Northeast Ohio Regional Sewer District ITL Replacement System – Request for Proposal

ATTACHMENT A: IMPLEMENTATION PARTNER PROFILE - STATEMENT OF INTEREST AND QUALIFICATIONS

Respondents must complete all blanks indicated below, attaching information as requested.

1.Submitted by:

A.Corporation

Partnership

Individual

Joint Venture

Other (Describe)

  1. Office location that will be responsible for providing these services:
  1. Name of parent company, if your firm is a subsidiary:
  1. Number of years your firm has been doing business under the name stated above: years.
  1. Number of years your firm has provided Oracle Implementation services: years.
  1. If the durations stated in items 2 and 3 above are not equal, what other services did you provide and what other name did your business use during that period which differs?
  1. What services, other than Customer Information (Inquiry) Implementation Services, does your firm presently provide?

6.If your firm is a corporation, provide the following:

A.Date of Incorporation:

B.Incorporated in the State of:

C.Chief Executive's Name:

  1. Chief Executive's Title:

7.If your firm is a partnership of individuals, provide the following:

A.Date of organization:

B.Name of owner(s) and ownership participation:

10.Have any of the principals in your organization changed within the last three- (3) years? If so explain:

  1. Total number of employees in 2015:
  1. Number of people assigned to the office location in Item 1.b above:
  1. Total number of employees local to the Cleveland metro area:
  1. Total number of programmers/developers:
  1. Total number of database administrators:
  1. Total number of Linux systems administrators:
  1. Total number of Windows 2008 system administrators:
  1. Number of years your organization has been providing implementation services in the public sector:

List dates and types of services provided:

  1. Please list the number and names of public sector Customer Information (Inquiry) Systems implementations or upgrades your firm has performed in the past 3 years. Please do not include clients you have provided staff augmentation or spot consulting for. Please list only full implementations and upgrades.
  1. List the names of firms, their principals and roles of proposed subcontractors or other business partners providing services under this RFP and for whom the respondent will serve as Prime Contractor:

21.Identify and list all legal actions wherein your company was a party, including (separate attachment, if necessary):

a) Debtor in bankruptcy

b) Defendant in lawsuit for deficient performance on a contract

c) Defendant in any criminal or civil action

The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the District in verification of the recitals comprising this statement of qualifications.

COMPANY NAME: ______

COMPANY ADDRESS: ______

PHONE: ______FAX: ______E-MAIL:______

Company Authorized Agent Signature: ______

Title:______Date:______

Notary

State of ______)

County of______)

______being duly sworn, deposes, and says that he/she is the ______

(Company Authorized Agent) (Title)

of ______, and that the answers to the foregoing questions and all statements therein

(Company Name)

contained are true and correct.

Subscribed and sworn before me this ______day of ______, 2002.

Notary public: ______

Address: ______

______

My commission expires: ______

Attachment A1 of 4