Quotation Number:
University of Cincinnati
Division of Administration and Finance
Facilities and Construction Services
RESPONSIBLE BIDDER INFORMATION FORM
(Attach additional pages as needed. Photo copy pages as needed.)
SHALL BE SUBMITTED WITH THE BID OR WITHIN THREE (3) BUSINESS DAYS
OF REQUEST, OR BID WILL BE REJECTED.
University Project No. University Project Name:
SECTION A: COMPANY BACKGROUND
COMPANY NAME:
PHYSICAL ADDRESS:
TELEPHONE NUMBER: (w/ Area Code) ( ) DATE:
FAX NUMBER: ( )
EMAIL ADDRESS:
AUTHORIZED OFFICIAL: TITLE:
(Authorized official must have authority to contractually bind the company)
Provide the following information:
a) Bidder’s overall experience in performing the type of construction or work specified, including number of years
in performing the type of construction or work specified under present and former business names;
b) Provide information regarding your company assets that would enable the performance of the specified work
(i.e. scheduling software, machinery/equipment, inventory, etc.);
c) Indicate the percentage and type of work that will be performed with your work force.
The apparent low Bidder shall submit upon request of the University either:
a) An annual financial statement prepared within the twelve (12) months prior to the Bid by an
independent licensed accounting firm, and the name, address, contact person and phone number of the
bank normally used by the Bidder for its primary banking; or,
b) A financial report generated within 30 days prior to the Bid from Standard and Poors, Dun and
Bradstreet, or a similar company acceptable to the University documenting the financial condition of
the Bidder, and the name, address, contact person and phone number of the bank normally used by the
Bidder for its primary banking.
RBI-1 of 4 Lead Contractor Project October 15, 2005
Quotation Number:
This information is not a public record under section 149.43, ORC; and will remain confidential, except
under proper order of a court.
SECTION B: LIST OF PROJECTS
COMPANY NAME:
• List all ongoing work, or work completed for the University of Cincinnati in the past four (4) years:
Title of project Completion Date University Project Manager
• Lead Contractors to identify projects completed in the last four (4) years, similar in size, cost and complexity and
carrying the Responsibility and Authority of the Lead Contractor (GC 4.2). Lead Contractor to show total amount
of contracts for the project indicated. (Attach separate sheet.)
• Other Contractors to identify all ongoing projects and projects completed in the last four (4) years, of
scope and complexity similar to the project being bid. (Attach separate sheet.)
• Project
• Scope of Work
• Location
• Client / Contact/ Phone No.
• Contract
• Total amount of contracts (for Lead Contractor).
• Has your company experienced any of the following within the last four (4) years:
Liquidated Damages Yes No Barred from Federal, State, or Local work. Yes No
Litigation Yes No Contract Termination Yes No
Arbitration/ADR Yes No Surety Take-over or Contract Abandonment Yes No
EPA/OSHA violations Yes No Prevailing Wage violations or judgements Yes No
Filed Bankruptcy Yes No Affirmative Action Violations Yes No
If YES to any of the above, explain below. (Provide attachment if necessary.)
• Indicate your firm’s “Experience Modification Rate” (EMR) for the past four (4) years
Rating/Year _____/_____, _____/_____, _____/_____, _____/_____
Notice Regarding EMR:
- Attach document(s) to support annual rating noted above.
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Quotation Number:
SECTION C: MANAGEMENT TEAM
COMPANY NAME:
IDENTIFY THE FOLLOWING INDIVIDUALS PERFORMING ON THIS CONTRACT (as applicable):
Principal: Years with this Firm: Total Exp.
Project Manager: Years with this Firm: Total Exp.
Field Superintendent: Years with this Firm: Total Exp.
Office Field Engineer: Years with this Firm: Total Exp.
CPM Scheduler: Years with this Firm: Total Exp.
Attach Resume including experience, accomplishments and professional background for the persons listed
above.
SECTION D: CERTIFICATION
I hereby certify that the information provided in this entire Responsible Bidder Information Form, including any and
all attachments and referenced information, is factual and complete.
COMPANY NAME
AUTHORIZED OFFICIAL (Please print or type)
SIGNATURE OF AUTHORIZED OFFICIAL DATE
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Quotation Number:
EDGE PARTICIPATION
Certified Statement of Intent To Contract and To Perform
Bidder: Submit one fully-completed form for each EDGE Business Enterprise
University Project No.:
Project Name:
A. Bidder Company Name:
B. Certified EDGE Business Enterprise information (for project contract at ANY tier)
Mark all that apply:
Bidder Subcontractor Material Supplier Professional Services Goods/Services
EDGE Business Name:
EDGE Business Address:
EDGE Business Federal Tax I.D. email:
Contact Person: Phone: ( )
Insert a brief description of materials, supplies, labor, etc., to be provided (may use industry codes).
C. Certification of Intent
By signing below, Bidder certifies that it intends to contract with the certified EDGE Business Enterprise for the
portion of the contract described above related to this project contract and for the estimated cost shown below. By
signing below, the certified EDGE Business Enterprise certifies that it intends to contract with the Bidder and
intends to provide the portion of the contract described above related to this project contract for the estimated cost
of:
and /100 dollars ($ ).
In the event the named Bidder is NOT the successful bidder, this Statement shall be null and void.
EDGE Business Enterprise Bidder
Authorized representative name, title (print or type) Authorized representative name, title (print or type)
Signature of authorized representative Signature of authorized representative
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