QUALIFICATION_SUBMITTAL_FORM_Non_FDOT.pdf
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- Solicitation number
- 25-0356-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The Qualification Submittal Form is a document for a non-FDOT (Florida Department of Transportation) contractor bidding on the Cured-In-Place Pipe (CIPP) Stormwater Pipe Rehabilitation project for Pinellas County Public Works. The form requires contractors to submit comprehensive documentation to qualify for the bid, including a bonding letter indicating maximum bonding capacity, an OpenGov Fillable-Final form, detailed project experience with at least three similar projects, and a minimum of three reference letters. Contractors must complete the form in its entirety, and failure to meet any of the specified conditions will result in disqualification from proceeding to Step Two of the bidding process.
The form captures critical information about a contractor's business and project history, including vendor details, officer/director information, and project-specific data such as project descriptions, owner and project manager contact information, project award and final amounts, design estimates, change orders, and scheduled and actual completion dates. The document is designed to thoroughly evaluate a contractor's qualifications, financial stability, past performance, and capability to successfully complete the CIPP stormwater pipe rehabilitation project for Pinellas County. By requiring extensive documentation and project history, the county aims to select a contractor with proven expertise in similar infrastructure rehabilitation work.
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Text version
QUALIFICATION SUBMITTAL FORM
STEP 1
PART A
The invitation to bid for this Project requires that this qualification submittal be included with the proposal and completed in its entirety. There is no FDOT prequalification for this invitation to bid.
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.
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: 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)
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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