Environmental Monitoring, Laboratory Analysis, and Reporting Services

Bid Form 3

Bidder must provide the information requested in the following sections.

1.BIDDER INFORMATION

Name of Entity:
Central Office/
Headquarters Address: / Address 1:
Address 2:
City, State, Zip Code:
Servicing Office Address (if different than Central Office/
Headquarters Address): / Address 1:
Address 2:
City, State, Zip Code:
Name of Parent Company (if any):
Entity’s Legal Structure: / Corporation
Partnership
Other / Joint Venture
Public Entity
State in Which Entity is Legally Organized:
Year Entity Started: / Number of Employees: / Number of Offices:
Location(s) of Offices (City and State):
Brief History of the Entity:
Overview of Entity’s Principal Lines of Work:

2.ANALYTICAL LABORATORY INFORMATION

In the following table identify the analytical laboratory bidder would use for the Services.

Analytical Laboratory
Name of Entity:
Street Address 1:
Street Address 2:
City, State, Zip Code:
Telephone Number:
Fax Number:
Is the Analytical Laboratory specified above a vendor under the Connecticut Department of Administrative Services (“DAS”) contract number 09PSX0054, “Environmental Laboratory Testing Services?” / Yes
No
If bidder answered “No” to the question above, bidder must provide as Appendix B to the bid a copy of the Analytical Laboratory’s Connecticut Department of Public Health (“CTDPH”) Approved Laboratory Testing Certification (indicating approvals for sample source type and examination/testing categories), the most recent CTDPH annual inspection report, and a copy of the most recent EPA Performance Evaluation Report Proficiency Scores.

3.SUBCONTRACTOR (SUBCONSULTANT) INFORMATION

Yes / No
Will bidder subcontract with entities,other than the Analytical Laboratory identified in Section 2 of this Form,for significant portions of the Services?

If bidder answered “yes” to the above question, provide the following information concerning the subcontractors. If bidder will subcontract with more than two entities, copy this page of the Form and provide the requested information on the additional subcontractors.

Subcontractor 1
Name of Entity:
Street Address 1:
Street Address 2:
City, State, Zip Code:
Telephone Number:
Fax Number:
Provide brief description of specific role Subcontractor 1 will have in providing the Services.
Subcontractor 2
Name of Entity:
Street Address 1:
Street Address 2:
City, State, Zip Code:
Telephone Number:
Fax Number:
Provide brief description of specific role Subcontractor 2 will have in providing the Services.

4.KNOWLEDGE, CAPABILITY AND EXPERIENCE

Describe bidder’s knowledge, capability and experience in providing services similar to the services addressed in this RFB. Specifically describe services regarding environmental monitoring, laboratory analysis evaluation, and reporting services associated with landfills, water contamination, plume delineation and characterization and monitoring program design and modifications. Indicate the experience of bidder in meeting monitoring and reporting deadlines as prescribed in the permits.
Describe bidder’s training and oversight regarding field work associated with monitoring. If submitting a bid for environmental monitoring at the Shelton Landfill and/or the Wallingford Landfill, also address “HAZWOPER” training in accordance with the requirements of 29 CFR 1910.120(3), which is applicable to both sampling personnel and supervisory personnel.
Describe bidder’s internal report review and quality assurance/quality control program.

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