Responsible_Contractor_Questionnaire_Form_B_3.pdf
PDF 135 KB Posted
- Attached to
- Farmers Market Restroom Facility
- Solicitation number
- RFP-RO-2024-007
- Issued by
- Oakland County, Michigan
About this file
The document is a Responsible Contractor Questionnaire Form B from Royal Oak, related to the Farmers Market Restroom Facility project in Michigan. The form is designed for contractors or subcontractors to provide detailed information about their company's qualifications, workforce capabilities, and compliance standards for bidding on the project. The questionnaire requires comprehensive documentation, including information about employee certifications, licenses, project history, staffing capabilities, workforce composition, and compliance with federal and state employment regulations.
The form seeks extensive verification of the bidding company's professional credentials, including the number of employees, certification levels of workers, work visa status, past project references, potential subcontractors, safety compliance history, drug and alcohol testing programs, and assurances about project timeline adherence. Bidders must provide detailed documentation such as staff license lists, certification sources, compliance verifications, violation histories, warranty statements, and potential change order estimates. The questionnaire is part of the City of Royal Oak's procurement process for the Farmers Market Restroom Facility project, with electronic proposals to be submitted through the procurement portal by 5:00 pm on December 12, 2024.
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Text version
Responsible Contractor Questionnaire Form B
Please complete the following information related to the company making the bid. This form is intended to give information related to the company.
Contract Number:
Are you completing this form as a: Contractor Subcontractor
Company Name:
Project Manager Information:
Name:
Phone:
Email:
Are you pre-qualified? Yes No
If yes, when were you pre-qualified as a responsible contractor?
Estimate the following:
Number of employees to complete the project:
Number of employees who are certified masters in their trade:
Number of employees who are certified journeypersons in their trade:
Number of employees who are using work visas:
Submit the following additional information or a statement that it does not exist/apply for your company:
A list of all licenses held by key staff members for this project.
Documentation of master or journeyperson certifications and statuses for employees who will be working on this project. Be sure to include the source for certifications.
Verification of compliance with federal and state laws regarding the employment of non-US citizens.
A list of projects completed (and associated client information, name and phone number) within the past five years that are comparable in size, complexity, budget, timeline to the project that is being bid on.
A list of portions of the project could be completed by a subcontractor. List those subcontractors and attach their Forms A and B as a part of your bid.
A list of any violations of federal, state, or local laws or regulations, including Occupational Safety Health Administrations, Michigan Occupational Safety.
A list of violations related to health administration, wages, workers compensation, unemployment compensation, that have been issued to or against the bidder in past five years.
A statement regarding the staffing capabilities and labor sources. Verification that employees are not misclassified as independent contractors.
An explanation of an existing fitness for duty program related to drug and alcohol testing for employees who would be working on the job site.
A warranty statement regarding labor, equipment, and materials.
A statement of potential change orders and approximate costs.
Assurances that the project timeline submitted by the contractor will be followed and the project will be completed in a timely manner.
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