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c) <br />d) <br /> <br />12. Affiliated Entities of the Principal(s): List the names and addresses of “affiliated entities” of the Vendor’s principal(s) <br />over the last five (5) years (from the solicitation opening deadline) that have acted as a prime Vendor with the City. <br />Affiliated entities of the principal(s) are those entities related to the vendor by the sharing of stock or other means of <br />control, including but not limited to a subsidiary, parent or sibling entity. <br />a) <br />b) <br />c) <br />d) <br />13. Has your firm, its principals, officers or predecessor organization(s) been debarred or <br /> Yes No <br />suspended by any government entity within the last three years? If yes, specify details in an <br />attached written response. <br />14. Has your firm, its principals, officers or predecessor organization(s) ever been debarred or <br /> Yes No <br />suspended by any government entity? If yes, specify details in an attached written response, <br />including the reinstatement date, if granted. <br />15. Specify the type of services or commodities your firm offers: <br />16. How many years has your firm been in business while providing the services and/or products offered within this <br />solicitation? <br />17. Is your firm’s business regularly engaged in and routinely selling the product(s) or services <br /> Yes No <br />offered within this solicitation? <br />18. Does your firm affirm that it is currently authorized by the manufacturer as a dealer/seller of the <br /> Yes No <br />product(s) offered herein, and warranty offered is the manufacturer’s warranty with the City <br />recorded as the original purchaser? The City reserves the right to verify prior to a <br /> <br />recommendation of award. <br />19. Has your firm ever failed to complete any services and/or delivery of products during the last <br /> Yes No <br />three (3) years? If yes, specify details in an attached written response. <br />20. Is your firm or any of its principals or officers currently principals or officers of another <br /> Yes No <br />organization? If yes, specify details in an attached written response. <br />21. Have any voluntary or involuntary bankruptcy petitions been filed by or against your firm, its <br /> Yes No <br />parent or subsidiaries or predecessor organizations during the last three years? If yes, specify <br />details in an attached written response. <br />22. Has your firm’s surety ever intervened to assist in the completion of a contract or have <br /> Yes No <br />Performance and/or Payment Bond claims been made to your firm or its predecessor’s sureties <br />during the last three years? If yes, specify details in an attached a written response, including <br />contact information for owner and surety company. <br />23. If requested, will your firm extend the same price, termsand conditions to other governmental <br /> Yes No <br />entities during the period covered by this contract? <br /> <br /> <br /> <br />