TC71846_SE10336_Att._2-Bidder_Quest_and_Refs.docx

Sourcing Event 0000010336 Attachment 2 Bidder Questionnaire and References Part I

Bidder Information Name of Firm:

Headquarter Address:

Phone No.:

Toll Free Phone No.:

Contact Name & Title:

E-mail:

SF Supplier ID:

Federal Tax ID:

Payment Terms:

Person Preparing Bid:

Local Representative Name and Number:

Contact Information for Placing Orders:

Telephone:

Fax:

Email:

Website:

24-hour Emergency Number:

Part II Bidder Questionnaire

1. Do you certify that you have complied and will continue to comply with Section 11.5 of this Solicitation entitled “Limitation on Communications During Solicitation?

2. Have you registered as a Bidder or Supplier, through the Supplier Portal (https://sfcitypartner.sfgov.org/)?

If yes, what is your Bidder ID or Supplier ID? _________________

3. Has your company enrolled with Paymode-X to receive electronic payments from the City?

https://www.sf.gov/get-paid-your-vendor-services

4. Have you registered your business with the San Francisco Treasurer & Tax Collector as required prior to submission of any Bid?

Enter your Business Tax Registration ID here: __________________________________

5. Are you claiming LBE preference on this solicitation per Chapter 14B?

To claim LBE preference for this solicitation, you must be certified in one or more of the following LBE certification category/categories by the Bid Due Date:

· Gas Station, Petroeum Equip and Supplies | EQ032

· Automotive Parts and Supplies | EQ093

· Auto Shop Equip, Sales, Maint. And Repair | GS112

Business Name

7. Can you comply with the terms set forth in Attachment 1, City’s Proposed Agreement Terms?

8. Have you entered a price on all line items in the PeopleSoft Sourcing Event in accordance with the instructions in the Solicitation?

9. Have you submitted with your Bid all the Minimum Qualification Documentation outlined in the accompanying solicitation document?

If you reply NO to any document, please explain.

10. Have you submitted with your Bid all the Required Supporting Documentation outlined in the accompanying solicitation document?

11. Have you submitted with your Bid a Bid Sheet that complies with the requirements of the accompanying solicitation document?

Part III Bidder References All Bidders, including current Contractor, must provide references for at least three (3) organizations of the approximate size and volume comparable to commodities and/or services described in this Solicitation. Upon request, successful Bidder(s) may also be required to submit a letter of reference from each reference listed within five (5) days of notification. Failure to do so may result in rejection of Bid.

Address (street, city, state, zip)

Contact Name

Phone No.

Email

Number of Years Providing Service

Address (street, city, state, zip)

Contact Name

Phone No.

Email

Number of Years Providing Service

Address (street, city, state, zip)

Contact Name

Phone No.

Email

Number of Years Providing Service

Part IV Bidder Release of Liability for References The undersigned hereby fully and forever release, exonerate, discharge and covenant not to sue the City, its commissions and boards, officers and employees, and all individuals, entities and firms providing information, comments, or conclusions ("Reference Information") in response to inquiries that the City may make regarding the qualifications or experience of a Prime Bidder, proposed joint venture partner, proposed subconsultant or proposed key/lead team member in connection with the selection process for Event ID: SFGOV-0000010336 OCA | TC71846 - Closed Loop Solvents & Rental Service from and for any and all claims, causes of action, demands, damages, and any and all liabilities of any kind or description, in law, equity, or otherwise arising out of the provision of said Reference Information. This Release and Waiver is freely given and will be applicable whether or not the responses by said individuals, entities or firms are accurate or not, or made willfully or negligently.

Company Name

Signature of Authorized Representative of Company Date

Print Name and Title

Part V.

Bidder Certification of Truth, Accuracy, and Completeness

I certify that based on information and belief formed after reasonable inquiry, the statements and information contained in this document are true, accurate, and complete. Additionally, by submitting this bid/proposal, I attest that I have reviewed and accepted all terms found in this solicitation, any and all addenda issued to this solicitation, and City’s contract terms.

Company Name

Signature of Authorized Representative of Company Date

Print Name and Title