: $
Final Project Total Amount: $
Design Professional/Engineer
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)
QUALIFICATION FORMS – BID SUMMARY
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:
Printed Name
TREASURER ADDRESS:
Printed Name
QUALIFICATION FORMS – BID SUMMARY
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:
Printed Name
Name ADDRESS:
Printed Name
Name ADDRESS:
Printed Name
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
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