QUALIFICATION_SUBMITTAL_FORM_Non_FDOT.pdf

248 KB Posted

Attached to
U. S. 19 Fuel Site Renovation
Solicitation number
23-1167-ITB-C
Issued by
Pinellas County, Florida

About this file

Written by GovTribe AI ·

This Qualification Submittal Form is a procurement document for a non-FDOT (Florida Department of Transportation) contract opportunity related to the U.S. 19 Fuel Site Renovation project. The form requires potential bidders to submit comprehensive documentation demonstrating their qualifications, including a bonding letter indicating maximum bonding capacity, completion of an OpenGov Fillable-Final form, detailed project experience with at least three similar projects, and a minimum of three reference letters from companies for whom they have completed similar scope work. Bidders must provide specific project details 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 emphasizes a strict pre-qualification process where failure to provide any required documentation will result in disqualification from proceeding to Step Two of the bidding process. The form requires detailed vendor information, including corporate structure details such as officer/director information, and mandates that bidders be prepared to execute the agreement within 10 calendar days of award notification. While specific pricing terms are not detailed in this qualification form, the document is part of a procurement process for a fuel site renovation project involving the closure of existing underground tanks and installation of new aboveground tanks, with the county providing separate environmental closure services.

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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 Section J – 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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