EXHIBIT 1
DEPARTMENT OF MANAGEMENT SERVICES
DIVISION OF REAL ESTATE DEVELOPMENT AND MANAGEMENT
CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION
INSTRUCTIONS PAGE
The information listed is required to be filed with the Department of Management Services (DMS) prior to award of Competitive Bid or shall be included with Construction Management (CM) at Risk Request for Qualifications (RFQ).
The identified Contractor or Bidder is required to complete all Items 1-14. If the bidder or contractor is a Joint Venture, then each entity that is a party to the Joint Venture must individually complete this Questionnaire.
Project Information:
Project Number - Use DMS project number as shown in the contract documents or RFQ advertisement.
Project Name - Use project name as shown in the contract documents or RFQ advertisement.
Project Location - Use location as indicated in the contract documents or RFQ advertisement.
1. Provide contractor corporate name as listed with the Department of State, Division of Corporation Listing on
or “”.
2. Provide requested Business Structure information.
3. Provide Annual Construction Gross Revenue for previous five (5) years.
4. Provide firm’s Current Bonding Capacity.
5. Provide Business Name information.
6. List number of full-time personnel within your organization.
7. Provide Subsidiary or Affiliated companies financial involvement information.
8. Identify construction management personnel experience for your organization.
9. Identify your organization or predecessor organizations failure to complete a project contract.
10. Identify if your organization has been involved in litigation.
11. List the most recent ten (10) contracts completed by your organization.
12. Explain the differences in final contract price and/or scheduled completion dates.
13. Identify any liquidated damages, penalties, liens, defaults or cancellations imposed or filed.
14. Provide contract information currently under construction.
DIRECTIONS: Items1 through 14 must be fully completed or marked “Does Not Apply” for any non-pertinent Item(s).
For CM at Risk the evaluators which are comprised of up to five (5) committee members will independently score category “Financial Capacity to Project Scope” listed under preliminary screening based upon information provided in Items 1-14, however, if needed, the Owner reserves the right to request your firm’s most recent “Financial Statement”.
If additional space is required, please attach supplementary pages.
DEPARTMENT OF MANAGEMENT SERVICES
DIVISION OF REAL ESTATE DEVELOPMENT AND MANAGEMENT
CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION
(Continued)
Project Number:
Project Name:
Project Location:
1. Firm Name:
Firm Address:
Contact Name and Telephone Number:
Contact Email Address:
The contractor acknowledges that this Contractor Experience Questionnaire and Financial Information are made for the express purpose of inducing the Department of Management Services (DMS) to award a contract to the contractor. Further, the contractor acknowledges that the agency may at its discretion, by means which the Owner may choose, determine the truth and accuracy of all statements made by the contractor herein. If needed, the Owner reserves the right to request your most recent Financial Statement.
2. Business Structure: (List firm names if Partnership or Joint Venture)
Proprietorship ( )
Corporation ( )
Joint Venture ( )
Partnership ( )
If owned by a parent company, provide parent company name:
Please provide copy of State of Florida Corporate Registration:
If Corporation answer below: If Joint Venture or Partnership, answer below:
Date of Incorporation: Date of organization:
In what State: Firms Involved:
Name of Corporate Officers:
President:
Vice President:
Secretary:
Treasurer:
3. Annual Construction Gross Revenue for Previous Five (5) Years:
Year $
Year $
Year $
Year $
Year $
DEPARTMENT OF MANAGEMENT SERVICES
DIVISION OF REAL ESTATE DEVELOPMENT AND MANAGEMENT
CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION
(Continued)
4. Firm’s Current Bonding Capacity:
Per Project Limit:
Per Aggregate Limit:
5. How many years has your organization been in the construction business?
B. How many years under your present business name:
C. How many years under previous business name:
(List other names):
1.
2.
3.
6. Number of full time personnel within your organization:
Current
A. Executive Administrators _________
B. Preconstruction Managers and Estimators _________
C. Construction Project Managers _________
D. Field Superintendents and Foremen _________
E. Other Field Construction Employees _________
F. Administrative Assistants _________
G. Total number of full time personnel _________
7. Subsidiary or affiliated companies which Principal(s) have financial interest and list nature of business:
1.
2.
3.
4.
5.
DEPARTMENT OF MANAGEMENT SERVICES
DIVISION OF REAL ESTATE DEVELOPMENT AND MANAGEMENT
CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION
(Continued)
8. Identify construction management personnel experience for your organization.
(Highlight personnel likely to be assigned to project being bid or solicited)
Name: Title: Years with firm / years in construction
1.
2.
3.
4.
5.
9. Within previous five (5) fiscal years has your organization or predecessor organizations ever failed to complete a project. If so, state name of organization and reason thereof.
1.
2.
3.
4.
5.
10. Within previous five (5) fiscal years has your organization been involved in litigation with your client? If so, please list and explain nature and current status.
1.
2.
3.
4.
5.
CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION
(Continued)
11. List the most recent ten (10) contracts completed by your organization:
| | | | | |Construction Duration |
| | | | | |Completion Dates |
|Owner of Project |Project Name and Location |Building Type |Name of Design Professional |Final Contract |Commencement |Completion |Months |
| | | | |Price | | | |
| | | |a | | | | |
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DEPARTMENT OF MANAGEMENT SERVICES
DIVISION OF REAL ESTATE DEVELOPMENT AND MANAGEMENT
CONTRACTOR EXPERIENCE QUESTIONNAIRE AND FINANCIAL INFORMATION
(Continued)
With reference to ten (10) most recently completed contracts, as listed on Page 5, answer the following questions:
12. Explain the differences in final contract price and/or scheduled completion dates.
13. Were there any liquidated damages, penalties, liens, defaults or cancellations imposed or filed?
If so, list the name and location of the project and why rejected from bidding?
14. Provide contract information currently under construction as requested below. (Use seven largest dollar value)
|A |B |C |D |E |
|Project Description Location & Owner |Design Professional |Total Contract Amount |Uncompleted |Scheduled Substantial |
| | | |Contract Amount |Completion Date |
| | | | | |
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|Total | | | | |
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