ROQ-172721
Professional On-Call Services / Pinal County
Finance Department
31 N. Pinal St.
Bldg. A
P.O. Box 1348
Florence, AZ85132
Responder Name: Responder Response
Responders shall complete the following Response Form, indicating their responses in the spaces provided. Additional pages may be added so long as they are clearly referenced in the spaces provided.
Please note: Any exception to the terms and conditions of the ROQ will not be accepted.
Acceptability of Responses
Offers that do not include fully completed copies of Response Forms 1 and Attachment A – Professional On-Call Services Contract may cause the entire offer to be deemed unacceptable and therefore non-responsive. Forms with incomplete or unacceptable responses will also be considered non-responsive.
1 Consultant Information
1.1Consultant Name:
Mailing Address:
City: Sate: Zip Code:
Phone Number: FaxNumber:
Email Address:
1.2Key Project Personnel:
Name: License #
Phone: Email:
……………………………………………………………………………………………………………………………….
Name: License #
Phone: Email:
Name: License #
Phone: Email:
………………………………………………………………………………………………………………………………
Name: License #
Phone: Email:
………………………………………………………………………………………………………………………………
Name: License #
Phone: Email:
1.3Will you be using subconsultants? Yes No
If yes, identify who:
Consultant Phone:
Consultant Email Address:
2.Experience
Please limit responses in this section to 10 pages
2.1Describe experience of key personnel working on comparable projects/contracts.
Responder Response
2.2Familiarity of personnel with municipal, local and state government standards.
Responder Response
2.3Qualifications and education of key personnel and support staff.
Responder Response
3.Organizational Chart
Please provide an organizational chart outlining staffing, key personnel and lines of authority.
Responder Response
4.References
Please list three (3), clients for whom you have performed services similar to the Statement of Work in this solicitation.
1. Company Name:
Address:
Contact Person:
Phone: Email Address:
Project Name:
2. Company Name:
Address:
Contact Person:
Phone: Email Address:
Project Name:
3. Company Name:
Address:
Contact Person:
Phone: Email Address:
Project Name:
5.Resumes
Please provide resumes for each professional who will assist in providing services or be a member of the project team. Resumes must include qualifications and experience of each professional. (Additional pages may be used if necessary)
Responder Response
End of Response Form 1 for ROQ - 172721Professional On-Cal Services