QUALIFICATION_SUBMITTAL_FORM_NON_FDOT.pdf
PDF 176 KB Posted
- Attached to
- WELL SERVICES FOR PINELLAS COUNTY UTILITIES
- Solicitation number
- 23-0884-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The Qualification Submittal Form is a procurement document for Pinellas County Utilities Engineering, designed to pre-qualify contractors for a five-year well services contract. The document requires bidders to provide detailed information about their company's qualifications, including project work types, experience with similar projects, reference letters, and the ability to perform various well-related services such as evaluation, maintenance, repair, rehabilitation, and construction of wells. Bidders must complete multiple sections detailing four similar past projects, including project descriptions, owner and project manager contact information, project award and final amounts, and scheduled and actual completion dates.
The form includes a comprehensive vendor information section requiring details about the firm's address, officer/director information, and additional contract requirements. Bidders must demonstrate qualification in work types including bascule bridge, bridge repair, building, electrical, marine, mechanical, road/street/storm sewer, roofing, well drilling, and water/sanitary sewer services. The document emphasizes that failure to meet any of the specified conditions will result in disqualification from moving forward in the bidding process. A bonding letter or parent guarantee, completion of an OpenGov Fillable-Final form, and at least three reference letters from similar projects are required to be considered for the contract.
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Text version
QUALIFICATION SUBMITTAL FORM
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 proposal 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 or a letter of parent guarantee indicating at a minimum the maximum amount of the budget estimate referenced in the Notice Section.
2. Please complete and return the OpenGov Fillable-Final.
3. Confirm Project Work Type(s) (outlined below – check appropriate box(es)
4. Provide your experience on Qualification Submittal Forms below outlining projects of a similar size and scope.
5. Provide a minimum of three reference letters from companies that you have performed projects of a similar size and scope.
Work Types your company is qualified to perform - *Check all boxes that apply
Project Work Types
Bascule Bridge Fixed Bridge Roofing
Bridge Repair Marine Well Drilling
Building Mechanical Water and Sanitary Sewer
Electrical Road, Street, Storm Sewer
**If any of the above conditions are not met, your company will be disqualified from moving forward with Step Two.**
The invitation to bid for this Project requires that this qualification submittal be included with the proposal 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 $
Company Name: Please include below
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 $
Company Name: Please include below
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 $
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: SSN:
Notes:
Officer/Director/Member: Title: DOB: SSN:
Notes:
Officer/Director/Member: Title: DOB: SSN:
Notes:
Officer/Director/Member: Title: DOB: SSN:
Notes:
Officer/Director/Member Title: DOB: SSN:
Notes:
Additional Information: (On Vendor or Contract Requirements)
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