QUALIFICATION_SUBMITTAL_FORM_Non_FDOT.pdf
PDF 289 KB Posted
- Attached to
- Chesnut Park Managed Aquifer Recharge Well Drilling And Completion Of Subsurface Testing
- Solicitation number
- 26-0046-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is a Qualification Submittal Form for non-FDOT prequalified contractors submitted to Pinellas County Utilities for the Chesnut Park Managed Aquifer Recharge Well Drilling and Completion of Subsurface Testing project in Florida. The project involves drilling and completing a 24-inch diameter injection well (MAR-1) to a total depth of 1,250 feet below land surface in John Chesnut Sr. Park, with potential construction of an optional 6-inch diameter monitor well (MW-1). The mandatory site visit was scheduled for November 5, 2025, at 10:00 am, with questions due by November 7, 2025, and proposal submissions due November 13, 2025, at 3:00 pm. The contract will be awarded to the lowest responsive, responsible bidder, with a contract duration of 540 consecutive calendar days including a 12-month guarantee period.
All non-FDOT prequalified contractors must submit a complete qualification package including a bonding letter indicating maximum bonding capacity, a completed OpenGov Fillable Form, detailed experience on at least four projects of similar size and scope with full project descriptions and owner/project manager contact information, and a minimum of three reference letters. The form requires comprehensive vendor information including firm name, address, and officer/director details with titles and dates of birth. Contractors must demonstrate corporate qualifications, provide their Florida contractor registration or certification number, and disclose all ownership interests. Failure to meet any of these qualification conditions results in disqualification from moving forward. A Small Business Enterprise (SBE) participation goal of 5% of contract value is available, and the project is co-funded by the Southwest Florida Water Management District (SWFWMD) in coordination with Pinellas County Utilities.
View the file
Other files
Show all 21
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
File details come from the government source that posted it. Updated .