Bid Proposal Template Form – Fill Out and Use This PDF

BID PROPOSAL

Proposed

Golden Door Charter School Alterations

for the

Friends of Golden Door Charter School, Inc.

180 9th Street, Jersey City, NJ 07302-1703

The following items must be included in the Bid:

Bid Proposal Form

Statement of Bidder Qualifications, including:

Compliance with New Jersey Prevailing Wage Act

Stockholder or Partnership Disclosure Affidavit

Non-Collusion Affidavit

Certificate of Insurance Statement

Affidavit Regarding List Of Debarred, Suspended Or Disqualified Bidders

Performance Record

Certification Statement

Certification of No Material Change of Circumstances

List of References

Affirmative Action Acknowledgement

Bid Security

Consent of Surety (Bonding Company’s “Guarantee Certificate”)

State of New Jersey DPMC “Notice of Classification” Affidavit

State of New Jersey DPMC “Uncompleted Contracts” Affidavit

State of New Jersey “Public Works Contractor Registration Act”

Certificate of Authority to Perform Work in NJ issued by the Department of Treasury, Division of Taxation. (see sample)

Business Registration Certificate issued by Department of Treasury, Division of Revenue. (see sample)

C. 271 Political Contribution Disclosure Form

By submitting this Bid, the Bidder also acknowledges that he has reviewed the following:

Contract Documents, the Site, local conditions and laws that may affect cost, progress or performance

Maintenance, Performance and Payment Bond Requirements

Proposed Agreement

_________________________________	__________________________
Name of Company	Contract for

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C.1-1

All paperwork required of the Prime Contractor shall also be submitted with this bid for each subcontractor including the Notice of Classification, Uncompleted Contracts affidavit, Certificate of Registration, along with evidence of security performance. One Bid Bond for the entire project is acceptable. If no subcontractor will be used, state “prime contractor” in the applicable space(s) below so that it is clear whether the prime contractor or a subcontractor will be performing the work in each of the listed trades. In this case, the Prime Contractor must have applicable Notice of Classification and Certificate of Registration for that trade.

All bidders must include at the time of bid, subcontractors with classifications in Structural Steel (C029), Plumbing (C030), HVAC (C039), and Electrical (C047).”

Subcontractor List:

State the following subcontractors who will be used on this Project:

Structural Steel:

C029

Plumbing:

C030

HVAC:

C039

Electrical:

C047

FAILURE TO PROVIDE SUBCONTRACTOR NAMES AND DOCUMENTATION IN EACH CATEGORY ABOVE MAY BE CAUSE FOR BID TO BE REJECTED.

ALTERNATE BIDS:

ALTERNATE BID ??? RENOVATION WORK –

State the overall lump sum price to be added to the Base Bid______ for all work necessary to

complete the proposed additional ________________________as outlined in the documents.

_________________________________________________________________Dollars

ADD ($_______________________)

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C.1-3

Bidder agrees to provide staff and equipment necessary, including expedited shop drawing preparation, expedited factory ordering and delivery efforts, expedited installation efforts and expedited clean up/punch list corrective efforts to meet the substantial completion date.

LIQUIDATED DAMAGES:

It is understood that the Date for Substantial Completion is an essential condition of this Contract and that TIME IS OF THE ESSENCE for this project. The Contractor shall be subject to a minimum assessment of Liquidated Damages in the amount of $1,000 per day for each calendar day that work is not completed beyond the required date stipulated above within the ‘Schedule Requirements’.

Submitted by:

				Subscribed	and	sworn
	_____________________________________			before me	on	this the
	(Official / Legal Name of Business)			________________ day of
	_____________________________________			____________ in the year
	(Business Address)			20__.
	_____________________________________			_____________________
	(Town)	(State)	(Zip)
				Notary Public of N.J.
	_____________________________________
	(Business Telephone)		(Fax)
				My Commission		expires
	_____________________________________			_____________, 20__.
	(E-Mail Address)
	_____________________________________			NOTARY SEAL:
	(Signature of Principal or Authorized Agent)

_____________________________________

(Print Name of Principal or Authorized Agent)

END OF SECTION C.1

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C.1-5

SECTION C.2 – BID PROPOSAL FORM

STATEMENT OF BIDDER’S QUALIFICATIONS:

(To be completed and submitted by all Bidders)

All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. Questions may be answered on separate attached sheets. The Bidder may submit any additional information he desires.

1. ______________________________________________________________________________

(Name of Bidder)

2. ______________________________________________________________________________

(Permanent Main Office Address)

3. ______________________________________________________________________________

(When Organized)

4. ______________________________________________________________________________

(If a Corporation, where incorporated)

5.Number of years engaged in construction or contracting business under present firm or trade name:__________.

6.Contracts on hand: (List gross amount of each Contract and the appropriate dates of Completion)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

7.General character of work performed by you: __________________________________________

8.Have you ever failed to complete any work awarded to you? _____________

If so, where and why? ____________________________________________________________

______________________________________________________________________________

9.Have you ever defaulted on a Contract? _____________

If so, where and why? ____________________________________________________________

______________________________________________________________________________

10.List the most important Contracts recently completed by you, stating approximate gross cost for each and the month and year completed: _________________________________________________

______________________________________________________________________________

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C.2-1

______________________________________________________________________________

______________________________________________________________________________

11.Experience in construction work similar in importance to this project: _______________________

______________________________________________________________________________

______________________________________________________________________________

12.Have you had any material adverse changes from the trades as listed in NJ Notice of Classification within the last five (5) years? ________ If so, list prior classification: ________________________

13.Background and experience of the principal member of your organization, including the officers:

______________________________________________________________________________

______________________________________________________________________________

14.Bank Reference: ________________________________________________________________

15.Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the proper agency? ______________________________________________

The undersigned, hereby authorizes and requests any person, firm or corporation to furnish any information requested by the proper agency in verification of the recitals comprising this Statement of Bidder’s Qualifications.

	Dated this ___________ day of _____________, 20_____.
	_____________________________________	Subscribed	and	sworn
	(Official / Legal Name of Business)
		before me on this
	_____________________________________	_________	day		of
	(Signature of Principal or Authorized Agent)
		_____________		in	the
	_____________________________________	year 20___.
	(Print Name of Principal or Authorized Agent)
		__________________
		Notary Public of NJ
		My Commission expires
		_____________, 20__.
		NOTARY SEAL:
	Golden Door Charter School	C.2-2

COMPLIANCE WITH NEW JERSEY PREVAILING WAGE ACT:

(To be completed and submitted by all Bidders)

Bidder's Past Record under the New Jersey Prevailing Wage Act (N.J.S.A. 34:11-56.24, inclusive) and all acts amendatory thereof and supplemental hereto.

Special Instructions: Answer each question with a "yes" or "no" entered in the space provided and furnish additional information when required.

1.Has the bidder been notified by the Commissioner of Labor and Industry by notice issued pursuant to N.J.S.A. 34:11-56.37 that he has been blacklisted for failure to pay prevailing wages as required by the New Jersey Prevailing Wages Act? __________

2.Has any person having an "interest" in the Bidder within the meaning of N.J.S.A. 34:11-56.38 been blacklisted as aforesaid? __________

3.Has any person having an interest in the Bidder within the meaning of N.J.S.A. 34:11-56.38 had any "Interest as aforesaid in any firm, corporation, or partnership which has been blacklisted as aforesaid? __________

4.If the answer to any of the aforesaid questions is "Yes" annex a full statement showing the date of the action taken by the Commissioner of Labor and Industry, the subsequent action, if any, taken with respect to such action of the Commissioner, the name of the person, firm, corporation or partnership blacklisted by the commissioner, and the nature, character and extent of the interest existing between the bidder and the name which was blacklisted as aforesaid.

5.Have you made application for certification pursuant to "The Public Works Contractor Registration Act" (P.L. 1999 C.238) (Attach copy of current certificate)? __________

______________________________________

BIDDER (Signature)

______________________________________

Print Name of Bidder

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NON-COLLUSION AFFIDAVIT:

(to be completed by all Bidders)

Non-Collusion Affidavit: It is mandatory that the Bidder attest to the following information by completing the form in its entirety.

STATE OF NEW JERSEY	}
	} SS.
COUNTY OF ______________	}

I, (full name) _____________________________________________________, of (city, town, or

borough)

___________________________, in the County of ________________________________, and State of

________________________________, of full age, being duly sworn according to law on my oath

depose and say that:

I am (official title) _______________________________________________ of the

firm/business named ____________________________________________________,

and a Bidder making the Proposal for the above named project, and that I executed the said Proposal with full authority so to do; that said Bidder has not directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in connection with the above named project; and that all statements contained in said Proposal and in this affidavit are true and correct, and made with full knowledge that the Owner and the State of New Jersey relies upon the truth of the statements contained in said Proposal and in the statements contained in this affidavit in awarding the contract for said project.

I further warrant that no person or selling agency has been employed or retained to solicit or secure such contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee.

All in accordance with N.J.S.A. 52:34-15, as amended and applicable.

		Subscribed	and	sworn
		before me on this
_________________________________________________		_________	day		of
(Signature of Authorized Representative)
		_____________		in	the
_________________________________________________		year 20___.
(Name and Title of Authorized Representative)
		__________________
		Notary Public of NJ
		My Commission expires
		_____________, 20__.
		NOTARY SEAL:
Golden Door Charter School	C.2-5

CERTIFICATE OF INSURANCE STATEMENT

(to be completed by all Bidders)

The Bidder fully understands the Owner insurance requirements as stated in the Modifications to General Conditions and agrees to provide all insurance required by these documents prior to award of contract.

_________________________________________________

(Signature of Authorized Representative)

_________________________________________________

(Name and Title of Authorized Representative)

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AFFIDAVIT REGARDING LIST OF DEBARRED, SUSPENDED OR DISQUALIFIED BIDDERS

(to be completed by all Bidders)

THIS FORM MUST BE COMPLETED, SIGNED, NOTARIZED AND SUBMITTED WITH BID

STATE OF NEW JERSEY	}
	} SS.
COUNTY OF ______________	}

I, (full name) _____________________________________________________, of (city, town, or

borough) of

___________________________, in the County of ________________________________, and State of

________________________________, of full age, being duly sworn according to law on my oath

depose and say that:

I am (official title) _______________________________________________ of the

firm/business named ____________________________________________________,

and a Bidder making the Proposal for the above named project, and that I executed the said Proposal with full authority to do so; that said Bidder is not at the time of the making of this bid included on the New Jersey State Treasurer’s, the Schools Construction Corporation’s or the Federal Government’s List of Debarred, Suspended or Disqualified Bidders as a result of action taken by any State or Federal Agency.

	Subscribed	and	sworn
_________________________________________________	before me on this
(Signature of Authorized Representative)
	_________	day		of
_________________________________________________	_____________		in	the
(Name and Title of Authorized Representative)	year 20___.

__________________

Notary Public of NJ

My Commission expires

_____________, 20__.

NOTARY SEAL:

Golden Door Charter School

C.2-7

PERFORMANCE RECORD (Continued) List of all contracts completed by you.

*Where Liens

Claims or

Stop Notice Filed

*Where

Any

Penaltie

s

Imposed

*Was Time

Extensio

n Necessar y

Date

Complet

e

Contra

ct Price

(Omit Cost)

Architec

t in

Charge

for

Owner

Prime

or Sub-

cont.

Name &

Location of

Project;

Type of

Work

Name of

Owner

* Explain “Yes” answers.

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C.2-9

CERTIFICATION STATEMENT:

(to be completed by all Bidders)

Explanation of details in connection with non-completion of contracts, time extensions, penalties imposed, labor troubles experience, liens, claims and notices filed against contracts listed in preceding item “Performance Record”.

The information above is true and complete to the best of my knowledge and belief.

STATE OF NEW JERSEY	}
	} SS.
COUNTY OF ______________	}

______________________________________, being duly sworn to law, deposes and says that he is

authorized to make this affidavit for and on behalf of the individual, partnership or corporation herein first named as the bidder, that deponent is familiar with the books of the said bidder and that the foregoing financial statement is a true and accurate statement taken from the books of said bidder of such financial condition as of the date herein first named; that the answers to the foregoing interrogatories are true and correct.

	_____________________________________________	Subscribed	and	sworn
	(Official / Legal Name of Business)
		before me on this
	_____________________________________________	_________	day		of
	(Signature of Principal or Authorized Agent)
		_____________		in	the
	_____________________________________________	year 20___.
	(Print Name of Principal or Authorized Agent)

__________________

Notary Public of NJ

My Commission expires

_____________, 20__.

NOTARY SEAL:

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C.2-10

AFFIRMATIVE ACTION QUESTIONNAIRE

The following question must be answered by all prospective contractors.

Do you have a Federal Letter of Affirmative Action Plan Approval from the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP)?

YES __________ NO __________

If yes, please submit a photostatic copy of such approval. This letter cannot be more than one year old from the date of instance.

If no, the prospective Contractor may still bid on the project as long as the question is answered.

_____________________________________________

BIDDER (Signature)

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CERTIFICATION OF NO MATERIAL CHANGE OF CIRCUMSTANCES

Bidder’s Name:

Address:

1.A statement as to the financial ability, adequacy of plant equipment, organization and prior experience of the bidder, as required by N.J.S.A. 18A:18A-28 has been submitted to the Department of Treasury within the last six (6) months preceding the date of opening of bids for this contract.

2.I certify, as required by N.J.S.A. 18A:18A-32 that there has been no material adverse change in the qualification except:

____________________________________________

(Name and Title of Signer – Please print or type)

________________________________	_______________
(Signature)	(Date)

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C.2-12

BUSINESS REGISTRATION CERTIFCATE

Sample

Golden Door Charter School

C.2-13

Continuation Page

C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM

Required Pursuant To N.J.S.A. 19:44A-20.26

Page ___ of ______

Vendor Name:

Contributor Name	Recipient Name	Date	Dollar Amount
			$

Check here if the information is continued on subsequent page(s)

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C.2-15

CONTRACTOR CERTIFICATION OF QUALIFICATIONS AND CREDENTIALS

CONTRACTOR

STATE OF NEW JERSEY			}
							} SS.
COUNTY OF ______________			}
I,	_________________________________,	of	the	(City,	Town,	Borough)	of
________________________ State of ______________________________, of full						age, being	duly

sworn according to law on my oath depose and say that:

I am ______________________________ of the firm of _________________________, the General

Contractor making the Proposal for the above named Projects and that I executed the said Proposal with full authority to do so. The firm of _________________________ possesses the following qualifications

and credentials:

(1)A current, valid Certificate of Registration from the Department of Labor issued pursuant to “The Public Works Contractor Registration Act,” P.L.1999, c. 238 (C.34: 11- 56.48 et seq.), a copy of which is attached hereto.

(2)A current, valid “Certificate of Authority to perform work in New Jersey”/Notice of Classification issued by the Department of the Treasury, a copy of which is attached hereto.

(3)A current, valid Contractor or Trade License required under applicable New Jersey law for any trade or specialty area in which the firm seeks to perform work, a copy of which is attached hereto.

(4)A suitable quality control and quality insurance program, as well as an appropriate safety and health plan that the firm will have in place during the term of construction of the School Facilities Project.

(5)An executed Affidavit, attached hereto, demonstrating that the amount of the firm’s Bid Proposal and the value of all of its outstanding incomplete contracts does not exceed the firm’s existing aggregate rating limit, as well as a certified copy of Department of the Treasury Form DPMC 701.

	Subscribed	and sworn
_____________________________	before me on this
Name of Contractor	_________	day	of
By:__________________________________	_____________ in		the
(Signature of Authorized Representative)	year 20___.
	__________________
	Notary Public of NJ
	My Commission expires
	_____________, 20__.
	NOTARY SEAL:
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NOTE: FAILURE TO COMPLETE AND SUBMIT THIS DOCUMENT WITH YOUR PROPOSAL MAY RESULT IN THE REJECTION OF YOUR PROPOSAL

END OF SECTION C.2

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C.2-17