View Bid - Loudoun Water

Loudoun Water May 28, 2013
APPENDIX A.2 – LOUDOUN WATER CONTRACTOR DATA FORM
(Must be completed and returned with Bid Submission)
Granular Activated Carbon for Broad Run Water Reclamation Facility
IFB Number: 2013-011-240
QUALIFICATIONS OF BIDDER: Contractor shall have the capability and capacity in all respects to fulfill the
contractual requirements to the satisfaction of Loudoun Water.
Indicate the length of time you have been in business as a company providing the type of commodity and
service required for this contract.
_______ years _______ months
Provide a minimum of five (5) references that can substantiate past work performance and experience in
the type of work required for this contract. Loudoun Water may make such investigations as it deems
necessary to determine the ability of the bidder to perform the work, and the bidder shall furnish to
Loudoun Water all such information and data for this purpose as Loudoun Water may request.
1. Name of Business, City, County or Agency
Mailing Address
Contact
Title
Phone No. Fax No.
Email Address
Contract Amount $
Contract Dates
Description of Work Performed
2. Name of Business, City, County or Agency
Mailing Address
Contact
Phone No.
Email Address
Contract Amount $
Description of Work Performed
Title
Fax No.
Contract Dates
3. Name of Business, City, County or Agency
Mailing Address
Contact
Phone No.
Email Address
Contract Amount $
Description of Work Performed
Title
Fax No.
Contract Dates
Granular Activated Carbon
For BRWRF 31 IFB No. 2013-011-240