TE24004 Exhibit A-2 Bidder Profile.docx

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Attached to
Crane Truck
Solicitation number
52114
Issued by
Washington

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This document is an Exhibit A-2 - Bidder's Profile for Competitive Solicitation No. TE24004 issued by the Washington State Department of Transportation (WSDOT). WSDOT intends to use this solicitation to award up to three contracts for a Crane Truck. The contract term is for up to forty-eight (48) months, with an initial term of twenty-four (24) months and an additional option term of twenty-four (24) months. The solicitation is based on firm fixed price and best value.

The document requests bidder information such as legal name, address, registration numbers, and certification as a minority, woman-owned, veteran-owned, or small business. It also requires the bidder to provide contract management and ordering/sales points of contact, as well as a minimum of three commercial or government references. The completed Bidder's Profile must be returned to the Contract Manager at WSDOT.

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Other files

File Type Posted
TE24004 Exhibit B Tech Spec Crane Truck.doc DOC document
TE24004 Exhibit C Price Sheet.doc DOC document
TE24004 Exhibit A-1 - Bidder's Certification.docx DOCX document
TE24004 Exhibit E Special Terms and Conditions.doc DOC document
TE24004c Exhibit D Contract.docx DOCX document
TE24004 Amendment 1.docx DOCX document
TE24004 Exhibit A-3 Surcharge Certification.docx DOCX document
TE24004s Crane Truck Sol.docx DOCX document

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EXHIBIT A-2 – BIDDER’S PROFILE

Competitive Solicitation:
No. TE24004 – Crane Truck
Bidder:
___________________________

Type/print full legal name of Bidder

BIDDER INFORMATION

Legal name of Bidder:

Address of Bidder:

Note: This information must match the information from Bidder’s Business License.

Business Name Address City, State, Zip Code

Bidder’s Washington State Department of Revenue Registration Number/Unified Business Identifier (UBI) Number:

Note: A nine digit UBI number is assigned to each registered businesses in Washington.

Taxpayer Identification No. (TIN):

Note: Your TIN will be either a number issued by the IRS (e.g., Employer Identification Number, Federal Tax Identification Number) or a number issued by the Social Security Administration (i.e., your Social Security Number). Do Not provide a Social Security Number.

Is your firm certified as a minority or woman owned business with the Washington State Office of Minority & Women’s Business Enterprises (OMWBE)?
Yes |_| No |_|

If yes, provide Bidder’s MWBE certification no.: ____________

Is your firm a self-certified Washington State Small Business?

Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Washington State Small Business.

Note: Regardless of size, a qualifying business must be owned and operated independently from all other businesses. In regard to size, the gross revenue thresholds, as reported on Bidder’s tax returns, are as follows:

· Microbusiness: Annual gross revenue of less than one million dollars.

· Minibusiness: Annual gross revenue of more than one million dollars, but less than three million dollars.

· Small Business: Annual gross revenue of less than seven million dollars over each of the three prior consecutive years.

Yes |_| No |_| If yes, provide the location for Bidder’s principal place of business:

Street Address City, State, Zip Code If yes, what is your business size (based on annual gross revenue)?

Microbusiness|_|
Minibusiness|_|
Small Business|_|

Is your firm certified as a Veteran-Owned Business with the Washington State Department of Veteran Affairs?

Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Certified Veteran-Owned Business.

Yes |_| No |_| If yes, provide Bidder’s WDVA certification no.: _____________

CONTRACT MANAGEMENT POINTS OF CONTACT FOR BIDDER

Authorized Representative Name:

Email:

Phone:

Contract Administrator Name:

Email:

Phone:

Address for WSDOT to send legal notices:

Company name:

Attn:

Address:

City/State/Zip:

ORDERING/SALES POINTS OF CONTACT (expand as necessary)

Name
Phone Number
E-mail
Area of Responsibility

REFERENCES

Provide a minimum of three (3) commercial or government references for which bidder has delivered goods and/or services similar in scope as described in the Competitive Solicitation.

REFERENCE 1

Company Name:

Contact:

Phone:

Email:

REFERENCE 2

Company Name:

Contact:

Phone:

Email:

REFERENCE 3

Company Name:

Contact:

Phone:

Email:

Return this Bidder’s Profile to Contract Manager at:

TEFBids@wsdot.wa.gov

EXHIBIT A-2 – BIDDER’S PROFILE: TE24004 – CRANE TRUCK PAGE 4

(Rev 2021-06-30) image1.jpeg image2.jpeg

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