Hydrofluosilicic Acid - City of Fort Lauderdale

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BIDDER NAME: Complete the following: GENERAL QUESTIONNAIRE Contact Name: Phone: Delivery/begin work in calendar days after receipt of Purchase Order: (Section 1.02 of General Conditions.): Days Payment terms (Section 1.03 of General Conditions: (net 30 if left blank) Total Bid Discount (Section 1.04 of General Conditions): Prices firm for acceptance for 90 days? (Section 1.05 of General Conditions.): gfedc Yes gfedc No Other 1. Number of years experience the bidder has had in providing similar services: Years 2. Manufacturer of Hydrofluosilicic Acid: 3. Location of manufacturer's works: 4. The typical percentage of acid is %. 5. Will weight certificate be provided? gfedc YES gfedc NO 6. Is a certified copy of the assay test of typical hydrofluosilicic acid supplied attached hereto? gfedc YES gfedc NO 7. Does acid comply with all applicable requirements of AWWA B703-71 (or latest revision)? gfedc YES gfedc NO 8. Some of the agencies participating in this bid do not own their own tanks. Please state lease arrangements for agencies which require that service: 9. What is your maximum free unloading time? hours City of Fort Lauderdale Bid 403-10368 10. Delivery: Number of calendar days required for delivery upon receipt of order: days. Oct 1, 2009 1:55:43 PM EDT p. 24
11. Note any exceptions to the safety measures mentioned in paragraph 2.03 of the Scope of Services: 12. Provide three references for which you have performed similar services. Company Name: Address: Contact Name: Telephone: Address: Company Name: Contact Name: Telephone: Address: Company Name: Contact Name: Telephone: 13. Have you ever failed to complete work awarded to you? If so, where and why? 14. List any licenses/permits, etc. you hold for performing this type of work: 15. Have you attached a sample copy of your Certificate of Insurance? YES gfedc NO gfedc 16. Other comments? City of Fort Lauderdale Bid 403-10368 The proposer understands that the information contained in these proposal pages is to be relied upon by the City in awarding the proposed contract, and such information is warranted by the proposer to be true. The proposer Oct 1, 2009 1:55:43 PM EDT p. 25
Page 1 and 2: City of Fort Lauderdale Bid 403-103
Page 3 and 4: evision thereof. The hydrofluosilic
Page 7 and 8: 1.09 FUEL SURCHARGE In consideratio
Page 9 and 10: Facility Name: Southwest Utilities
Page 11 and 12: Property damage $100,000 each occur
Page 15 and 16: This form is only to be filled out
Page 17 and 18: City of Fort Lauderdale GENERAL CON
Page 23: NON-COLLUSION STATEMENT: By signing
Page 27 and 28: BID/PROPOSAL SIGNATURE PAGE How to
Page 29: Question and Answers for Bid #403-1

Hydrofluosilicic Acid - City of Fort Lauderdale

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