Vendor_Qualification_Form.pdf

PDF 154 KB Posted

Attached to
DNR RFB Dove Island PWA Asphalt
Solicitation number
2000016203
Issued by
Lac Qui Parle County, Minnesota

About this file

This document is a Qualification Form for a state government contract opportunity for the Dove Island Public Water Access Asphalt project. The contract requires the successful respondent to have substantially completed, as a prime contractor, at least one $25,000 or greater contract installing bituminous parking lots, roads, or trails since August 2020. The state reserves the right to contact the provided references and review the respondent's qualifications, which include meeting project milestones, communication, on-site supervision, subcontractor coordination, compliance with prevailing wage laws, and payment of subcontractors. The solicitation response will be rejected if the respondent has been found in default or had a contract terminated for cause in the last 36 months.

The document does not provide details on pricing terms, set asides, incumbents, funding requirements and sources, or other salient information beyond the qualification requirements. It focuses solely on the contractor qualification criteria for this specific state government contract opportunity.

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DNR_RFB_Dove_Island_PWA_Asphalt.pdf PDF
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Qualification Form

QUALIFICATION FORM

2025-190 Dove Island Public Water Access Asphalt

This Qualification Form must be submitted with your solicitation response. A solicitation response received without this form, or with an outdated version, may be rejected.

The State (or its representative) reserves the right to clarify the required qualification information submitted on this form before an award is made. The solicitation response will be rejected if qualifications are not met.

1. Respondent has substantially completed, as a prime contractor, the work for at least one written and verifiable contract since August 2020 installing bituminous parking lots, roads, or trails. This contract must have had a value of $25,000 or greater.

*Property Owner:

Property Owner Contact Person: Contact Person’s Telephone #:

Dollar Amount of Contract: Substantial Completion Date:

Project substantially completed under (check one):

☐ Current Company Name

☐ Previous Company Name

*Property Owner:

Property Owner Contact Person: Contact Person’s Telephone #:

Dollar Amount of Contract: Substantial Completion Date:

Project substantially completed under (check one):

☐ Current Company Name

☐ Previous Company Name

*The term “Property Owner” means the person or entity identified as the owner of the property where the work referenced for Qualification Requirement was performed.

The State (or its representative) reserves the right to contact the references listed above for Qualification Requirement or to request the Responder to provide additional reference projects for review. The solicitation response will be rejected if the

State, in its sole discretion, receives information that indicates the responder is non-responsible. Information considered includes but is not limited to: 1) project milestones (meeting substantial and final completion dates); 2) communication with project owner and subcontractors; 3) on-site supervision; 4) coordination of subcontractors; 5) violation of Minnesota prevailing wage law; and 6) nonpayment of subcontractors.

2. Has your Company been found in default or had a contract terminated for cause in the last 36 months?

It is required that your company has not had this occur.

NOTE: If this question is answered as “yes”, your solicitation response will be rejected.

☐YES ☐NO

Certification

By signing this form, I certify the information provided is complete and accurate.

Authorized Signature: Date:

Printed Name: Telephone:

Company Name: Title:

File details come from the government source that posted it. Updated .