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Chabot-Las Positas Community College District

REQUEST FOR STATEMENT OF QUALIFICATIONS (RFQ) A-15

DESIGN/BUILD ENTITY

FOR NEW ACADEMIC CLASSROOM BUILDING 100 LAS POSITAS COLLEGE

Qualifications Due:

THURSDAY, NOVEMBER 20, 2014 by 4:00 P.M.

Return Qualifications To:

Doug Horner, Director of Facilities 7600 Dublin Blvd., 3rd Floor

Dublin, CA 94568

CHABOT-LAS POSITAS COMMUNITY COLLEGE DISTRICT RFQ A-15 DESIGN/BUILD ENTITY FOR NEW ACADEMIC CLASSROOM

BUILDING 100, LAS POSITAS COLLEGE

Pre-Qualification Package

TABLE OF CONTENTS Notice of Qualification to Design/Build Entities Introduction and Overview

Introduction Instructions for Completing the Pre-Qualification Application Pre-Qualification Process General Information Overview of Las Positas College Project Explanation of Scoring Framework Scoring Matrix

Pre-Qualification Application I. Information About Design/Build Entity Members

A. General Contractor B. Architect of Record C. Principal Engineer D. Electrical, Mechanical, and other Design/Build Subcontractors

II. Essential Requirements for the Design/Build Entity III. Scored Questions

A. General Contractor B. Architect of Record C. Principal Engineer D. Electrical, Mechanical, and other Design/Build Subcontractors

IV. Recent Construction Projects Completed V. Resumes

VI. Declaration

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NOTICE OF QUALIFICATION TO DESIGN/BUILD ENTITIES NOTICE IS HEREBY GIVEN that the Chabot-Las Positas Community College District, State of California, hereby calls for Statements of Qualifications – Design/Build Entity, New Academic Classroom Building 100, Las Positas College, RFQ No. A-15 to be delivered to the Director of Facilities on THURSDAY, NOVEMBER 20, 2014 by 4:00 p.m. at 7600 Dublin Blvd., 3rd Floor, Dublin, CA 94568. Faxed, e-mail or late proposals will not be accepted. Qualifications shall be presented in accordance with the RFQ documents for the same, which are on file with the Contract Manager, Facilities Planning & Management Department at the office address listed above. Qualifications packages will be available October 27, 2014 at: http://www.clpccd.org/bond/BiddingProjectBusinessOpportunitiesRFPandServices.php Inquiries regarding this qualification package should be directed to office of the Contract Manager, Facilities Planning & Management Department at [email protected] and in the subject line reference RFQ No. A-15 on all email inquiries. This RFQ shall also be subject to any and all applicable laws, regulations and standards. For more information, please refer to the Facilities Measure B Program Website at http://www.clpccd.org/bond/BiddingProjectBusinessOpportunitiesRFB.php.

Publication Dates: October 27, 2014

November 3, 2014

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Request for Pre-Qualification (RFQ A-15) Submittals from Design/Build Entities Introduction Chabot- Las Positas College District, “District” plans to develop a new Academic Classroom Building 100 at the District’s Las Positas College Campus. The District intends to request competitive proposals from pre-qualified Design/Build Entities. In order to obtain the necessary information from Design/Build Entities, the District has prepared this Pre-Qualification Package, which contains:

1. Instructions for completing the Pre-Qualification Application; 2. A description of the Pre-Qualification Process; 3. An overview of the project; 4. The scoring worksheets; and 5. The Pre-Qualification Application.

Instructions for Completing the Pre-Qualification Application All Pre-Qualification Applications shall be made on the attached application furnished by the District. The applications can be obtained at the following website: http://www.clpccd.org/bond/BiddingProjectBusinessOpportunitiesRFPandServices.php Requests for clarification of the process or the documents must be submitted by email to Victoria Lamica, Contracts Manager at [email protected] no later than 4:00 PM, Tuesday, November 11, 2014. Applicants shall submit three (3) hard copies of the Application and one (1) electronic copy on a CD. Applications shall be submitted in sealed envelopes, clearly marked as follows:

RFQ A-15 Design/Build Entity for New Academic Classroom Building 100, Las Positas College Pre-Qualification Application From: Design-Build Entity Business Name Attention Doug Horner, Director of Facilities

Applications must be received by Chabot-Las Positas Community College District, 7600 Dublin Boulevard, 3rd Floor, Dublin, CA 94568 by THURSDAY, NOVEMBER 20, 2014 by 4:00 PM. Late Applications will not be accepted.

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mailto:[email protected]

Pre-Qualification Process The Pre-Qualification process for this project involves two steps: Step 1 – Completion of Application: Each application must conform and be responsive to the standard application provided by the District. The completed Application must contain information on each of the following members of the Design/Build Entity’s Team:

1. General Contractor 2. Architect of Record 3. Principal Engineers 4. Electrical and Mechanical subcontractors 5. Any Design/Build subcontractors

Any Team member determined not to be pre-qualified will result in a determination of “Not Pre-Qualified” for the entire Design/Build Entity. Any deviation from the standard application form, failure to provide all of the required information, untruthful or misleading answers will establish the application as non-responsive and be grounds for determination of “Not Pre-Qualified” for the entire Design/Build Entity. The District reserves the right to reject any or all pre-qualification applications and to waive any irregularities. Pre-Qualification applications for past projects or for other public agencies are not applicable. A new Pre-Qualification application is required to be considered for this advertised project. Step 2 – Short Listing: Completed Applications will be reviewed against the Scoring Matrix included in this RFQ. Three (3) teams will be invited to submit a Design/Build Proposal for the new Academic Classroom Building 100. Responsive completion of the Pre-Qualification Application includes:

1. Completion of the questionnaire 2. Licensure in good standing with the State of California 3. Bonding and surety availability in accordance with these published requirements 4. Verified experience on comparable projects

General Information Timeline – The following is the anticipated timeline for the Design/Build project. Pre-Qualification of Design/Build Teams:

• Request for Information submitted by: November 11, 2014 • Statements of Qualification due by 4:00 p.m.: November 20, 2014 • Qualified Short-Listed Design/Build teams announced by December 10, 2014

Proposal & Contract Phase: • Issuance of Request for Proposal: January 15, 2014 • Proposals due: April 2014 • Contract award: June 2014

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Design and Construction Phase:

• Notice to Proceed to Design - June 2014 • Notice to Proceed – Bldg. 700 Renovation - June 2014 • Occupancy New Academic Classroom Building 100 - Summer 2018

Requirements for Pre-Qualification - The District’s evaluation is solely for the purpose of determining which Design/Build Entities are deemed responsible and qualified. Pre-qualification of Design/Build Entities will be reviewed and determined by the District based upon the submitted Pre-Qualification applications and any other information available to the District. The District may request a Design/Build Entity to submit additional information pertinent to the Application. The District also reserves the right to investigate and rely upon information from other available sources in addition to any documents or information submitted by the Design/Build Entity. The District’s pre-Qualification determinations will be based on objective evaluation criteria. The District retains the sole discretion to determine issues of compliance and to determine whether a Design/Build Entity is responsive and responsible. The District will determine a Design/Build Entity’s quality, fitness and capacity to perform comparable projects satisfactorily. However, neither the determination that a Design/Build Entity is prequalified, nor any prequalification rating, will preclude the District from additional post-proposal consideration and determination of whether a proposer has demonstrated the requisite trustworthiness, quality, fitness, capacity and experience to be eligible for award of the Design/Build contract. Responses to the Pre-Qualification application and questionnaire and any financial information submitted for pre-qualification evaluation are not public records and not open to public inspection. The District will maintain the confidentiality of these records to the extent permitted by law. In the event a third party requests these confidential records, the District will notify the affected Design/Build Entity, and it shall be the Design/Build Entity’s responsibility to defend the District in any action to compel disclosure of the Design/Build Entity’s confidential information. The District reserves the right to modify, suspend, or cancel this Project, including the Prequalification Phase, in whole or in part, at any time and at its sole discretion. Costs for developing responses to this Application are entirely the responsibility of the Design/Build Entity’s and shall not be chargeable to the District. Inquiries regarding this qualification package should be directed to office of the Contract Manager, Facilities Planning & Management Department at [email protected] and in the subject line reference RFQ No. A-15 on all email inquiries.

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A Design/Build Entity is defined by Education Code section 81701(c) as “a corporation, limited partnership or other association that is able to provide appropriately licensed contracting, architectural, and engineering services as needed pursuant to a design-build contract.” For purposes of the Project prequalification, each Design/Build Entity must identify and provide information for the General Contractor, Architect, Principal Engineers, Mechanical and Electrical Subcontractors and Design-Build Subcontractors. All electrical and mechanical subcontractors must be pre-qualified. The Design/Build Entity may pre-qualify one Mechanical and Electrical firm or may pre-qualify multiple firms and may later obtain bids to perform that work. Pursuant to Public Contract Code section 81704, subsequent to the District’s selection of the Design/Build Entity, the services of other sub-contractors or sub-consultants who are not identified as team members either in this Prequalification Phase or the Proposal Phase must be procured by the Design/Build Entity in accordance with Public Contract Code section 81704, and all such Sub-contractors shall be afforded the protections of Public Contract Code sections 4100 et seq. The District reserves the right to specify additional requirements for Sub-contractors or sub-consultants not included in the Prequalification document, in the Request for Proposals for the Project. Overview of the Las Positas College Project The Project will demolish Buildings 100, 200 and 300 on the Las Positas College campus and replace them, in the same location, with a new approximately 38,000 Gross Square Foot state-of-the-art classroom and computer laboratory building. It is anticipated that the new classroom and lab building will be a flexible, accessible, technologically sophisticated, energy efficient facility. The District will be evaluating which design-build team can best incorporate design innovation while delivering a LEED Gold facility or better, utilizing the bridging documents developed by the bridging Architect, Lionakis. The construction budget is approximately $20 million. The District is currently preparing a Request for Proposal (RFP), which will be provided to three (3) selected Design/Build Entities. Lionakis is assisting the District with the preparation of bridging documents that will be included in the RFP and is excluded from being on any of the Design/Build Entity teams for the Las Positas College project. In addition, the following firms have provided support to Lionakis the preparation of the RFP and are also excluded from being on Design/Build Entity teams:

• Integral Group - Mechanical, Electrical & Plumbing Engineering • CSW- Civil Engineering • ANLA- Landscape Design • Smith, Fause, McDonald - Telecommunications, Data Engineering

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Explanation of Scoring Framework The prequalification determination for a Design/Build Entity will result from consideration of the scores attained in all parts of the Pre-Qualification Questionnaire. PART I: INFORMATION ABOUT THE DESIGN/BUILD ENTITY Part I applies to the Design/Build Entity as a whole and is for identification purposes only. There is no scoring value to this part. PART II: ESSENTIAL REQUIREMENTS FOR THE DESIGN/BUILD ENTITY AS A WHOLE Part II applies to the Design/Build Entity Team as a whole and consists of a series of pass/fail qualification questions. All questions must be answered correctly or the Design/Build Entity may be disqualified with no consideration given to the remainder of the Questionnaire. PART III: SCORED QUESTIONS FOR INDIVIDUAL MEMBERS OF THE DESIGN/BUILD ENTITY TEAM Parts III includes minimum scores that must be attained for the General Contractor, Architect, Principal Engineers and Subcontractors. Scores at or above the minimums will be combined with the scores of the other parts of the Prequalification Questionnaire to determine the Total Score for the Design/Build Entity. PART IV: RECENT CONSTRUCTION PROJECTS COMPLETED In order to help the District assess the extent to which the Design/Build Entity Team has the experience, competency, capability, and capacity to complete a project similar in size, building type, and complexity of the Project, Part IV requires the Design/Build Entity to submit information on recently-completed projects that are of similar size, building type, and complexity. The District will have sole discretion to determine which projects are similar to the Project. PART V- RESUMES Provide resumes of the key personnel that would be assigned to the project. PART VI: VERIFICATION Part VI requires verification under oath by the Design/Build Entity and each pre-qualified team member in a manner consistent with the verification requirements for civil pleadings pursuant to Code of Civil Procedure section 446. The District will not review Prequalification Questionnaires that are not properly verified.

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PRE-QUALIFICATION APPLICATION

Chabot-Las Positas Community College District

REQUEST FOR STATEMENT OF QUALIFICATIONS (RFQ) A-15

DESIGN/BUILD ENTITY

FOR NEW ACADEMIC CLASSROOM BUILDING 100 LAS POSITAS COLLEGE

Qualifications Due:

THURSDAY, NOVEMBER 20, 2014 by 4:00 P.M.

Return Qualifications To:

Doug Horner, Director of Facilities 7600 Dublin Blvd., 3rd Floor

Dublin, CA 94568

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I. INFORMATION ABOUT DESIGN/BUILD ENTITY MEMBERS

DESIGN/BUILD ENTITY Name: Primary Contact: _________________________________________ Address:

Phone: FAX: Primary Contact Email: _____________ GENERAL BUIILDING CONTRACTOR Name:

Primary Contact: _________________________________________ Address: __________ ________________________________________________

Phone: ___________ Fax: _______________Primary Contact Email________________ ARCHITECT OF RECORD Name:

Primary Contact: _________________________________________ Address:

Phone: ___________ Fax: _______________Primary Contact Email________________

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Design-Build Entity Member(s) List all professional disciplines (e.g., Architect, General Building Contractor, Principal Engineers, Electrical subcontractor, Mechanical subcontractor, and other subcontractors) performing Design-Build work. It is acceptable to list up to three firms for electrical and mechanical subcontractors. Use additional sheets as necessary. Discipline (i.e., architect, engineer, electrical contractor, etc.)

Name

Legal Entity (i.e. corporation, partnership, sole proprietor)

For all partnerships or other associations listed above that are not legal entities. Please provide a copy of the business agreement/license creating the partnership or association.

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Provide a Project Organization Chart which shows all firms that the DESIGN BUILD ENTITY is pre-qualifying in this Application. General Contractors are free to develop their list of Design-Build subcontractors.

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I (A) INFORMATION ABOUT THE DESIGN-BUILD ENTITY Is the Design-Build Entity the same entity as the General Building Contractor?

Yes No If “No” and the Design/Build Entity is a separate entity from the General Building

Contractor- complete the following information about the Design/Build Entity. If “Yes” proceed to Section I (B)

1. Name of Design/Build Entity: 2. Date of Company formation (or incorporation): 3. State of formation or incorporation: 4. How many persons does the Design-Build Entity currently employ? 5(a) If the General Contractor is a corporation, provide the following:

Provide information for each officer of the corporation and owners of 10% or more of the corporate stock.

Position

Name

Years with Co.

% Ownership

CEO

President

Secretary

Treasurer

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5(b) If the Design-Build Entity is a sole proprietorship, please complete the following:

Owner

Years as Owner

5(c) If the Design-Build Entity is a joint venture, or a partnership, provide the

following information for each member of the joint venture, or for each partner: (Attach additional pages if necessary)

Name of Individual Or Entity

Principal Contact

Position

Years with Joint

Venture/ Partnership

% Ownership

Interest

6.

Has there been any change in ownership of the Design-Build Entity during the last three years? (NOTE: A corporation whose shares are publicly traded is not required to answer this question with regard to public trades.) Yes No If “yes”, explain on a separate page.

7.

Is the Design-Build Entity a subsidiary, parent, holding company or affiliate of another design or construction firm? (NOTE: Include information about other firms if one firm owns 50 percent or more of another, or if an owner, partner, or officer of your firm holds a similar position in another firm.) Yes No

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If “yes”, explain on a separate page.

8.

State the Design-Build Entity’s gross revenues for each of the last three years:

YEAR: ____________ YEAR: __________ YEAR: ___________ $____________ $__________ $___________ 9.

List all California contractor license numbers, classifications and expiration dates currently held by the Design-Build Entity:

License Number

Trade Classification

Date Issued Expiration Date

(Attach additional pages if necessary) 10.

Has the Design-Build Entity changed names or license numbers in the past five years?

Yes No If “yes”, explain on a separate page.

11.

Has any owner, CSLB qualifier or corporate officer of the Design-Build Entity operated as a contractor under any other name or license number (not listed in 9 above) in the last five years?


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12. Provide the following information for key staff members who will be managing

the project during design and/or construction of the project: (Attach additional pages if necessary)

Design-Build Entity

License Number (if applicable)

Years of Experience

Project Manager

Design Manager

Construction Manager

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I (B). INFORMATION ABOUT THE GENERAL BUILDING CONTRACTOR 1. Name of General Building Contractor: 2. Date of Company formation (or incorporation): 3. State of formation or incorporation: 4. How many persons does the General Contractor currently employ? 5(a) If the General Contractor is a corporation, provide the following:

Provide information for each officer of the corporation and owners of 10% or more of the corporate stock.

Position

Name

Years with Co.

% Ownership

CEO

President

Secretary

Treasurer

5(b) If the General Contractor is a sole proprietorship, please complete the following:

Owner

Years as Owner

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5(c) If the General Contractor is a joint venture, or a partnership, provide the following

information for each member of the joint venture, or for each partner: (Attach additional pages if necessary)

Name of Individual Or Entity

Principal Contact

Position

Years with Joint


% Ownership

Interest

6.

Has there been any change in ownership of the General Building Contractor during the last three years? (NOTE: A corporation whose shares are publicly traded is not required to answer this question with regard to public trades.) Yes No If “yes”, explain on a separate page.

7.

Is the General Building Contractor a subsidiary, parent, holding company or affiliate of another construction firm? (NOTE: Include information about other firms if one firm owns 50 percent or more of another, or if an owner, partner, or officer of your firm holds a similar position in another firm.) Yes No If “yes”, explain on a separate page.

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8.

State the General Building Contractor’s gross revenues for each of the last three years:

YEAR: ____________ YEAR: __________ YEAR: ___________ $____________ $__________ $___________ 9.

List all California contractor license numbers, classifications and expiration dates currently held by the General Contractor:

License Number

Trade Classification


(Attach additional pages if necessary) 10.

Has the General Contractor changed names or license numbers in the past five years?


11.

Has any owner, CSLB qualifier or corporate officer of the General Contractor operated as a contractor under any other name or license number (not listed in 9 above) in the last five years?


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12.

Surety Information for General Contractor:

Bonding Co./Surety:_______________________________________________________ Surety Agent: ___________________________________________________________ Agent Address: __________________________________________________________ Telephone No.: __________________________________________________________ 13.

List all other sureties (name and full address) that have written bonds for the General Contractor during the last five years, including periods during which each wrote the bonds:

Surety

Address

Periods of Coverage

14. Provide the following information for key staff members who will be managing

the project during design and/or construction of the project: (Attach additional pages if necessary)

General Contractor

License Number (if applicable)

Years of Experience

Project Manager

Construction Manager

Superintendent

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I (C). INFORMATION ABOUT THE ARCHITECT OF RECORD Definitions:

“Architect of Record” shall mean the licensed design professional whose stamp will appear on project documents. The Architect of Record must be licensed in the State of California. 1. If the Architect of Record is different from that of the General Contractor, please

answer the following: 2. Name of Architect of Record Firm:

1(a)

Date of company formation or incorporation: ______________________

1(b)

State of formation or incorporation:

______________________

1(c)

How many persons does the Architect of Record’s firm currently employ?

______________________

1(d) If the Architect of Record’s firm is a corporation, provide the following

information for each officer of the corporation and owners of 10% or more of the corporate stock.

Position

Name

Years with Co.

% Ownership

CEO

President

Secretary

Treasurer

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1(e) If the Architect of Record is a sole proprietorship, complete the following:

Owner Years as Owner

1(f) If the Architect of Record’s firm is a joint venture or partnership, provide the

following information for each member of the joint venture or each partner. (Attach additional pages if necessary)

Name of Individual or Entity

Principal Contact

Position

Years with Joint


% Ownership

Interest

1(g) Has there been any change in ownership of the Architect of Record’s firm during the

last three years?

Yes No


(NOTE: A corporation whose shares are publicly traded is not required to answer this question with regard to public trades.) 1(h) Is the Architect of Record’s firm a subsidiary, parent, holding company or affiliate of

another firm?

Yes No

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1(i) Has any corporate officer or owner of the Architect of Record's firm, worked for any

other design firms in the past five years?

(NOTE: Include information about other firms if an owner, partner, or officer of your firm holds a similar position in another firm.)

Yes No


1(j). Has the Architect of Record’s firm changed names in the past five years?

Yes No

If “yes”, explain on a separate page including reason for change.

2. Provide the following information for key staff of the Architect of Record’s firm

who will be designing the project: (Attach additional pages if necessary)

Architect

License Number Years in Practice

Project Manager

Project Architect

Principal in Charge

8.

State the Architect’s gross revenues for each of the last three years: YEAR: ____________ YEAR: __________ YEAR: _____________

$____________ $__________ $_____________

If “yes”, explain on a separate page. (NOTE: Include information about other firms if one firm owns 50 percent or more of another, or if an owner, partner, or officer of your firm holds a similar position in another firm.)

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I (D). INFORMATION ABOUT PRINCIPAL ENGINEER Definitions:

• Principal Engineer (also known as Design Professional(s) of Record) shall mean the licensed design professional whose stamp will appear on project documents. Principal Engineer is required to be licensed in the State of California.

• This section is to be completed by member firms of the Design-Build Team that only provide professional services. Construction Subcontractors that will be a Design-Build subcontractor must complete Section I(E).

• Attach copies of Section I(D) for each Principal Engineer that the Design-Build Entity seeks to submit for prequalification.

If the Principal Engineer’s firm is different from that of the General Contractor, please answer the following:

1. Name of Principal Engineer’s Firm: 2. Discipline:

2(a)


2(b)


______________________

2(c)

How many persons does the Principal Engineer’s firm currently employ?

______________________

3. If the Principal Engineer’s firm is a corporation, provide the following information

for each officer of the corporation and owners of 10% or more of the corporate stock.

Position

Name

Years with Co.

% Ownership

CEO

President

Secretary

Treasurer

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4. If the Principal Engineer is a sole proprietorship, complete the following:

Owner

Years as Owner

5. If the Principal Engineer’s firm is a joint venture or partnership, provide the following

information for each member of the joint venture or each partner. (Attach additional pages if necessary)

Name of Individual

or Entity

Principal Contact

Position

Years with Joint


% Ownership

Interest

6. Has there been any change in ownership of the Principal Engineer’s firm during the

last three years?

Yes No


7. Is the Principal Engineer’s firm a subsidiary, parent, holding company or affiliate

of another firm?

(NOTE: Include information about other firms if one firm owns 50 percent or more of another, or if an owner, partner, or officer of your firm holds a similar position in another firm.)

Yes No


(NOTE: A corporation whose shares are publicly traded is not required to answer this question with regard to public trades.)

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8. Has any corporate officer or owner of the Principal Engineer’s firm, worked for any

other design firms in the past five years?

(NOTE: Include information about other firms if an owner, partner, or officer of your firm holds a similar position in another firm.)

Yes No


9. Has the Principal Engineer’s firm changed names in the past five years?

Yes No

If “yes”, explain on a separate page including reason for change.

10. Provide the following information for key staff of the Principal Engineer’s firm

who will be designing the project: (Attach additional pages if necessary)

Principal Engineer


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I (E). INFORMATION ABOUT ELECTRICAL, MECHANICAL, AND OTHER DESIGN-BUILD SUBCONTRACTOR(S)

Attach copies of Section I(E) for each Electrical and Mechanical subcontractor and other subcontractors that will be performing Design-Build work. Pre-qualification information shall be submitted for each electrical and mechanical subcontractor and other Design-Build subcontractors. 1. Name of Subcontractor:

____________________________

2.

Date of company formation or incorporation:

____________________________

3. State of formation or incorporation:

____________________________

4.

How many persons does the Subcontractor currently employ?

____________________________

5(a). If the Subcontractor is a corporation, provide the following information for each

officer of the corporation and individuals who own 10% or more of the corporate stock.

Position Name Years with Co.

% Ownership

CEO

President

Secretary

Treasurer

5(b). If the Subcontractor is a sole proprietorship, complete the following:

Owner

Years as Owner

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5(c). If the Subcontractor is a joint venture or partnership, provide the following information for each member of the joint venture or each partner:

Name of Individual

or Entity

Principal Contact

Position

Years with Joint


% Ownership

Interest

6.

Has there been any change in ownership of the Subcontractor during the last three years? (NOTE: A corporation whose shares are publicly traded is not required to answer this question with regard to public trades.) Yes No


7.

Is the Subcontractor a subsidiary, parent, holding company or affiliate of another construction firm?

(NOTE: Include information about other firms if one firm owns 50 percent or more of another, or if an owner, partner, or officer of your firm holds a similar position in another firm.) Yes No If “yes”, explain on a separate page.

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8.

State the Subcontractor’s gross revenues for each of the last three years: YEAR: ____________ YEAR: __________ YEAR: _____________

$____________ $__________ $_____________ 9.

List all California contractor license numbers, classifications and expiration dates currently held by the Subcontractor:

License Number

Classification


10.

Has the Subcontractor changed names or license numbers in the past five years?

Yes No If “yes”, explain: on a separate page.

11.

Has any owner, CSLB qualifier or corporate officer of the Subcontractor operated as a contractor under any other name or license number (not listed in 9 above) in the last five years?


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12.

Surety Information for Subcontractor: Bonding Co./Surety: _______________________________________________

Surety Agent: _____________________________________________________

Agent Address: ____________________________________________________

Telephone No.: ____________________________________________________

13.

List all other sureties (name and full address) that have written bonds for your firm during the last five years, including the periods during which each wrote the bonds:

Surety

Address

Periods of Coverage

14.

Will your firm provide design-build services for this project?

Yes No If “yes”, complete the following.

15. Provide the following information for key staff of the Design-Build

Subcontractor’s firm who will be designing the project: (Attach additional pages if necessary)

Principal Engineer


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16. If the Principal Engineer’s firm is different from that of the Design-Build

Subcontractor, answer the following:

Name of Principal Engineer’s Firm:

Discipline: (a)


(b)


______________________

(c)

How many persons does the Principal Engineer’s firm currently employ?

______________________

17. Provide the following information for key staff of the Principal Engineer that will

contract with the Design-Build Subcontractor’s firm: (Attach additional pages if necessary)

Principal Engineer


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II. ESSENTIAL REQUIREMENTS FOR THE DESIGN-BUILD ENTITY

Definitions: The term “Associates” shall mean any and all of the following:

• The current qualifiers for all current Contractors State License Board contracting licenses held by the contractor.

• All current officers of a contractor, which is a corporation. • All current partners of a contractor, which is a partnership. • All current joint ventures of the joint venture contractor, which is seeking

prequalification. 1. Does the General Building Contractor and each proposed Subcontractor possess a

current California contractor’s license for the project for which it intends to submit a proposal?

Yes No

2. Does the General Contractor have a liability insurance policy with a policy limit

of at least $2,000,000 per occurrence and $4,000,00 aggregate from a California admitted company with an A.M Best rating of A or better and a Financial Condition rating of IX or better?

Yes No If yes, provide the following information. (Attach a separate page if more than one policy.) __________________________________________________________________ Insurance Company

__________________________________________________________________ Policy Number

__________________________________________________________________ Policy limit per occurrence

__________________________________________________________________ Aggregate policy limit

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3. Does the General Contractor and each proposed Subcontractor have current workers’ compensation insurance policies as required by the Labor Code or are legally self-insured pursuant to Labor Code sections 3700 et. seq.?

Yes No If yes, provide the following information. (Attach a separate page if more than one policy)

__________________________________________________________________ Insured

__________________________________________________________________ Carrier

__________________________________________________________________ Policy Number

4. Has the latest copy of an audited financial statement (no more than two years old) with accompanying notes been attached for the General Contractor? (An audited financial statement with accompanying notes of a parent company guarantor may be substituted. A financial statement that is not audited is not acceptable. A letter verifying availability of a line of credit is not a substitute for the required financial statement.)

Yes No

5. Has a notarized statement from an admitted surety insurer (approved by the California Department of Insurance) and authorized to issue bonds in the State of California been attached, which states that the General Contractor’s current bonding capacity is sufficient for the project for which you seek pre-qualification? (Statement must be from the surety company, not an agent or broker.)

Yes No

6. Has any contractor license held by the General Contractor or its associates or any of the proposed Subcontractors or their associates, been revoked or suspended within the last five (5) years?

Yes No

7. Has a surety firm completed a contract or paid for completion of a contract on behalf of any member of the Design-Build Entity’s team because they were terminated by the project owner within the last five (5) years?

Yes No

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8. Within the last five years was the Design-Build Entity, General Contractor or any

proposed Subcontractor declared ineligible to bid on a public works contract, to be awarded a public works contract, or to perform as a subcontractor on a public works contract, pursuant to either Labor Code section 1777.1 or Labor Code section 1777.7?

Yes No

9. Has any member of the Design-Build Entity Team (contractors, architects, engineers or others) or any member’s associates, any of the corporate officers, partners, ever been convicted of a crime involving the awarding of a contract for a government project, or the bidding or performance of a government contract within the last five (5) years?

Yes No

10. Do all of the design professionals who are expected to work on the project possess current California professional licenses for the services, which they intend to provide?

Yes No

11. Are the Design Professional(s) of Record covered by a professional liability insurance policy with a policy limit of at least $1,000,000 per occurrence and $2,000,000 aggregate from a California admitted company that provides coverage for work on a design-build contract (answer for each individual design professional of record that is a member of the Design-Build Entity’s Team)?

Yes No

If yes, provide the name of the insurance company, policy number, and policy limits.

__________________________________________________________________ Insurance Company

__________________________________________________________________ Policy Number

__________________________________________________________________ Policy limit per occurrence

__________________________________________________________________ Aggregate policy limit

33

12. Has any professional license held by any design professional that will provide

services been revoked at any time in the last five years?

Yes No 13. Does the General Contractor and each proposed Subcontractor seeking

prequalification, know and understand their obligations regarding the employment of apprentices on public works under Labor Code section 1777.5 and California Code of Regulations, Title 8, section 230.1, and do they intend to comply with these requirements, including the requirement, if applicable, to request the dispatch of apprentices from an apprenticeship program approved by the California Apprenticeship Council?

Yes No

14. If the D-B Entity is a joint-venture or partnership, has the D-B Entity attached a copy of the agreement creating the entity and which specifies that all partners or association members agree to be fully liable for the performance under the design-build contract? NOTE: A corporation or sole proprietorship is not required to answer this question.

Yes No

15. Has the D-B Entity completed two or more public sector Design-Build projects with a total contract value of $10,000,000 or more in the last seven years?

Yes No

For purposes of this section, the term “project” shall mean a project as defined in Public Contract Code section 20133(c)(4) as “ the construction of a building and improvements directly related to the construction of a building…” and the terms “public sector” shall mean any work performed pursuant to a contract with a public or other governmental agency.

16. Have both the General Contractor and the Architect of Record completed at least three projects of at least $10M for a California Higher Education organization which means a Community College, California State University or University of California campus in the past 5 years? These projects do not need to be design build nor as projects performed jointly. Yes No

17. Is any member of the Design-Build Entity Team (General Building Contractor, Architect, Principal Engineer or Subcontractors) and/or its associates currently the debtor in a bankruptcy case?

Yes No

34

If “yes”, indicate the case number, bankruptcy court, and the date on which the petition was filed. ____________________ _______________________ _________________ Case Number Bankruptcy Court Date Filed

18. Was any member of the Design-Build Entity Team (General Building Contractor,

Architect, Principal Engineer or Subcontractors) or its associates in bankruptcy at any time during the last five years? (This question refers only to a bankruptcy action that was not described in answer to question 18, above)

Yes No

If “yes”, indicate the case number, bankruptcy court, and the date on which the petition was filed.

____________________ _______________________ _________________ Case Number Bankruptcy Court Date Filed

19. In the last five years has any member of the Design-Build Entity Team (General Building Contractor, Architect, Principal Engineer or Subcontractors) or its associates, been debarred, disqualified, removed or otherwise prevented from bidding on, or completing, any government agency or public works project for any reason?

Yes No

20. Has any member of the Design-Build Entity Team (General Building Contractor, Architect, Principal Engineer or Subcontractors) or its associates ever been found liable in a civil suit or found guilty in a criminal action for making any false claim or material misrepresentation to any public entity?

Yes No

35

III. SCORED QUESTIONS III (A). SCORED QUESTIONS FOR THE GENERAL CONTRACTOR Definitions: The term “Associates” shall mean any of the following:



prequalification. A-1 How many years has the General Building Contractor been licensed in California? Years: ________________ A-2. At any time in the last five years has the General Building Contractor or its

associates been assessed liquidated damages of more than $50,000 on a construction contract with either a public or private owner?

Yes No

If yes, explain on a separate page, identifying all such projects by owner, owner’s address, name of entity against whom assessment was made, the date of completion of the project, amount of liquidated damages assessed and all other information necessary to fully explain the assessment of liquidated damages.

A-3. Has the General Building Contractor or its associates ever defaulted on a construction contract?


If “yes”, explain on a separate page. State the name of the organization debarred, the year of the event, the owner of the project, and the basis for the action.

A-4. Has the General Building Contractor or its associates ever been denied an award

of a public works contract based on a finding by a public agency that they were not a responsible bidder?

Yes No

36

If “yes”, on a separate page identify the year of the event, the entity denied the award, the owner, the project, and the basis for the finding by the public agency.

(NOTE: The following two questions refer only to disputes between contractors and owners of projects. You need not include information about disputes with suppliers, other contractors, or subcontractors. You need not include information about “pass-through” disputes in which the actual dispute is between a subcontractor and a project owner.)

A-5. In the past five years has any claim in excess of $50,000 been filed in court or

arbitration against the General Building Contractor or its associates concerning their work on a construction project?

Yes No

If “yes”, on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution).

A-6. In the past five years has the General Building Contractor or its associates made

any claim in excess of $50,000 against a project owner concerning work on a project or payment for a contract and filed that claim in court or arbitration?

Yes No

If “yes”, on a separate page identify the claim by providing the name of claimant, the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution).

A-7. In the last five years has any insurance carrier, for any form of insurance, refused

to renew the insurance policy for the General Building Contractor or its associates due to non-payment or contractor losses?

Yes No

If “yes”, on a separate page give name of the insured; name the insurance carrier, the form of insurance, and the year of the refusal.

A-8. Has the General Building Contractor, any of the corporate officers, partners, or its

associates ever been convicted of a crime involving any federal, state, or local law related to construction?

37

Yes No

If “yes”, explain on a separate page, including identifying who was convicted, the name of the victim, the date of the conviction, the court and case number, the crimes, and the grounds for the conviction.

A-9. Has the General Building Contractor, any of the corporate officers, partners or its

associates ever been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty?

Yes No

If “yes”, identify on a separate page, the person or persons convicted, the court and case number, the crimes, and the year convicted.

A-10. During the last five years, has there ever been a period of time when the General

Building Contractor or its associates had no surety bond in place during a public construction project when one was required?

Yes No

If yes, indicate the period during which no surety bonds were in place, name of entity without the surety bond, the name of project owner, and if coverage was denied the date coverage was denied and the name of the company that denied coverage.

A-11. Has CAL OSHA cited and assessed penalties against the General Building

Contractor or its associates for any “serious,” “willful” or “repeat” violations of its safety or health regulations in the past five years?

(NOTE: If you have filed an appeal of a citation, and the Occupational Safety and Health Appeals Board has not yet ruled on your appeal, you need not include information about it.)

Yes No

If “yes”, on separate page describe the citations, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any OSHA decision.

A-12. Has the Federal Occupational Safety and Health Administration cited and

assessed penalties against the General Building Contractor or its associates in the past five years?

38

(NOTE: If an appeal of the citation has been filed and the Appeals Board has not yet ruled, or if there is a court appeal pending, you need not include information about the citation.)

Yes No

If “yes”, on separate page describe the citations, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any decision.

A-13. Has the EPA, any Air Quality Management District or any Regional Water

Quality Control Board cited and assessed penalties against either the General Contractor or its associates or the owner of a project during the time in which the preceding parties were performing on a contract in the past five years?

(NOTE: If an appeal of the citation has been filed and there is no ruling yet, or if there is a court appeal pending, you need not include information about the citation.)

Yes No


A-14. How often does the General Building Contractor require documented safety

meetings to be held for construction employees and field supervisors during the course of a project?

__________________________________________________________ A-15. List the General Building Contractor’s Experience Modification Rate (EMR)

(California workers’ compensation insurance) for each of the past three premium years: (NOTE: An Experience Modification Rate is issued to your firm annually by your workers’ compensation insurance carrier.)

Year: EMR: Year: EMR: Year: EMR:

39

If your EMR for any of these three years is 1.00 or higher you may attach a letter of explanation.

A-16. Within the last five years has there ever been a period when the General Contractor or its associates had employees but was without workers’ compensation insurance or state-approved self-insurance?

Yes No

If “yes”, please explain the reason for the absence of workers’ compensation insurance on a separate page. If “No,” please provide a statement by your current workers’ compensation insurance carrier that verifies periods of workers’ compensation insurance coverage for the General Building Contractor for the last five years. (If the General Contractor has been in business for less than five years, provide a statement by your workers’ compensation insurance carrier verifying continuous workers’ compensation insurance coverage for the period that your firm has been in business.)

A-17. Has there been more than one occasion during the last five years in which the

General Building Contractor or its associates was required to pay either back wages or penalties for failure to comply with the state’s prevailing wage laws?

Yes No

If ”yes,” attach a separate page, describing the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed, the number of employees who were initially underpaid and the amount of back wages and penalties that were assessed.

A-18. During the last five years, has there been more than one occasion in which the

General Building Contractor or its associates have been penalized or required to pay back wages for failure to comply with the Federal Davis-Bacon prevailing wage requirements?

Yes No

If ”yes,” attach a separate page, describing the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed; the number of employees who were initially underpaid and the amount of back wages and penalties that were assessed.

A-19. If the General Building Contractor operates its own State-approved apprenticeship

program, provide the following information on a separate page:

(a) Identify the craft or crafts in which you provided apprenticeship training in the past year.

40

(b) State the year in which each such apprenticeship program was approved,

and attach evidence of the most recent California Apprenticeship Council approval(s) of your apprenticeship program(s).

(c) State the number of individuals who were employed by your firm as

apprentices at any time during the past three years in each apprenticeship and the number of persons who, during the past three years, completed apprenticeships in each craft while employed by your firm.

A-20. At any time during the last five years, has the General Building Contractor or its

associates been found to have violated any provision of California apprenticeship laws or regulations, or the laws pertaining to use of apprentices on public works?

Yes No If “yes”, provide the date of the findings and attach a copy of the final decision. _____________________________________________ Date of Findings

A-21. Do agreements exist between the General Building Contractor and registered

apprenticeship programs which have been approved by the California Apprenticeship Council and have graduated apprentices in the preceding five years, for all apprenticable crafts which may be employed by the General Contractor on this project? (This graduation requirement shall not apply to programs providing apprenticeship training for any craft that has not been deemed by the Department of Labor and the Department of Industrial Relations to be an apprenticable craft within the period of June, 1999 to June, 2003.) Yes No

A-22. Has the General Building Contractor built facilities with a project value of at least

$10M for higher education institutions in the last 5 years?

Yes No

Number of Projects__________ Largest Project____________ List five most relevant Projects and complete Project Data Sheets.

A-23. Please fill in the following blanks based on the General Building Contractor’s

attached financial statement:

41

Curent Assets: $________________ Curent Liabilities: $________________ Total Net Worth: $________________ Current Ratio (Assets/Liabilities): $________________ Working Capital (Current Assets - Current Liabilities): $________________ Submit the latest audited financial statement for the General Contractor’s previous fiscal year.

A-24. Has the General Building Contractor completed a project that was LEED certified

in the past 5 years?

Yes No

Number of Projects__________ Largest Project____________ A-25. Has the General Building Contractor completed a Design-Build project approved

by the Division of State Architect?.

Yes No

42

III (B). SCORED QUESTIONS FOR THE ARCHITECT OF RECORD Definitions:

• “Architect of Record” shall mean the licensed design professional whose stamp will appear on project documents. The Architect of Record is required to be licensed in the State of California.

Name of Architect of Record: Name of Firm: B-1. How many years has the Architect of Record been licensed and practicing in

California? Years: ________________ B-2. Has the Architect of Record or the firm ever been denied an award of a public

works contract based on a finding by a public agency that they were not a responsible bidder?

Yes No


B-3. In the past five years has any claim in excess of $50,000 been filed in court or

arbitration against the Architect of Record or the firm concerning its design work on a project?

Yes No

If “yes”, on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution).

B-4. In the past five years has the Architect of Record or the firm, made any claim in

excess of $50,000 against a project owner concerning its architectural work on a project and filed that claim in court or arbitration?

Yes No

43

If “yes”, on separate page identify the claim by providing the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution).

B-5. In the last five years has any insurance carrier, for any form of insurance, refused

to renew an insurance policy for the Architect of Record or the firm, based on non-payment or losses?

Yes No

If “yes”, on separate page give name the insurance carrier, the form of insurance and the year of the refusal.

B-6. Has the Architect of Record, any of the corporate officers, partners, or the firm

ever been convicted of a crime involving any federal, state, or local law related to construction?

Yes No

If “yes”, on a separate page identify who was convicted, the name of the victim, the date of the conviction, the court and case number, the crimes, and the grounds for the conviction.

B-7. Has the Architect of Record, any of the corporate officers, partners, or the firm

ever been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty?

Yes No

If “yes”, on a separate page identify the person or persons convicted, the court and case number, the crimes and the year convicted.

B-8. Has the Architect of Record designed facilities costing more than $10M for higher

education institutions over the last five (5) years?

Yes No

Number of Projects________ Largest Project____________ List three most relevant projects and complete three Project Data Sheets.

44

B-9. Has the Department of Consumer Affairs taken any disciplinary action against the Architect of Record?

Yes No

If yes, please explain on a separate page.

B-10. Has the Architect of Record completed a project that was LEED certified in the

past 5 years?

Yes No

Number of Projects__________ Largest Project____________

B-11. Does the Architect currently employ USGBC LEED accredited professionals?

Yes No

If yes, identify up to 5 who may be involved in the design of the Project:

Name Year Accredited

B-12. Has the Architect of Record completed a Design-Build project approved by the

Division of State Architect?

Yes No

45

III (C). SCORED QUESTIONS FOR THE PRINCIPAL ENGINEER Definitions:

• Principal Engineer shall mean the licensed design professional whose stamp will appear on project documents. Principal Engineers are required to be licensed in the State of California.

• Attach copies of Section III (C) for each Principal Engineer that the Design-Build Entity seeks to submit for prequalification.

Name of Principal Engineer: Name of Firm: C-1. How many years has the Principal Engineer been licensed and practicing in

California? Years: ________________ C-2. Has the Principal Engineer or the firm ever been denied an award of a public

works contract based on a finding by a public agency that they were not a responsible bidder?

Yes No


C-3. In the past five years has any claim in excess of $50,000 been filed in court or

arbitration against the Principal Engineer or the firm concerning its design work on a project?

Yes No

If “yes”, on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution).

C-4. In the past five years has the Principal Engineer or the firm, made any claim in

excess of $50,000 against a project owner concerning its architectural work on a project and filed that claim in court or arbitration?

46

Yes No

If “yes”, on separate page identify the claim by providing the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution).

C-5. In the last five years has any insurance carrier, for any form of insurance, refused

to renew an insurance policy for the Principal Engineer or the firm, based on non-payment or losses?

Yes No

If “yes”, on separate page give name the insurance carrier, the form of insurance and the year of the refusal.

C-6. Has the Principal Engineer any of the corporate officers, partners, or the firm ever

been convicted of a crime involving any federal, state, or local law related to construction?

Yes No

If “yes”, on a separate page identify who was convicted, the name of the victim, the date of the conviction, the court and case number, the crimes, and the grounds for the conviction.

C-7. Has the Principal Engineer any of the corporate officers, partners, or the firm ever

been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty?

Yes No

If “yes”, on a separate page identify the person or persons convicted, the court and case number, the crimes and the year convicted.

47

C-8. Has the Principal Engineer designed facilities costing more than $10M for

California institutions of higher education in the last 5 years?

Yes No Number of Projects______________ Largest Project________________

List the three most relevant projects and complete a project Data Sheet for the most relevant

C-9. Has the Department of Consumer Affairs taken any disciplinary action against the

Principal Engineer?

Yes No


C-10. Has the Principal Engineer completed a project that was LEED certified in the past 5 years?

Yes No


48

III (D). SCORED QUESTIONS FOR THE ELECTRICAL, MECHANICAL, AND OTHER DESIGN-BUILD SUBCONTRACTOR(S)

Attach copies of Section III (D) for each Electrical, Mechanical, and other Design-Build Subcontractor(s) to be considered for eligibility to bid as a Subcontractor in the Request for Proposals. Definitions: The term “Associates” shall mean any of the following:



prequalification. Subcontractor Name: Discipline/Trade/Craft D-1. How many years has the Subcontractor been licensed in California? Years: ____________________ D-2. At any time in the last five years has the Subcontractor or its associates been

assessed liquidated damages of more than $50,000 on a construction contract with either a public or private owner?

Yes No

If yes, explain on a separate page, identifying all such projects by owner, owner’s address, name of entity against whom assessment was made, the date of completion of the project, amount of liquidated damages assessed and all other information necessary to fully explain the assessment of liquidated damages.

D-3. In the past five years has the Subcontractor or its associates ever defaulted on a

contraction contract?


49

D-4. Has the Subcontractor or its associates ever been denied an award of a public works contract based on a finding by a public agency that they were not a responsible bidder?

Yes No


(NOTE: The following two questions refer only to disputes between contractors and owners of projects. You need not include information about disputes with suppliers or other contractors.

D-5. In the past five years has any claim in excess of $50,000 been filed in court or

arbitration against the Subcontractor or its associates concerning their work on a construction project?

Yes No

If “yes”, on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution).

D-6. In the past five years has the Subcontractor or its associates made any claim in

excess of $50,000 against a project owner or a General Contractor concerning work on a project or payment for a contract and filed that claim in court or arbitration?

Yes No

If “yes”, on a separate page identify the claim by providing the name of claimant, the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution).

D-7. In the last five years has any insurance carrier, for any form of insurance, refused

to renew the insurance policy for the Subcontractor or its associates due to non-payment or contractor losses?

Yes No

If “yes”, on a separate page give name of the insured, name the insurance carrier, the form of insurance, and the year of the refusal.

50

D-8. Has the Subcontractor, any of the corporate officers, partners, or its associates

ever been convicted of a crime involving any federal, state, or local law related to construction?

Yes No

If “yes”, explain on a separate page, including identifying who was convicted, the name of the victim, the date of the conviction, the court and case number, the crimes, and the grounds for the conviction.

D-9. Has the Subcontractor any of the corporate officers, partners, or its associates ever

been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty?

Yes No

If “yes”, identify on a separate page the person or persons convicted, the court and case number, the crimes, and the year convicted.

D-10. During the last five years, has there ever been a period of time when the

Subcontractor or its associates had no surety bond in place during a public construction project when one was required?

Yes No

If yes, indicate the period during which no surety bonds were in place, name of entity without surety bond, the name of project owner, and if coverage was denied the date coverage was denied and the name of the company that denied coverage.

D-11. Has CAL OSHA cited and assessed penalties against the Subcontractor or its

associates for any “serious,” “willful” or “repeat” violations of its safety or health regulations in the past five years?

(NOTE: If you have filed an appeal of a citation, and the Occupational Safety and Health Appeals Board has not yet ruled on your appeal, you need not include information about it.)

Yes No

If “yes”, on separate page describe the citations, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any OSHA decision.

51

D-12. Has the Federal Occupational Safety and Health Administration cited and assessed penalties against the Subcontractor or its associates in the past five years?

(NOTE: If an appeal of the citation has been filed and the Appeals Board has not yet ruled, or if there is a court appeal pending, you need not include information about the citation.)

Yes No


D-13. Has the EPA or any Air Quality Management District or any Regional Water

Quality Control Board cited and assessed penalties against either the Subcontractor, its associates, or the owner of a project during the time in which the preceding parties were performing on a contract in the past five years?

(NOTE: If an appeal of the citation has been filed and there is no ruling yet, or if there is a court appeal pending, you need not include information about the citation.)

Yes No


D-14. How often does the Subcontractor require documented safety meetings to be held

for construction employees and field supervisors during the course of a project?

________________________________________ D-15. List the Subcontractor’s Experience Modification Rate (EMR) (California

workers’ compensation insurance) for each of the past three premium years: (NOTE: An Experience Modification Rate is issued to your firm annually by your workers’ compensation insurance carrier.)

Year: EMR: Year: EMR:

52

Year: EMR:

If your EMR for any of these three years is or was 1.00 or higher you may attach a letter of explanation.

D-16. Within the last five years has there ever been a period when the Subcontractor or its associates had employees but was without workers’ compensation insurance or state-approved self-insurance?

Yes No

If “yes”, please explain the reason for the absence of workers’ compensation insurance on a separate page. If “No,” please provide a statement by your current workers’ compensation insurance carrier that verifies periods of workers’ compensation insurance coverage for the Subcontractor for the last five years. (If the Subcontractor has been in business for less than five years, provide a statement by your workers’ compensation insurance carrier verifying continuous workers’ compensation insurance coverage for the period that your firm has been in business.)

D-17. Has there been more than one occasion during the last five years in which the

Subcontractor or its associates was required to pay either back wages or penalties for failure to comply with the State’s prevailing wage laws?

Yes No


D-18. During the last five years, has there been more than one occasion in which the

Subcontractor or its associates have been penalized or required to pay back wages for failure to comply with the Federal Davis-Bacon prevailing wage requirements?

Yes No


D-19. If the Subcontractor operates its own State-approved apprenticeship program,

provide the following information on a separate page:

53

(a) Identify the craft or crafts in which you provided apprenticeship training in the past year.

(b) State the year in which each such apprenticeship program was approved,

and attach evidence of the most recent California Apprenticeship Council approval(s) of your apprenticeship program(s).

(c) State the number of individuals who were employed by your firm as

apprentices at any time during the past three years in each apprenticeship and the number of persons who, during the past three years, completed apprenticeships in each craft while employed by your firm.

D-20. At any time during the last five years, has the Subcontractor or its associates been

found to have violated any provision of California apprenticeship laws or regulations, or the laws pertaining to use of apprentices on public works?

Yes No

If “yes”, provide the date of the findings and attach a copy of the final decision. _____________________________________________ Date of Findings

D-21. Do agreements exist between the Subcontractor and registered apprenticeship

programs which have been approved by the California Apprenticeship Council and have graduated apprentices in the preceding five years, for all apprenticable crafts which may be employed by the Subcontractor on this project? (This graduation requirement shall not apply to programs providing apprenticeship training for any craft that has not been deemed by the Department of Labor and the Department of Industrial Relations to be an apprenticable craft within the period of June, 1999 to June, 2003.) Yes No

D-22. Has the Subcontractor performed on a contract to construct a $10M or larger

facility for California higher education institutions within the last 5 years?

Yes No Number of Projects ________________ Largest Project______________ List three most relevant projects and complete a Project Data Sheet for the most relevant project

54

D-23. Has the Subcontractor completed a project that was LEED certified in the past 5 years?

Yes No


D-24. Has the Subcontractor’s Principal Engineer designed facilities costing more than $10M for California institutions of higher education in the last 5 years?

Yes No

Number of Projects______________ Largest Project________________

List the three most relevant projects and complete a project Data Sheet for the most relevant

D-25. Has the Department of Consumer Affairs taken any disciplinary action against the

Subcontractor’s Principal Engineer?

Yes No


D-26. Has the Subcontractor’s Principal Engineer completed a project that was LEED certified in the past 5 years?

Yes No

55

IV. RECENT CONSTRUCTION PROJECTS COMPLETED 1. How many comparable projects have the Design-Build Entity, General Contractor

and Architect of Record worked on together over the past 5 years?,

2. How many comparable design-build projects have the Design-Build Entity, General Contractor, Architect of Record involved in this Design-Build Entity ever worked together on?

3. For the projects over the past 5 years, list volume of construction, number of design-build projects and value of largest design-build project, which the Design-Build Entity, General Contractor, Architect of Record, Principal Engineer(s), Electrical, Mechanical, and other Design-Build subcontractors have worked on, not necessarily together.

Organization Volume D-B Number Largest D-B Project

4. Provide information on the quantity of most relevant projects from the listed

Design-Build Entity Team using the following project information form :

Organization Number Design-Build Entity 1 General Building Contractor 5 Architect of Record 3 Principal Engineer-Each 1 Subcontractors- Each 1

56

PROJECT INFORMATION SHEET DESIGN BUILD ENTITY, GENERAL CONTRACTOR AND

SUBCONTRACTORS VERIFY ALL CONTACTS PRIOR TO SUBMITTAL. Firms are advised that the District reserves the right to verify all Project information submitted below. It is the Firms’ responsibility to ensure contacts are available to District for verification. Material inaccuracies may result in reduced qualification scores and dis-qualification. Do not leave any spaces blank. Responses such as “N/A” are not acceptable. If not applicable, state “Not Applicable” and explain why. If none, state “NONE.”

Reference Information:

Project Name: Project or Contract Number:

Project Location: , , Street Address City & State Zip Code

Owner Information: Owner’s Name Contract Person Title Address: , , Street Address City & State Zip Code Telephone: Facsimile: Email:

Firms’ Office that Performed the Work:

, , Street Address City & State Zip Code

Firm’s Project Manager for project:

Firm’s Superintendent for project:

Did Contractor self-perform any work? YES NO If yes, list trades:

57

Design Firm: Contact Person Title Address: , , Street Address City & State Zip Code

Telephone: Facsimile: Email:

Name of Design Firm’s Project Manager for project:

Contract Time: Start Date: Scheduled Completion Date: Month/Day/Year Month/Day/Year Actual Completion Date:

Days Extended due to Unexcused Delays:

Month/Day/Year Contract Amount:

$ $ $ Base Amount Adjustment Due to Change Orders Final Contract Amount

Project Information Was the project a Design-Build project? Yes No

Type of Project: Educational Classroom, Computer Lab

Other: __________________________

Type of Owner: Public Private

Other: __________________________

What was the building area of the project (square footage)? _________________SF

Was the project built in California? Yes No

Did the project achieve USGBC LEED Certification ? If so, Certification Level___________

Yes No

Project Description: (Provide a brief description including project photo)

58

Team Member Performed on this project team Do not

mark in this column

Architect Yes No General Building Contractor

Yes No

Design-Build Entity’s Subcontractors (insert your list):

Yes No Yes No Yes No

59

PROJECT INFORMATION SHEET ARCHITECT AND PRINCIPAL ENGINEER

VERIFY ALL CONTACTS PRIOR TO SUBMITTAL. Firms are advised that the District reserves the right to verify all Project information submitted below. It is the Firm’s responsibility to ensure contacts are available to District for verification. Material inaccuracies may result in reduced qualification scores and disqualification. Do not leave any spaces blank. Responses such as “N/A” are not acceptable. If not applicable, state “Not Applicable” and explain why. If none, state “NONE.”

Project Name: Project or Contract Number:

Project Location: , , Street Address City & State Zip Code

Owner Information: Owner’s Name Contact Person Title Address: , , Street Address City & State Zip Code Telephone: Facsimile:

Email:

Address of Firms’ Office that Performed the Work:

, , Street Address City & State Zip Code

Name of Firm’s Project Manager for project:

Contractor:

Contact Person:

Address: , , Street Address City & State Zip Code Telephone: Facsimile: Email:

60

Schedule Information Start Date: Scheduled Completion Date: Month/Day/Year Month/Day/Year Actual Completion Date:

Days Extended due to Unexcused Delays:

Month/Day/Year Project Cost Information

$ $ $ Base Amount Adjustment Due to Change Orders Final Contract Amount Was the project a Design-Build project? Yes No

Type of Project: Educational

Classroom, Computer Lab

Other: __________________________

Type of Owner:

Public Project

Private Project Other ____________________

What was the building area of the project (square footage)? ______________________SF

Was the project built in California? Yes No

Did the project achieve USGBC LEED Certification ? If so, Certification Level___________ Yes No

Project Description: (Provide a brief description including project photo)

Team Member Performed on this project team Do not

mark in this column

Architect Yes No General Building Contractor

Yes No

Principal Engineers Yes No Subcontractors Yes No

Yes No Yes No

61

PART V: KEY PERSONNEL V. Provide resumes of key personnel from the Design-Build Entity Team

62

PART VI: DECLARATION Under Penalty of Perjury Part VI requires verification under oath by the Design-Build Entity, General Building Contractor, Architect of Record, Principal Engineer(s) and Listed Subcontractors that the information contained in this Pre-Qualification Application relating to their firm is correct and complete to the best of their knowledge. The District will not review Pre-Qualification Applications that do not contain signed verifications from each of the Design-Build Entity firms included in this Pre-Qualification Application. I, the undersigned ____________________________________________, certify and declare that I have read all the foregoing answers to this Pre-Qualification Application; that all responses are correct and complete of my own knowledge and belief. I declare under penalty of perjury under the laws of the State of California, that the foregoing is true and correct.

(Signature of Individual that may legally bind the Firm)

(Printed name)

(Place of Execution)

(Date)

(Firm)

63

The rating of the Design-Build Entity will be based on the scores for the individual sections of the questionnaire. The successfully qualified Design-Build Entity must separately pass all three scored sections in the Pre-qualification Questionnaire: II Essential Requirements for the Design-Build Entity, III Scored Questions, IV Recent Projects Completed and V Proposed Key Staff.

Pre-Qualification Questionnaire: Part I

Information About the Design-Build Entity Members This part seeks information about the makeup of the Design-Build Entity, and is for identification purposes only.

Pre-Qualification Questionnaire: Part II

Essential Requirements for the Design-Build Entity This part seeks information about various members of the Design-Build Entity, and consists of qualify and don’t qualify questions. All questions must be answered correctly or the Design-Build Entity will be disqualified. If the Design-Build Entity is unable to correctly answer each of these questions, it will be disqualified regardless of the results of the scored questions.

Question #

Yes

No

Score

1 0 1 2 0 1 3 0 1 4 0 1 5 0 1 6 1 0 7 1 0 8 1 0 9 1 0 10 0 1 11 0 1 12 1 0 13 0 1 14 0 1 15 0 1 16 0 1 17 1 0 18 1 0 19 1 0 20 1 0 Total Score

Pre-Qualification Questionnaire: Part III

Scored Questions Part III (A) Scored Questions for the General Contractor

A minimum score of 100 must be attained or the General Contractor will be rated as not qualified which in turn disqualifies the Design-Build Entity. A score between the minimum and the maximum will be combined with the scores of the other parts to determine the total score for the Design-Build Entity. III (A) Scored Questions for the Contractor Question #

Quantity

Yes

No

Score

A-1

5 yrs or less = 0 pts 6 yrs = 1 pts 7 yrs = 3 pts 10 yrs + = 5 pts

N/A

N/A

A-2

0-1 Projects = 10 pts 2 Projects = 3 pts More than 2 Projects = 0 pts

N/A

N/A

A-3

N/A

0

5

A-4

N/A

0

5

A-5

5 pts for 0 or 1 instance 3 pts for 2 instances 0 pts for more than 2 instances

N/A N/A

A-6


N/A N/A

A-7

N/A

0

5

A-8

N/A

-10

5

A-9

N/A

-10

5

A-10

N/A

0

10

Question #

Quantity

Yes

No

Score

A-11


N/A

N/A

A-12


N/A N/A

A-13

5 pts for 0 to 1 instance 3 pts for 2 instances 0 pts for more than 2 instances

N/A N/A

A-14

10 pts for at least once a week 5 pts for every two weeks 0 pts for less than every two weeks

N/A N/A

A-15

10 pts for .85 or less 5 pts if between .86 and 1.00 0 pts for greater than 1.00

N/A N/A

A-16

5 pts for 0 instance 0 pts for greater than 0

N/A N/A

A-17

5 pts for 0 to 2 instances 3 pts for 3 instances 0 pts for more than 3 instances

N/A N/A

A-18


N/A N/A

A-19

N/A

N/A N/A

A-20


N/A N/A

A-21 N/A 5 0 A-22

0-2 Contracts = 0 pts 3-5 Contracts = 5pts 6+ Contracts = 10 pts

N/A N/A

A-23a NET WORTH Less than $4 mil = 0 pts $4 mil to $12 mil = 3 pts Over $12 mil = 5pts

N/A N/A

A-23b CURRENT RATIO Less than 1.0 = 0 pts 1 to 1.15 = 3 pts Over 1.15 = 5 pts

N/A N/A

A-23c WORKING CAPITAL Less than $3 mil = 0 pts $3 mil –$10 mil = 3 pts

N/A N/A

Question #

Quantity

Yes

No

Score

Over $10 mil = 5 pts A-24 0-2 Contracts = 0 pts

3-5 Contracts = 5pts 6+ Contracts = 10 pts

N/A N/A

A-25 10 0

Part III (B) Scored Questions for the Architect of Record A minimum score of 50 must be attained or the Architect will be rated as not qualified which in turn disqualifies the Design-Build Entity. A score between the minimum and the maximum will be combined with the scores of the other parts to determine the total score for the Design-Build Entity. Question #

Quantity

Yes

No

Score

B-1


N/A

N/A

B-2

5 pts for 0 instances 3 pts for 1-3 instances 0 pts for more than 3 instances

N/A N/A

B-3

5 pts for 0 instances 3 pts for 1- 2 instances 0 pts for more than 2 instances

N/A N/A

B-4


N/A

N/A

B-5

N/A -10

5

B-6 N/A

-10 5

B-7 N/A

-10 5

B-8 0 pts for 0-2 Projects 3 pts for 3-6 Projects 10 pts for 7+ Projects

N/A N/A

B-9 N/A

0 10

B-10

0 pts for 0-2 Projects 3 pts for 3-6 Projects 10 pts for 7+ Projects

N/A

N/A

B-11

N/A 5 0

B-12

N/A 10 0

Total Score (Disqualified if less than 50)

Part III (C) Scored Questions for the Principal Engineer(s) The maximum possible score for Part III (C) is 75. A minimum score of 45 must be attained or the principal engineer will be rated as not qualified which in turn disqualifies the Design-Build Entity. A score between the minimum and the maximum will be combined with the scores of the other parts to determine the total score for the Design-Build Entity. Question #

Requirements/Questions

Yes

No

Score

C-1


N/A

N/A

C-2


N/A

N/A

C-3


N/A

N/A

C-4

5 pts for 0 instances 3 pts for 1-3 instances 0 pts for more than 3 instances

N/A

N/A

C-5

N/A

-10

5

C-6 N/A

-10 5

C-7 N/A

-10 5

C-8 0 pts for 0-2 Projects 3 pts for 3-6 Projects 10 pts for 7+ Projects

N/A N/A

C-9 N/A

-10 5

C-10 0 pts for 0-2 Projects 3 pts for 3-6 Projects 10 pts for 7+ Projects

N/A N/A

Total Score (Disqualified if less than 40 )

Part III (D) Scored Questions for the Subcontractor(s) The Design-Build Entity must include mechanical and electrical contractors and other Design-Build Subcontractors. The Design-Build Entity can propose several alternative subcontractors. Each alternative subcontractor should be scored. A minimum score of 90 must be attained or the Subcontractor will be rated as disqualified. All alternative subcontractors must be disqualified in order to disqualify the Design-Build Entity. Question #

Quantity

Yes

No

Score

D-1


N/A

N/A

D-2

0-1 Projects = 10 pts 2 Projects = 3 pts More than 2 Projects = 0 pts

N/A

N/A

D-3

N/A

0

5

D-4

N/A

0

5

D-5


N/A N/A

D-6


N/A N/A

D-7

N/A

0

5

D-8

N/A

-10

5

D-9

N/A

-10

5

D-10

N/A

0

10

D-11


N/A

N/A

D-12


N/A N/A

D-13

5 pts for 0 to 1 instance 3 pts for 2 instances 0 pts for more than 2 instances

N/A N/A

Question #

Quantity

Yes

No

Score

D-14

10 pts for at least once a week 5 pts for every two weeks 0 pts for less than every two weeks

N/A N/A

D-15

10 pts for .85 or less 5 pts if between .86 and 1.00 0 pts for greater than 1.00

N/A N/A

D-16

5 pts for 0 instance 0 pts for greater than 0

N/A N/A

D-17


N/A N/A

D-18


N/A N/A

D-19

N/A

N/A N/A

D-20


N/A N/A

D-21 N/A 5 0

D-22

0-3 Contracts = 0 pts 4-9 Contracts = 3pts 10+ Contracts = 10 pts

N/A N/A

D-23

N/A 5 0

D-24

0-1 Contracts = 0 pts 2-5 Contracts = 5 pts 6+ Contracts = 10 pts

N/A N/A

D-25

N/A 5 0

D-26

N/A 5 0

Total Score (Disqualified if less than 90)

Part 4- Relevant Experience (Recent Construction Projects Completed) The General Contractor (GC) must provide the five (5) most relevant projects, three (3) from the Architect of Record (AR) plus one (1) project from each Principal Engineer (PE) and each listed Subcontractor (Elec/Mech). Firm

Requirement / Question

Score

DB-4.1 Joint Projects 1-10 Pts DB-4.2 Joint D-B Projects 1-20 pts DB 4.3 Joint Experience 1-5 pts GC-1

Relevance- 1-5 pts Cost/Schedule Performance 1-5 pts Team Member Involvement 0-5 pts

GC-2


GC-3


GC-4


GC-5


AR-1


AR-2 Relevance- 1-5 pts Cost/Schedule Performance 1-5 pts Team Member Involvement 0-5 pts

AR-3 Relevance- 1-5 pts Cost/Schedule Performance 1-5 pts Team Member Involvement 0-5 pts

PE-1 Relevance- 1-5 pts Team Member Involvement 0-5 pts

PE-2 Relevance- 1-5 pts Team Member Involvement 0-5 pts

Elec-1 Relevance- 1-5 pts Team Member Involvement 0-5 pts

Mech-1 Relevance- 1-5 pts Team Member Involvement 0-5 pts

Part 5- Proposed Staff Experience (Key Personnel) The Design-Build Entity must provide the listed key staff from the General Contractor, Architect of Record plus one person from each Principal Engineer and listed Subcontractors. Firm

Requirement / Question

Score

GC-1 Project Manager

Relevant Projects- 1-5 pts Years of Experience 1-5pts Years in Role 0-5 pts

GC-2 Constr Manager

Relevant Projects- 1-5 pts Years of Experience 1-5 pts Years in Role 0-5 pts

GC-3 Superin-tendent


AR-1 Project Manager


AR-2 Design Architect


AR-3 Const Adm Manager


PE-1 Project Engineer


Elec-1 Proj Mgr

Relevant Projects- 1-5 pts

Elect-1 Designer


Mech-1 Proj Mgr


Mech-1 Designer


Other Sub Proj Mgr


Other Sub Designer


SUMMARY Part Discipline Scoring Qualified-Yes/No 2 Design/Build Entity N/A 3 General Contractor Architect of Record Principal Engineer Electrical Subcontractor Mechanical Subcontractor Design/Build Subcontractors 4 Design/Build Entity General Contractor Architect of Record Principal Engineer Electrical Subcontractor Mechanical Subcontractor Design/Build Subcontractors 5 General Contractor Architect of Record Principal Engineer Electrical Subcontractor Mechanical Subcontractor Design/Build Subcontractors 6 Design/Build Entity N/A Total Score

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