T1414 22DPP00696 Bidder Data Sheet.docx
DOCX document 243 KB Posted
- Solicitation number
- 22DPP00696
- Issued by
- New Jersey
About this file
This document is a Bidder Data Sheet for Bid Solicitation #22DPP00696 issued by the State of New Jersey Department of the Treasury Division of Purchase and Property. The form is used to evaluate the bidder's ability to complete the scope of work for this contract opportunity. Part I of the form requires the bidder to list prior contracts of similar size and scope as evidence of their qualifications. Part II requires the bidder to disclose any negative actions taken by other contracting entities against the bidder, such as letters of potential default, termination for cause, or negative audits or findings.
The related state and local contract opportunity is for a Hospital Based Paternity Acknowledgement Program and Database, which covers the jurisdictions of Mercer County and Trenton City in New Jersey. No additional details about the scope of work, quantities, response dates, or contract term are provided in the given materials.
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Text version
STATE OF NEW JERSEY
DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
BIDDER DATA SHEET
| BID SOLICITATION #: |
| 22DPP00696 |
| BIDDER: |
THIS FORM WILL BE USED IN EVALUATING THE BIDDER’S
ABILITY TO COMPLETE THE SCOPE OF WORK.
PART I - CONTRACTS OF SIMILAR SIZE AND SCOPE
List prior contracts performed by the Bidder. Emphasis should be placed on contracts that are similar in size and scope to the work required by this Bid Solicitation as evidence of the Bidder’s ability to successfully complete the scope of work required by this Bid Solicitation. If the Bidder has not had any prior contracts, enter “None” below.
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract Scope of Work:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Contact Name:
Contact Phone No.:
Contact Email:
Attach additional sheets if necessary.
PART II – NEGATIVE ACTIONS AGAINST THE BIDDER
Provide a list of any negative actions taken by other contracting entities against the Bidder in the course of performing these projects including, but not limited to, receipt of letters of potential default, default, cure notices, termination of services for cause, or other similar notifications/processes. Additionally, the Bidder should provide details, including any negative audits, reports, or findings by any governmental agency for which the Bidder is/was the Contractor on any contracts of similar scope. In the event a Bidder neglects to include this information in its Quote {Proposal}, the Bidder’s omission of necessary disclosure information may be cause for rejection of the Bidder’s Quote {Proposal} by the State. If no negative actions were taken against the Bidder, enter “None” below.
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Negative Action:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Negative Action:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Negative Action:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Negative Action:
Contact Name:
Contact Phone No.:
Contact Email:
Attach additional sheets if necessary.
| DPP Rev. 3.6.2018 |
| Page 1 of 2 |
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