HomeMy WebLinkAboutAgenda Bill 5.C-Attch1 08/16/2004a
Request for Qualification, from, Interested
General Contract®irs and Electrical Subcontractors
and.
Invitati®n,to .Submit Prequalification Packages
for
THE- CITY OF PETALLTMA
ELLISCREEK, WATER I�E`CYCLING"FACILIT'Y
August 2004
•
Requ.604or Qualifications. from 'Interested�
Generavl. Contractors and Electrical Subcontractors_
For the City,of Petaluma,
Ellis. -Creek Water Recycling Facility
NOTICE IS HERE BY GIVEN; that Prequalification Packages will be ,r',eceived on October.,.7,
2004 ;at the hour of 2:00 P M::by, the ,Ci't-y Clerk of the City of ;Petaluma °at the City Clerk's
office ,at City Hall; 1.1 English,"S,treet, Petaluma, CA', "94952=2610; for prequalification to
participate in bidding for, the";contract to con_'stru_ cf theI.Elhs Creek, Water;Recyclirig°Facility, 4100
Lakeville Highway, Petaluma, CA "(Project No C500402) (hereafter ``Project"). General
Contractors and electrical' subcontractors who wish to, participate: in."bidding for the, contract to
construct the Project ;must subm completed Prequalification Packages (hereafter "Package") on
the forms , included herein ,.-Only general :contractors and, electrical subcontractors that . submit
completed Packages and meet' ;the ,City's ;prequal"ificatidh requirements will be eligible. Ao
participate in bidding_ for the contract 'to construct the'Project..General.'contractors will only be
able to list re ualified �� bco_ntractors in their bid f p q or the electrical portion :of 'the project.
Completed Packages ,'including one ongiriaI' and six copies of tlie;Package, maybe delivered or
mailed"to Petaluma's City, Clerk's office at ,the above address, 'and:must;bereceived by the date
and time above in ,order to be, considered. Subject to conditions ,prescribed in the Package,'
, ,general contractors and electrical' subcontractors are invited 'to ' apply ,for prequalification to bid
on the Project.
PROJECT: A single cor tract'will .be, awarded for construction of the .Project. The proposed
Work is generally described as fohows: Ellis Creek Water,Recycling Facility (WRIT) including, a
complete new `facility for^ wastewater' treatment including screening and vortex,. grit removal,
Oxidations Ditches, ,Secondary Clarifiers; Tertiary, Filters, UV' disinfection, hypochlorite
k. ,, , T p g
disinfection, existingpondNimprovements 'treatment;' and olislun wetlands. Project includes all
architectural, civil;. mechanical 'structural, electrical and ,instrum'entation elements for new
facility. Other mortk includes: Lakeville Highway improvements, SCADA and PLC system. The
construction cost;:of the WRF is,estirnated, at-.$60 to $70' million.
Progress .Specification and Drawings' for the 'WRF ,are ,availabl'e..f6r review at the Cit'y's Water
Resources and Conservation Deb_ artment, 1,1 English Street, Petaluma; CA 94952. Ms. Darlene
Riley is accepting appointments to review the document, for the City .of Petaluma. ''Her 'phone
number is (707) 778 45,85. Review ,can also be. conducted at the offices of the Construction
Manager, The Covello ,Group,. Me,.,, 1660 Olympic Blvd,,.�Suite ,3-00, Walnut_'Creek;, CA -94596.
,Ms. Cindy Park is� accepting appointments to review the,documents for The Covello.,Group. Her
phone _number i°s(925) 933=23'00. Review c"an"also be ,conducted at the offices ofI the Designer,
Carollo Engineers,; -2700 Ygnacio Valley Road, Suite 300, Walnut Creek, CA 94598. Review
hours are 8:00 am - 5:0;0 pm, Monday°,through Friday on a first come first serve basis.
Date:
;Milestone:
October 7, 2004
Prequalificati'ori Packages Due
November 2, 2004.
Notices to Prequalified. Firms
December 1, 2004
Advertise,for=Bids
February 1, 2005
'O.pen;Bids
March 7, 200'5
Award. Construct*'
March 2008
Construction/Startup Complete
This 'Prequalification Package is specific to the Project, and:is not.a qualification for°performing
other City projects or City projects in general.
Each general contractor "and electrical subcontractor wishing "to submit a: h" d for the Pro' ect must
fully complete the,Package, provide all.materials requested and satisfy,the:minimum.
prequalification criteria.
The City has. determined that•general contractors b'idding on the.:Projecf must have a Class A
contractor's license inorder ,to be eligible for an -award of the co_ritract., Electrical subcontractors
bidding -on the :Project must.have a C-10 contractor's license. Any bidder or contractor iot so
licensed maybe subject tof'afflegal penalties imposed by law,,including; but;no"_t limited to —an
appropriate disciplinary action by the Contractors' ;State License Board. .
The completed Packages, are riot • public. records' and are -not open to bubl'c -inspection. All
information ,provided will be kept confidential .to the extent permitted, by law. The City, of
Petaluma reserves, the right to reject any and all completed Packages ;and to. waive any
irregularities in ,the information contained therein.
Each package must 'be signed' under penalty of perjury by an. 'individual who has the legal
authority to bind Ithe entity, submitting the Package, or on whose behalf that person is signing.
The City rnust receive 'all Packages and materials requested therein by the date and time �sei forth
above. A- Package received after that time will ,not be considered and the contractor on whose
belia'1`f it is submitted will` not be eligible to bart`ic'ip
ate in bidding -for the.coi tract to construct the
Proj ect.
Prospective General' Contractors and Electrical Contractors may obtain, one set of
prequalification docurments at no cost at the Water; Resources and Conservation 'Department
office, l l English Street; Petaluma, CA 94952-261.0. You may also order a. copy by -calling "the
Department of Water Resources and Conservation.at (707) 778-4304.
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The City shall;not be liable'for any costs incurred by contractors in the preparation. and submittal
of responses to ihis,Request for!Qualif cations:
A mandatory Prequal'ification Package Conference Will ;be held on September 15,'20:04 :at 10:00
a.m. at. the 'City of Petaluma's Council .Chambers, 'located at 11 English <Street, Petaluma,
California. Representatives from the City,, The Covello Group (the City's Construction
Manager) and Carollo Engineers (the City's Design "Engineer) will bey available to discuss the
Project, at, this conference. Al interested contractors are required,to attend. No. site visits will be
given but an overview of the- roeet site, Will be resented at'the .Conference.
g P T p
The City of Petaluma, greatly appreciates your interest' in this project and looks forward to
receiving your responses.
Date
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Michael T. Ban; P:E_ Director
Water. Resources; and, Conservation Deparhiient
a.
CITY OF PETALUMA
ELLIS, CREEK WATER RECYCLING
LIN G FACILITY
PrequAification. Package
Table of'Cbfti&nts
e
Instructions
Questionnaire
Part-1: Essential Requirements, for, Qualification
Part II:'
A:. Current Organization and'Structure, of Business.
B. History of the Business!,an &Drganiizational Perf6rfnanc I e
C Licenses
D. -Disputes
E. Criminal Matters andR6lAted Civil Suits
F. Bonding
G. Compliance with Occupational, Safety and Health- Laws
H. Prevailing Wage and, A i �rent cesmT) Compliance Record
Part III: Recent Construct.ion."Proj ects Completed
Part IV: Current Status of Open Contracts
Part V: Project Personnel Ekberiefice
Part VI: Project Personnel' Experience :(Badkup),-
Affidavit
Attachments:
No. 1: Liability and Insurance
No. 2: EMR Criteria
No. 3: Affidavit of Saf6ty Com-phance
Prequalification Evaluation
Project Experience Interview Questions*
(1) Complete" and subn'uft this'- page with the pyequalification', package
to indicate completion ;and incorporation'of',6ich of the'lisied items
with this package.
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Page
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9
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to
11
12
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14.
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Initial Each
Item (1)
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Instructions' for Coinpletion of
General 'Contractor and Electrical Subcontractor
Prequalification Packages
Instructions to Prospective Bidders':
Each general contractor and electrical subcontractor _wishing to .participate in bidding for. the
'contract to construct the Petaluma Ellis Creek_ Water Recycling Facility Project,, (hereafter
"Project") must fully complete the Questionnaire included.* with this Package, provide all
information and materials requested, and satisfy the prequalification criteria. Attach additional
sheets as needed, to provide complete 'responses.
As provided in Public Contract -Code § 20101, completed Packages: and financial information are
not public records and will not be. open to public `inspection. All information provided will be
kept confidential to the extent permitted by law.. The. City of Petaluma (hereafter "City")
reserves the right to reject, any and all submittals and to waive any ,irregularities in the
information contained' herein.
Each Package must be completed with all information requested and be signed under penalty of
perjury by an individual who has the legal, authority to bind the contractor on whose behalf that
person is signing. The City must receive all Packages and material's requested therein by the
date and time stated in the Notice. Packages received after that time will. be' returned- unopened,
and the contractor will. not be eligible to participate in bidding, for the contract to construct the
Project. Incomplete or. unsigned Packages will be returned without review and the contractor
will not be eligible to participate, in bidding for the contract to construct -the Project.
The prequalif cation ,of prospective bidders will be determined by evaluation of the information
submitted by prospective bidders. The City may verify any or all information provided in
completed Prequalification Packages '(hereafter "Package"), consider information provided by
sources -other than the prospective contractor, and conduct"such investigations as the City deems
appropriate to assist in the evaluation of contractor's responsibility; qualifications and financial
capacity.
If the contractor seeking :prequahfication has not been in business for the time period for which
information is requested, it shall submit information on predecessor entities covering that time
period. This requirement applies toi, joint ventures, who shall submit information on each of the
joint venture entities for the specified time period for which 'information is requested.
The City will determine which contractors are responsive to the material terms and conditions of
the Invitation to 'Submit Prequalification Packages.' The City will then determine which .of the
responsive contractors are technically, financially and otherwise qualified and responsible to
perform the Project satisfactorily and who have the capacity to meet all other requirements of the
proposed Project. The City may reject any submitted Packages it determines to be
nonresponsive, or if the City determines; in its sole discretion, that, the contractor is not capable
of .performing the proposed Project satisfactorily_ based upon its review of the contractor's
experience, technical and financial capabilities, or failure to provide information. requested
relating to such determination.
The .City reserves the right to determine that any contractor is not qualified or responsible at any
time before or :after the Packages. are received and .evaluated, if it finds that information provided
in the response to the .Invitation to Submit° Prequalification: Packages is materially inaccurate, or
false; or upon evidence of collusion or other.illegal practices on the'part of a,contractor.
Contractors' (general ,and electrical) who do not:meetthe following, criteria are. not qualified to
submit bids for the contractto construct the Project'and will not be found:resporisible:
(1) have the.correctacense, and
(2) have not had, a,surety°finish work on any contract in the past;five.(5) years, and
(3) provide at least the.minimum insurance,requirements called for in,Attachment No.
1,. and,
(4) have a,modification rate of no more than 0.95 and.have not received any "serious
and willful" violations. of Labor Code§'6300 et seq. in.the;past'five (5)'years.
In addition to requirements 1-4, above, general contractors must also:
for
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have successfully completed "in the past five (5) years at least one ,contract„
construction of a wastewater or other_water treatment plant 'of at least 5MGD,-
with . a minimum bid amount of $35 Million and complexities, similar to the
Project utilizing treatment. processes', similar to those of the Project. The
,electrical, mechanical and -.instrumentation .systems must have been part of that.
contract; and
(.6)
provide 'a written commitment from,a co rI orate surety, licensed t1.o conduct surety,
business in California, to furnish payment and performance bonds in the full
amount of the bid price for the Project; and
(7)
identify a,project manager and superintendent for the_P,roj'ect, ;and their backups,
who have held similar positions in. the, past five (5) years on at least one
wastewater or .other water treatment ,plant construction project of .at least 5MGD
with complexities similar to the Project utilizing treatment processes similar. to
those of theProj ect, .and
(8)
identify anindividual project scheduler .and backup, who have performed
scheduling services in the last five, (5) years ,for construction of :a wastewater or
other public. facility of a size; complexity and duration similar. to the ,Project. In
lieu, of.identifyi'ng such individuals,. identify an entity'.meeting the criteria that will
provide those services.
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In addition to requirementsI, through; 4, above, electrical. subcontractors' must also:
(5) have successfully completed' in the .past f ve (5) years at least onecontract for
construction.,and '.startup. of the electrical system of a wastewater or other water
treatment plant of at :least 5MGDwith. a, minimum electrical bid amount of $5
Million, ', and complexities ,similar to: the .Project utilizing treatment processes
similar'toi�those"of.the.Project; and
(6) identify a superintendent and foreman, for the Project' who. have held similar
positions in the,' past f ve (5) years on at least one wastewater or other water
treatment'plant'construction project of at least'5MGD°with complexities similar to
the Project utilizing treatment processes''similar to those of the Project.
The City,will evaluate all. completed;Packages•on a Pass/Fail basis. Contractors must meet all of
the criteria in order to pass. 'Contractors who do: not'meet'all, of the •criteria will fail and will not
be qualified to participate in bidding for the contract to construct the'Project.
Causes for disqualification or rejectionmay include' but dare °not limited to, the following as
measured by the responses in the Package and other information acquired during the evaluation
of the Package:
1. Lack of ability,,;. capacity or' skill of 'Contractor to perform the contract or to
provide the services; required..
r 2. Lack of ability;.;'capability, or skill,, of Contractor to perform the contract or to
provide' -
,.the services promptly, or. within the . time specified, without delay or
interference.
3. :Lack of ,character, integrity, reputation;; judgment,, experience and efficiency of
Contractor.
4. Inadequate-fperfd=dnce, ofprevious,contracts or, services by Contractor.
5. Lack of coriipliance,,.pt6vious or existing; by Contractormith laws and ordinances
relatingto,,contract& or- services.
6. Insufficient financial resources of Contractor,to perform the contract and provide
the, services.
7. Unaccep'table ,nurrili'er or cope of any conditions attached to the Package by
Contractor.
8: Unacceptable safetyrecord.
t e purpose: of deterniimn , which bidders: ,
The evaluation- ,is solely for • h pure g are qualified to
successfully perform the type ofVork `included in the Project in -a timely manner. 'The contract
for construction -of the;';Project will be :awarded, if at4all,;,;to _he,;responsible, pre=qualified bidder
submitting the lowest; responsive:,`,bid. Neither. issuing the; Invitation to 'Submit .Prequalification
Packages ,nor revi'ewirig ,responses'y 'to,,,.the� "invitation;, nor any other activity related to the
prequalification process, obligates ihe-Cityto award'a contract, for construction'�of the Project to a -
particular contractor; or'at all. „.
The -,City o'f:.Petaluma ,reserves. the right,to reject any'or all Packages, any or all bids, and to
waive any irregularities in'anyPackage submittal or bid received.
3.
If any information provided by a. prospective bidder becomes inaccurate,tthe party who provided
the inforrnation.rnust .immediately notify the City and provide updated accurate information in
writing, and under penalty of perjury.
The. City will notify prospectivecontractors of' the result of the prequalifi'cation process in
writing. Any, contractor who is disqualified- may' appeal the determination to the City. The
appeal, process is as follows:
.`Within two (2) business days.. of receipt of written notice of disqualification, the
prospective ,contractor shall notify the City of its intent to appeal. The' notice iof appeal shall be
made-ih:Writing..and delivered to the City Clerk of Petaluma at the address, in the Noticelnviting
Submission. of Prequalification Packages. If requested `by .the prospective contractor ,in, the. notice
of appeal, .the City, sliall.,provide notification in writing of the basis of the disqual'if cation and
any 'supporting evidence received from others or adduced as a result of an investigation by. the
City. The 'City shall provide this information within.. three (3) business days of receiving the
notice ofappeal.
Within two. (2) business days of receipt' of the City's information, the prospective
contractor shall submit any and all evidence it.°wants the City to consider m support of its'
qualification, to perform the, Project. or submit a "written request' fora hearing at Which:to, present
evidence. The: evidence orrequest for hearing shall'be'in writing and- delivered to the City Clerk
of Petaluma at the address in. the Notice Inviting �Subrrission of Pregtialification:Packages..
- If :the City receives :a timely.request for ,a hearing, the hearing will be held within three
(3) business days of the date the City receives the, request. The hearing will ..be before the
Director of the Water Resources and Conservation Department, or his designee, and, will be
recorded' on audio and/or videotape. The prospective- contractor may request that; '' e-hearirig,be
recorded stenographically. ;If the prospective contractor `requests a stenographi''record, itshall
be solely responsible for arranging the stenographer and paying.411 costs for the transcript: At
the City's :request,. the prospective contractor shall' furnish the City with a copy of the transcript,
and the City shall pay no more than the cost of -the copy.
The City shall give the prospective bidder or subcontractor written notice, of the outcome
of the appeal no later than two (2) days .after' tlie'.hearin& is concluded.. The City's decision will
be final and binding.
If a prospective bidder or subcontractor does notappeal a determination of disqualification or
denial of prequal'ificafion through the process described above, the City's.- decision on
prequalification;may.be- adopted without further proceedings: - Failure to appeal within, the time
set forth. above 'shalfbe deemed failure to exhaust administrative remedies and act,as a bar
to subsequent litigation.or other claims procedures.
Because of -the deadline for the City to have the Project complete'and in operation, the, City will
strictly °enforce the time limits in ,connection with appeals of determination of contractor
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qualifications, and the bid date will;not'be extended .on account of appeal of a determination
that a contractor is not qualified to submit a bid for the contract to construct the Project.
Any objection, to the prequalification materials, or explanation desired by a prospective bidder
regarding the .meaning or interpretation of the prequalification materials, must be 'requested in
writing by first-class mail, e=mail or facsimile, before 5:00 p.m.," September 27, 2004. Oral
explanations or instructions will not..be binding unless issued as a formal addendum to the
Package. Any information provided, to any prospective contractor concerning a solicitation will
be furnished to all prospective contractors. By submitting a completed Package, the prospective
contractor waives any and all objections to the form and .content, of the Package.
Bidders should submit questions regarding' the Prequalification Package to the Construction
Manager as follows:
Mr. Bruce Presser, P.E.
The Covello Group, Inc.
1660 Olympic Blvd., Suite 300
.Walnut Creek, CA 94596
Fax (925) 933-0434
Phone (925) 933-2300
Email bpresser(ZcovelloP_roun.com
By my signature below, I acknowledge receipt of this document and agree to be bound by its
terms and agree to submit it°with prequalification package.
Date Signature -
Name of contractor on whose behalf ,this docurnent is signed:
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Questionnaire
Contractor Prequa'lification Package for (check,one): ( ) General Contractor
(, ) Electrical Contractor
Contact Information
.A. Full -name of Contractor (as it appears on license):
Type of organization (Corporation, partnership,,etc.)
If corporation, indicate state �of United States of incorporation:
Corporate Tax Identification Number:
Is the corporation currently'registeted and in- good' standing with the State of California
Secretary of State?
• All other names under'which your firm has operated'in the last five years:
B. State exact ;street address of your firm.
Street Address:
C'. Telephone Number...
D. Fax Number:
E. Contact Person:
F. Email Address
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PART I. ESSENTIALREQUIREMENTS FOR,QUALIFICATION
Contractor will be immediately disqualified if the answer Ao any of question's S
through, 5 is "no:" - -
Contractor- will -be immediately disqualified'if the answer to any of questions 6; 7,.8
or 9 is `-`yes:"
1. Contractor possesses a valid and ,current California. Contractor's license (,General Class A
Electrical GIG) for,the project for which it intends to submit a,bid.
❑ Yes ❑ No
2. Contractor will comply. with, and provide all insurance as defined in Attachment No., 1,
Liability and Insurance.
0 Yes F-I No
NOTE: Provide a notarized statement from the insurance carrier(s) you will utilize
on the project certifying that the. specified 'insurance requirements will be met. The
carrier(s) must be admitted in 'the state of California or,permitted. to 'do business
under the Surplus Line Law of the 'state -of California sand have. a current
A.M. Best's rating of no less than A:VII. Please note that these are preliminary
insurance requirements that are, subject to change.- The contractor will be required .
to,provide insurance as provided for'in the Bid.Documents.
3. Contractor has current workers' compensation insurance policy as required by the: Labor
Code or is legally self insured pursuant toLabor Code section 3700 et. seq.
❑ Yes ❑ ;No ❑
4. Have you attached your latest copy of a reviewed or' audited financial .,statement with
accompanying notes and.supplemental information?.
❑ Yes 0 No
.NOTE: A .financial statement that :is not either reviewed or audited is not
acceptable. .A letter, verifying availability, of a- line of credit may also be attached;
however, it will be 1considered as supplemental infofmation only, and is° not a
substitute for the required" financial statement.
5. Have you attached a ,notarized statement from an admitted surety insurer (approved by
the California D-epartment of Insurance) and`, authorized °to issue 'bonds in the State of
California, which states -that your current.�bonding, capacity is sufficient_ for- the .project for.
which ,you seek pre -:qualification?
0 Yes ` []. No
NOTE: Notarized statement must be from the surety company; not on [agent or
broker.
6. Has, your contractor's license.been revoked at, anytime in the last five years?
❑ Yes ❑ No
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I. 7. Has a surety' firm complete tract on your, behalf, paid. completion because
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your a con lf, or aid• for
our firm was default termina
ted Hated by the prod ect .owner within the last five (5) years?
❑ Yes ❑ No
8. At the time of submitting this pre -,qualification form,is your -firm ineligible to bid on or
be awarded a public workscontract, or perform as a subcontractor on a public works
contract, pursuant to either.Labor Code. section 1777.1 or Labor Code.section 1777.7?
FT Yes ❑ No
If the answer is "Yes;" state Ithe beginning and. ending,dates.,of the period of debarment:
9. At anytime during, the last fiveyears, has -your:,-fmn,:�or anv�of,its, owners, or officers been
convicted of amcrime involving'tlie awarding of a,contract of a Fgoveniment construction
project, or the bidding,,or•perform' nce ofiia•government contract?
❑ Yes . ❑, No�
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PART II. ORGANIZATION; HISTORY, ORGANIZATIONAL PERFORMANCE,
COMPLIANCE WITH CIVIL'AND CRIMINAL LAWS
A. Current Organization and Structure of the"Business
For Firms That Are Corporations:
la. Date incorporated:
lb. Under theJaws' of what,staie:
1c. Provide all the foil'owing,inforniation for'each person who is eithe (a) an officer of the
corporation (president, vice president; `secr`etary, treasurer), or (b) the owner Hof at least ten
per cent' of thecorporation's stock.
Name I Position " [ Years with Co. I %Ownership
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1 d. Identifyevery construction firm that any personlisted above has been associated with °(as
owner, general partner, limited partnenor officer) at any time during theJast five,years.
NOTE* For this question, "owner" .and "partner" refer to ownership of'ten per cent
or' more. of the business; or -10 per cent or more. of its stock,1f the business is a
corporation.
Dates of Person's Participation
Person's Name Construction Firm. with Firm
I
For Firms That Are Partnerships:
l a. Date of forination:
lb. Under the l'aws:of what state::
1c. Provide all the following information for each partner. who owns 10 per,cent or more of
the, firm.
Name I Position I' Years with Co. %Ownership
-1d. Identify every construction company. that any partner has been associated. with (as owner,
general partner-, limited partner or officer) at any time during the last five years'.
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NOTE: For'this question, "owner" and "partner" refer°to ownership •of ten percent
® or moreof the business; or ten '.per cent or more of'its stock, if the business is a
corporation.
Dates of Person's Participation
Person's Name I ,Construction Company. I with:Company
For Firms That Are So1e' Proprietorships:
1 a. Date of commencement of.business.
lb. Social security number. of`compap owner.
lc. Identify every construction firm that the business owner -;has been 'associated with (as
owner, general partner; limit'ed.partrievor officer),atany time during_ the last five years.
NOTE: For 'this question, "owner" and `,partner" ' refer -to ownership often percent'
or more of .the business;' or ten, percent or more of its stock;, if the business is a
corporation.
Dates of Person's Participation,
[Person's Name I Construction Company •I •with Company
For Firms That Intend to.Make .a Bid�as Part of a Joint: Venture:
1 a.' Date of commencement of j dint -venture.
lb. Provide all of the following 'information for each firm.°that is a member. of the joint
venture that expects to bid ownee or more projeets
Name of firm I % o Ownership :of Joint Venture
I I I
B. History of the, Business and Organizational Performance
2. Has there .been any change in ownership of the firm at any time during the last three
years?
NOTE: A corporation Whose shares are publicly, traded is not required to answer
this question.
❑ Yes ❑ No
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If "yes;'' explain on a separate ,signed page._
3. Is the firm a subsidiary; parent; holding company or affiliate of another construction
firm?
NOTE- Include information about other,firmsif one firm owns.'50 per cent or, more
of'another, or. Wan owner; partner, or officer of your firm holds a similar, position in
another ;firm.
Yes, ❑ No
If:"yes;" explain on a separate signed page.
4. „ Are any corporate officers, partnem or owners connected to ally other, construction'finns?
NOTE:. Include information.; about other ,firms ;if an owner; partner,, or officer, of
your firm holds a similar position'in another firm.
❑ . Yes ❑. No
If "yes,-. explain on a separate signed -page.
5. State your firm's grossirevenues for.each:of.the iastthree fiscal years:
(20.03 .= 2004) (2002 — 2003) (2001— 2002)
6. How many yearn has, your organization been in business mi California as a contractor
under ;your -°present business name and license number? years
7. Is your firm currently'the -debtor-in a bankruptcy case?
❑ Yes - ❑ .No
If `;yes;" please attach a -copy of the banlaliptcy petition; showing the case, number, and
the date on which the petition was filed.
8. :Was your firm in ;bankruptcy'at any time during the e last five years? (This question refers
only to a bankruptcyaction that was not described in answer to question 7,. above)
Yes 0 No
If "yes;" please. atfach a copy of the bankruptcy petition, showing„ the case number. and
'the date ,on which the petition was -filed, and a copy of the Bankruptcy Court's discharge
order, or of; anyother_document that ended the case, if no discharge order Was 'issued.
C. Licenses
9. List all California -construction license numbers, classifications. and expiration dates of
the California contractor licenses held by your firm:
is
11
10. If. anof your firms; licene , ss , are.held yin the name of a corporation,or partnership,list
belowthe names of zthet qualifying indivdua'1(s) listed on the CSLB records who meet(s)
the experence,and examination requirements for each license.
11. Has your firm changed names-or-1'icense number.in the past five years?
❑ Yes ❑ No
If "yes," explain on a separate signed page, including the reason. for the change.
12. Has any owner, partner or (for corporations) office_ r.of your firm -operated a construction
firm under_ any, other name in the last five years?
❑ Yes ❑ No
If "yes," explain ona separate signed page, including the reason for the change_
13. Has any CSLB, license held by your firm or its;Responsible Mahaging Employee (RME)
or Responsible Managing Officer (RMO) been susperided .or revoked within the last five
years?
❑ Yes ❑ .No
If "yes," please explain on a.separate signed sheet.
14. Within the, past fve (5) years,;has. the California Contractors State License Board taken
disciplinary action �agairist your firm?
❑ Yes ❑ No
If "yes;" please provide details about each such. complaint and attach .copies of all
documents in your custody, control or possession which relate to the complaint:.
D. Disputes
15. At any time in the last five years has your firm; ;been assessed and paid liquidated
damages after- completion of a'project under a construction .contract with either a public
or private owner?
❑ Yes ❑ No
If yes; :explain on a separate signed page, identifying all such projects* by owner, owner's
address, .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.
16. In the last five years has your firm, or any firm with which any of your, company's
owners,. officers or ' partners was associated', been debarred; disqualified, removed or
otherwise prevented from bidding on, or 'completing, .any government`agency or public
works proj ect'for any "reason?
NOTE: "Associated with" refers to another construction firm'' in which, ,an, owner,
partner or officer of your firm held a similar. position, and which 'is listed in
response to question lc or Id on this form.
❑ Yes ❑ . No
12
If "yes," explain on a separate. signed page. State whether`th6 firm involved was. the firm
applying!for pre-qual fication.liere or another firm. Identify -by name�ofthe company, the
name of the person within your firm who was .as"sociated with that company, the year of
the event, the owner of the proj ect, the proj ect and the basis for the action.
17. In the last five years has your.firm been demed,an award of a public works contract
on:a finding ,by a°public agency that. your company was not a, responsible bidder.?
❑ Yes ❑ No
If "yes," explain on a separate signed, page. Identify the year of the event, the owner, the
project and the basis for the -finding, by the public agency.
NOTE: 'Thee following two, questions refer only to disputes, between your firm and
the owner of a project. You need 'not include information about disputes between
your firm and a supplier, another contractor, or subcontractor: You need not
include information. about ."pass -through" disputes in which the actual dispute is
between a sub -contractor and.a project owner., Also, you may ;omit reference to all
disputes about amounts ,less than $1�00,000.
18, In the past five years has any claim against your firm concerning your firm's work on a
construction project been filed=in court or,arbitr-ation?
❑ Yes. ❑ No
If "yes, on- separate'signed, sheets ofpaper 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 in which the case was ,filed and. a brief description of the status of the
claim if not limited by a confidentiality agreement (pending or, if resolved, a brief
description of the resolution).
191. In the past five years has your, firm made any claim against a project owner concerning
work on a proj ect or payment for a contract and -filed that claim in court or arbitration?'
❑ Yes ❑ No
If' "yes," on separate signed sheets of paper 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- in which ,the case was filed and a
brief :description of the, .status of 'the claim :if not limited by a confidentiality agreement,
(pending, orif resolved, a brief description of the resolution).
20. At any time during thel past five years, has. any surety company made any ,payments on
your .fire's behalf as a result of " a default; to satisfy any claims made against a
performance or payment bond issued on your firm's behalf, in connection with a
construction,proj ect, either public or private?
Yes ❑ No
•
13
If "yes," explain on' a separate signed page thel amount of each,such. claim, the name and -
itelephone number of the claimant; the date of the claim,: 1the,gr6unds for the claim, the
present status of the :claim; the date :of resolution of such claim, if resolved,, the method by
which such, was -resolved if resolved, the nature of the resolution and the amount, if any;
at which the claim,, was resolved:
21. In the last five years has any insurance carrier, for any form. of insurance, 'refused_ to
renew the insurance po'licy'for your firm?
❑ Yes ❑- No
If "yes," explain_ on -a separate, signed page: Name the, insurance carrier, the. form of
insurance and the year`of the refusal.
E. Criminal Matters And Related;Civil Suits
22. Has your firm- or any of its ,owners, officers _or partners ever. been found liable in a civil
suit or found .guilty in a criminal action for making any false claim or material
misrepresentation t'a anypublic agency or entity?
❑ Yes ❑ No
If "yes," explain on a `separate signed page; _including identifying who was involved, the
name of the public agency, the date of the investigation and the grounds for the finding.
.23. Has your firm or any, of its owners, officers or partners ever been convicted of a crime
involving.any federal, state; or local law related'to construction?
t❑ Yes No .
If "yes," explain on a separate. signed page, ,including identifying -who was involved, the
name of the public agency, the date of the conviction,and the; grounds for the conviction.
24. Has your firm or any of'its owners, officers .or partners, ever been .convicted of a federal
or state crime of fraud', theft, or any other act of dishonesty?
❑ Yes 0 .No
If "yes," identify on a separate signed page the -person or persons convicted -,the court
(the county if a state court, the district or location of the federal 'court), the year- and the
criminal conduct.
F. - Bonding
25; Bonding capacity: Provide documentation from your' surety, -identifying the following:.
Name of bonding company/surety:
t
Name of surety agent, address'and telephone number:
a. Current bonding capacity?
14
b. Unencumbered bonding capacity?
26. If your firm was'r-equire-d .to pay a premium of more than 'one -per cent for a performance
and payment bond. !on any project(s) -on which "your firm worked at any time .during the .
last `five years,, state the percentage. that your firm was required to pay. You may provide
an explanation for a percentage rate higher than one per cent, if you wish to; do. so.
27. List fall other sureties. (name and full address) that have written bonds for your firm
during'the last- five years, including the dates during which each wrote,the'bonds:
28. During the last five years, has your firm, ever been denied bond .coverage by a surety,
company, or'has there ever beena. period of time when your firm had no surety bond in
.place during a public construction proj ect when_ one was required?
❑. Yes; ❑ No
If yes, provide details on a separate signed sheet -indicating the .date when ;your firm was
denied coverage and the name -of the company or -companies which denied coverage; and
the, period -during which youliad no. surety bond in.place.
G., Compliance with Occupational Safety andRealth Laws and with Other Labor
Legislation Safety
29. Has `,CAL OSHA cited and assessed penalties against your- firm for any "serious,"
"willful" or "`iep'eat" "violations ,of.its safety or tealth;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 yourappeal, you need not include
information about it.
r
❑ Yes ❑ No .
If `-`yes,:" attached a separate signed page describing the citations; including information
about the dates .of'the citations, the nature of the violation, the project on which the
citation(s) was or were :issued, the amount of penalty paid?, if any. 'If the citation was
appealed to the Occupational Safety and Health' Appeals Board. and a :decision .has been
issued; state the case number and the date of -the, decision. >
30. Has the federal Occupational 'Safety and Health Administration cited and .assessed
penalties against your 'firm in the past five years?
1.5
ed a NOTE: If you have fil n appeal of a citationand the Appeals (Board.has "not yet
ruled "on your,appeal.I, �or if there is :a court appeal pending, you (need not include
information, about°'the:�citation.
❑ Yes EJ No..
If "yes, "attach, a separate.signed' page, describing each citation. . .
31.
Has the EPA or. any. Aif Quality Management ;District or, any Regional Water��Quality
Control Board cited and, assessed, penalties ° against;leither.your'firm or'the owner, of a "
project on which your firm' was the, contractor, in the past five, years,?
NOTE: If you'have filed an.appeal of a citation. and theAppeal's Board-1as not yet
ruled" on'Iyour ;appeal,, orif there is a courtappeal pending; you need'not include
information, about, the citation:, .
❑ Yes ❑ No '
If "yes," attach a separate signed page describing each citation.
32.
Experience Modification Rate (EMR): Complete Attachment;No,. 2
33.
Affidavit of Safety Compliance: Complete Attachment'No. 3.
34.
Within the last five years hasahere .ever been,a period.'when your firm had employees but
was without, workers' compensation, insurance or.state-approved self-insurance?
❑ Yes 0' :No
If "yes," please) explain the' reason for the absence .of workers' compensation insurance on
"No," 'your
a separate signed 'page'. If please provide a statement by current workers'
-
compensation insurance carrier. that verifies periods' of�workers'_ compensation insurance
coverage for the last" five years. (If your firm, has been in the construction business for
less than:five.y„ears,,provide a statement by your';workers' comp ensation.insurance carrier
verifying continuous workers`' compensation imurance coverage'for the period that your
firm has been in the construction business.)
H.
i
Prevailing Wage andliAppreniieeship,Compliance Record
•
35. Has there„been more than one occasion during,Ahelast five years in which your firm was
required`to pay either back"wages;' or penalties for your own. firm's failure to comply with
the siate
's prevailing wage laws?
`NOTE: This question refers only to your own' firin's violation,of prevailing wage
laws, not to violations of thel,pr"evailing wage laws, by: a subcontractor.
❑ Yes ❑ No,
If "yes,"' attach ;a- separate,signed- page or pages,, describing the nature of each violation,
identifying, `the 'name of the ,Iproject, the date of its completion), the public agency for
which it was rconstucted; the number of employees who were initially underpaid- and the
amount of back wage's aiid penalties that you were required to pay.
16
36. During the, last five ,years, has there been.more than:one occasion in which your own firm •
has been penai ed or required, to payback wages for failure to`comply with the federal
Davis -Bacon prevailing wage requirements?
❑ Y'es ❑ No
If "yes," attach 'a separate ;signed page or pages_ describing the nature of 'the violation,
identifying the'name of the project, the date of its, completion, the public agency for
whi'ck it was constructed;. the number of employees who were initially underpaid, the
amount of back wages you were required to pay along with the amount of any,, penalty
paid.
37. At. any "time during the last five years; has your firm been found -to have violated any
provision of California apprenticeship laws or regulations, or the _laws pertaining_ to use of
apprentices .on public works?
NOTE: You may omit reference to any incident that occurred prior,to January.1,
2903, if the violation was by a ,subcontractor and your firm, as -general contractor on
a'project, had. no' knowledge. ofthe subcontractor's violation at the time it occurred.
Yes , ❑ No
.If "yes," provide the date(s) of such findings, ;and attach copies of the Department's .final
decision(s).
•
17
PART III. RECENT CONSTRU,CTI:ONIPROJECTS COMPLETED
Contractor- shall provide infoririation about six public works projects completed within
the last five years. At least three (3) of the projects must be wastewater or water projects
'Of similar size nand complexity. The general contractor must list at least one project with
a minimum completion value of;$35.0. million.- The electrical contractor must list at least
one project Wifh a minimum completion value of $5.0 million. Names and references
must be current and verifiable.. Use separate sheets of paper that contain all of the
following, information:
Project Name:
Location:
Owner:
Owner Contact (name and current phone number):.
Architect or. Engineer:
Architect or Engineer Contact (name and current phone number):
Construction Manager (name and current phone number):
Description of Project; Scope'of Work Perfornied:
t
Original Bid Amount:
Total Value of Construction (including change. orders):
IS
Original Scheduled Completion -Date:
Time Extensions ,Granted (number of days):
Date of Substantial Completion'
Electrical Contractor Only:
Genetal Contractor:
General Contractor (name and current phone number):
•
5
W
19
Part IV-= Current Status of Open Contracts after 9/1/04 _(1Vlake Copies As. Requiredl.General contractors list contracts valued at
$10.0 million; electrical subcontractors list contracts valued at $2.0 million or more.
Project Name & Owner Owner Original Dollar Value Percent Original Estimated
Type of Work Name Representatiye Contract Value Complete to Date Physically Completion Completion
Phone Complete Date Date
Name I ' No.
20
Part V= Project, Personnel Project Experience„
Please summarize .the construction experience of the proposed project manager,' superintendent, and scheduler of,your organization and the backups .to these key
positions (generdl_contracto"r). Electrical subcontractors- please provide information for project managers, superintendent and foreman.
Indi_vidu_ al's Name --P_osition Construction Construction -Experience During the Last 5 Years
Experience
'Total Employed by
Years Your r Firm
Y%N Yrs Project Name Value of Type of Work In What No.
I Work I (WWTP,, Other) I' Capacity? Yrs.
1� 01
Part Vl- Proiect Personnel Proiect Exuerience (Backuu)
Please summarize the construction ekperience of the backups to proposed key personnel of your organization (as described in Part V).
Individual's Name Position Construction Construction Experience During the -Last 5 Years
Experience
Total Employed by
Years Your Firm _
YIN Y_r>s Project Name Value of Work Type of Woork_, _In' What No.
(Road; ,Capacity? ors.
Underground)
l
22
AFFIDAVIT •
We, the undersigned, (name) as the. authorized
representatives for (company) ,.an
interested contractor for the City of. Petaluiiia's;Ellis .Creek Water Recycling Facility;, do hereby
attest, that all statements and representations made herein are true and correct. to the best of our
knowledge. These statements are made openly and 'freely without intent to, influence' or
embellish actual conditions or circumstances that occurred. I declare under penalty of perjury
under the laws,ofthe: State of California that the foregoing is correct.
We acknowledge:that we have received, Addendum through
'We understand that the, City,will investigate any and all statements and representations made by
us and, our fim-in. this Statement of :Qualifications :and: we freely give our permission for them to
do so. Should releases,',be `required by any of our ,professional, financial',. or, bonding `insfitutions
to release verification of the enclosed' data, we have provided them. We: agree 'to. waive any
claims ,against' the City, Construction. Manager, Design 'Engineer and/or any third party
designated:by the City for the release of the information necessary to evaluate-this"Statement of
Qualifications.
We further understand that,any false. statement or representations, made: -in this application will
result.in disqualification'of our firimas a bidder for the Project. If it is.deteriniiied that�these,false
statements or ;representations were . purposefully made to change, hide,` or. obscure, negative
information from the City in an attempt to qualify under- these false pretenses;, the action will
result in loss 'of. eligibility' for .our' fi'rrn to qualify, for any City of Petaluma contracts for a
minimum period of one (1) year and a, maximum period of five (5) years from the date of
discovery. ,If the 'discovery of false representation, occurs after the contract is, .awarded to our
firm, we, understand and agree that the City reserves the right to terminate the contract Tor cause
and to seek legal remedy under the prevailing statutes,.
Attested:
Date , 2004
(Name).
(Signature)
(Title)
(Name)
(Signature)
(Title)
Corporate Seal
1�
23
ATTACHMENT NO.2
SAFETY QUALIFICATION WORKERS' COMPENSATION EXPERIENCE
MODIFICATION CRITERIA
The following information `will be used to determine if you meet the minimum safety
requirements for this project: `To- qualify to bid and be awarded the project, the Contractor's
three year average Workers' Compensation Experience Modification (EMIR), must not be greater
than .95 (95%), Please obtain a letterfrom your insurance carrier (or state fund if applicable)
with your interstate EMR'-s for the 'last .three full rating periods. If you do not have an interstate
rating, obtain.your intrasiate.'ENIR�. Attach the letter as part of this package. The Contractor
shall' -list the Experience, Modification Rate for the last three complete years (available from your
insurance carrier).
•
Three Year Average =
Are the above rates interstate orintrastate?
If intrastate, which state?
*,NOTE: Any'of the following methods of "obtaining a_letter" are acceptable- .
• Furnish a: ,letter .from your insurance agent; insurance carrier or state fund (on their
letterhead) verifying.,the EMR data listed above; .or'
• Furnish .a Photostat of the last three years' Experience Rating Caleulation Sheets, which
your insurance carrier- should .forward'fo,you;annually; or
• If you are .in a "state fund" state, such`as Ohio. or West Virginia, furnish a Photostat of 'the
state's last three years annual` "statement page"'that shows the modification rate and the
coverage period.
11
ATTACHMENT, &0� 3
Sk'CilON'00400
AFFIDAVIT OF SAFETY COMPLIANCE
The Contractor hereby, acknowledges City concerns it regarding, safety at its facility at,
I I d at ' the Project
worksite. The Contractor shall conduct its -operations4o, elmm ' ni ate- or reduce hazards and id risks associated
with Contractor"s to --,pr,'eVent accidents,.and injuries, and - to preve
nt property damages.
Therefore, strict compliance with all of the most current safety, health and environmental regulations
(federal, state and' -Iocal),is, required. Non-compliance 6, these, regulations may result in suspension or
with
termination of work in progress.
The Contrdctor'.s:, Safety- Programs must' accomplish.. the foregoing objectives. The Cbntractor certifies
that its,,Safety Pro y an wift!satisf� these requirements.
Programs comply, The. Contractor also certifies, that
each.:Subcontradtor and Sub -subcontractors and, other parties with which it has agreements to perform
work- on the Project works- ite will also co
inply, and will satisfy these requirements.
The mandatory (and other), Contractor Saf6ty Programs are delineated in Part A of the attached
-;Contractor Safety Operations ;Requirements.. The Contractor further certifies that it can furnish
mandatory, satisfactory evidence ,of compliance.
The Contra6tor further acknowledges that. its Subcontractors and Sub -subcontractors will provide all
Safety Compliance documents in accordance with Specification Section.0.0490.
Signature Name of. Bidder
Title Date
Attach a. Certificate of AbIowledg ent for the
em Notar yto theAffidavit.
Petaluma Prequal 0049,0-1
.
CITY OV'PETALUMA
ELLIS CREEK- WATER RECYCLING: FACILITY
PREQ'UALI-FICATI®N`EVALUATION
General
Electrical
Contractor Name:
Evaluation Criteria- Pass/Fail
I Part I:
I
I Essential Requirements
Part.M
I A. Current Organizddon
B. Business History
I C..Licenses,
I D., Dispurimtes.;;
E: Cinal Matters
IF. Bonding I -
I G. Safefy .
I H. Prevailing Wage .arid Apprenticeship
Part III.
Recent Constructed Projects Completed' and
I Reference Clieck_
Part IV:
I Open Contracts
I
Part V & V'I
I I
I Project Personnel.
Attachments_
] .M.- 1.- Liab'ility,and Insurance,
No. ,2 —,EMR Criteria,
I° No..3 _ Affidavit.ofSafetyCompliance
..-PROJECT EXPERIENCE
INTERVIEW .QUESTIONS
The following questions will; 'be. used. t6, interview randomly selected
lected contacts from completed
projects: The City, will. conduct theiniervi,ew:,s. No actico,oh they -dontr4ctor's, part is necessary.
These questions -are ,,included .'�m,,th&package. ,to th.econtractor-f6r information only.
The highest,pos§ible. scor'e.is` I 3.&,points. . A score less Ilian 60 points disqualifies a contractor
from bidding on the Project. A, score of 'between 60arid. 18 indicates the City will conduct
additional interviews of otherref6rdtices. A score of 78- or, higher on all interviews is sufficient
for prequalification.
First, please give a. brief &sptipti0ii of the project.
I,. Are., there, any -outstanding stop notices, hens, or claims -by the 'contractor that are
currently. unresolved -cifi. contracts for which notices of completion were recorded' more
than 120,days 'a' go? �-point for each is deducted fibm,.overall score; maximum amount to
be deducted is 5 points).
2.- On a scale I :.of 140,with lf'0 being-thebest;did the contractor provide adequate personnel?
(Max: 10points)
3. On a scale of 140, with 10 being the best, did the contractor provide adequate .
supervision? -(Max., 10 points) -
4. On a scale- of 1-10, With 10 being the best, was; there adequate equipment provided on the
job? (Max. 10,,points)
5. On a scale of 1-10, with 10being the best, was the contractor timely in providing reports
and other paperwork-, includin9 ,change order paperwork and' scheduling updates? (Max.
.10 points)'
6.:Ofi a scale of 1-10, with IO'being the best, did the contractor adhere to the project
:schedule that your (agency) (business) approved? (Max. 10 points)
7. Was.the project completed on time? (10 points if the answer is "Yes")
Or, if the, answer is "no", on A. scale of 1-10, W Ah'10 being the best, to what extent was
the contractorxes-Ponsible for the dela.v,in completion?
8. On a scale of 14 0,'with 'l 0, being the, best, rate, the contractor on the timely submission of
reasonable, cost and time, estimates to perform change.order work. (Max. 10 points)
9. On a "scale of'1-10, with 10 .being, the best, rate the ,contractor on how wellthe contractor
performed the work after a change order was issued and how well the contractor
integrated the change order work into existing work. (Max. 10 .points)
10. On a- scale of I-j0; with 10 being, the best, rate how the contract:or,performed,in turning
in'Operations & Maintenance manuals, completing as -built. pro viding -required.
training, -and taking care of warranty i'tems?,' (Max. 10 points)
11. On a scale of 1-10; with 10 being the'best, rate the. contractor on whether there were an
unusually high number of claims, given the riatUre of the project, or unusual difficulty -,in
resolving them. ' (Max. 10 points)
12. On a scale of 1-10, with 10 being, the best, rate the contractor with respect -to timely
payments' by the contractor to subcontractors and suppliers. (If the person being
interviewed knows of no such difficulties, the score on. this question should be"`10.")
13. On a scare. of 1-1:0; with 10. being ;the`best, rate the.contractor with respect to safety: Was
shoring provided properly, were lock /`out tag out, procedures followed, did the,contractor
provideroutine safetytraihing?
14. On a scale of 1--10,, with 10 being the best, how would you rate .the overall quality�of the
contractor's work? (Max. 10 points)
•
,ATTACHMENT.NO: 1
SECTION 00800
'SUPPLEMENTARY GENERAL CONDITIONS'
-12.0 LIABILITY'AND INSVRANCE
2.1 Insurance
Within ten (10) days after award:;ofthe Contract, the Contractor-shallkpromptly obtain, at its own
expense, all the insurance;required-by. Section 00800-20, LIABILITY AND INSURANCE, and
submit coverage verifi'cation`for review atid'approval by the City prior to the City's execution of
the Contract.
i. The Notice to. Proceed with the Work_under this 'Contractwi11 -notce issued,,,and the Contractor
shall not commonce-work, until such insurance has been approved ,b'y the City. Such insurance
shall remain in full force and effect 0411 times during the prosecution of the Work and until the
final completion :and acceptance thereof. ' In addition; the Commercial General Liability
insurance shall be maintained for a minimum, ,of -five �(5) years after final completion and
acceptance of the'Work. The' Notice to Proceed.does not relieve the Contractor of the duty to
obtain such insurance as required'herein.
�. The Contractor shall not allow -anv subcontractor to commence work on its subcontract until all
similar insurance required of the subcontractor, except Builder's Risk Insurance, has been
obtained and verified bytheContractorrand submitted to-the!ConstructionManager for the City's
review and records. Subcontractors shall furnish original certificatesand required endorsements
as verification of insurance coverage. 'The insurance liabilitylimits specified in Section 00800-
2.0, LIABILITY AND INSURANCE, shall also apply -for all subcoritractors:listed in Section
00430, DESIGNATION OF SURCONTRACTORS': The Contractor shall designate the
required -insurance liability limits, for all other subcontractors.
Companies'writing the insurance underthis article shall`be licensed'to,dobusiness inthe Stateof
California or be -permitted tomdo business under. the, Surplus,jLine-'Law of,the ;State of California.
Insurance is to be placed with insurers with a. current A.M., Best's rating, of rib less, than A:VII•.
All.policies of insurance required herein shall provide that'they may be suspended; voided,
canceled, reduced in coverage or in limits only after thfi y.(30) days' prior notice by certified
mail return receipt•requested: has been given to the City.
Contractor shall include all costs for insurance in its bids.
Nothing contained in these insurance requirements is to be.construed as,li'miting the extent of the
Contractor's responsibility ,for payment of damages resulting from its operations under this
Contract. Coverage required hereunder shall operate'as Primary insurance.
Petal u m a_Preq ual ification 00800 - 1
The Contractor shall.take out, payfor; and maintain throughout the duration of this Contract and
for such additional periods as more specifically required' herein the .following insurance
coverage:
2.1..1 Commercial General Liability_ and Automobile Liability Insurance- This insurance:shall
protect the Contractor from claims for bodily ;i--jury' and property damage which may arise
because of the nature of the work or ,from operations under this Contract. The Commercial
General Liability Insurance shall -be maintained forfive{5)-years after final completion and shall
provide cover -age on an occurrence basis.
a. Additional Insureds -The Commercial General Liabilitypolicyofinsurance shaltinclude
as additional insureds the City, of Petaluina; each of its off cers, officials; employees,
agents and volunteers; the Design Consultant,. the Construction Manager and each of
their partners, officers, employees, and agents and coverage provided'to such additional
insured-. This policy shall provide coverage to each of the said insureds with respect to
said work. 'Said policy shall provide prunary coverage to.the full,limI of liability stated
in the declarations.
b.(1) Amount of Coveraue(General Contractor)= The bodily injury; personal in .and
property damage liability -of the Corrimercial General Liability insurance shall provide
coverage;in the following limits of liability: $2;0.00,000 on account:of anyone:occurrence
for•bodil-y injury and.property damage, $2,000,000 personal and advertising "injury limit
,-with an annual ,general aggregate limit of not less than $10 million; and $1,0 million
products and completed. operations aggregate; combined single,'limi't: The Automobile
Liabilityinsurance.policy shall provide minimum limits of $-1,000,000 per accident, for
bodily injury and property damage ;and $5,000,000 policy aggregate arising out of the
ownership, maintenance, or use, of any owned or non -owned vehicles..
b.(2) Amount of CoveraRe(Electrical Subcontractor) -The bodily injury, personal,injury and
property damage liability oftheCommercial General Liability insurance shall provide
coverage in the following liinits.of hability:'$2,000,000 •on account of any one occurrence
for bodily -injury and propertydamage, $25000,000 personal and advertising injury limit
with, an annual general „aggregate limit- of .not -less than $4 million, and •$4 .million
products and completed operations aggregate; combined single limit. The Automobile
Liability insurance policy shall provide rniniinum limits of $1,000,000"per accident and
$2,000,000 policy aggregate arising- out of the ownership; maintenance, •or.use of any
owned .or non -owned vehicles.
C. Subcontractors —;T-1 e•bodilyin*ury and propertydamage-liabili'ty'insurance shall not be
deemed to require the Contractor to have, its :subcontractors named as insureds in the
Contractor's, policy, but the policy shall protect, the Contractor from contingent liability
which�may arise from. operations of 'its subcontractors.
Petaluma Prequalification 00800 - 2
• d. Included Coverage, = The above Commercial General Liability insurance shall also.
include the following coverages:
Premises - Operations
Independent Contractors
Products r Completed Operations
Personal Iniury - (False Arrest, Libel, Wrongful Eviction, etc.)
Advertising Iniury
Broad Form Property Daina2e. Including, Completed Operations
Separation of Insureds/Cross-Liabilitv Provision
Dutv to Defend all Insureds
Deletion of any Limitation -on Coverage for Bodilv Iniury or Prop_ erty Damage Arising
out of Subsidence 'or Soil or Earth HMV vemerit
Separate A2ue2ate - A provision that the annual. general aggregate and the products and
completed operations annual aggregate shall apply separately'to each project for which
Contractor provides services away from premises owned by or rented to Contractor.
XCU - (Explosion, Collapse, Underground Damage) XCU may be deleted when not
applicable to operations performed by the Contractor or its subcontractors.
Environmental
Blanket Contractual Liability
e. Umbrella. POliCV - At the option .of the Contractor,, primary limits.,may, be, less than
required, with an Umbrelh0olicy providing the additional limits needed. This form of
insurance will be acceptable provided that the Primary and Umbrella Policies both.
provide the insurance coverages herein required, including all additional insured
requirements. The' umbrella.policy shall be provided on a "following form" basis, With
coverage at least as broad as provided on the underlying Commercial General Liability
insurance.
2.1.2 Workers' Compensation Insurance - In accordance with the provisions of Article 5,
Chapter 1, Part 7, Division (commencing with,Section 1860) and Chapter 4, Part 1, Division 4
(commencing with Section 3700) of the Labor Code of the State of California, the Contractor is
required to secure the payment of compensation to its employees and for that.purpose obtain and
keep in effect adequate Workers' Compensation Insurance. If the Contractor, in the sole -
Petal uma_Prequalification 00800 - 3
discretion -of the City, satisfies the City of 'the, responsibility and capacity under the applicable
Workers' Compensation Laws, if any, to act as self -insurer, the Contractor may so act, and in
such case, the insurance required by thi's paragraph need. not be provided.
The Contractor is advised of the provisions of Section 3700 of the Labor Code, which require
every employer to be insured against liability for Workers' Compensation or to undertake self-
insurance in accordance with the provisions of that code, and shall comply with,such provisions
and have Employers' Liability limits- of $1;000,000 per accident and..per employee, and in the
aggregate for injury by disease; before commencing the performance of the work. of this
Contract.
Before the Notice to Proceed with the Work under this Contract is issued, the Contractor shall
submit written evidence that the Contractor has obtained for theperiod of the Contract Workers'
Compensation. and Employer's Liability Insurance as required for all persons whom it employs,or
may employin carrying out the work under this Contract: Such evidence of coverage shall be
accompanied by an endorsement from the insurer agreeing to waive all rights of subrogation
against.the City,'its elected or appointed officials employees, agents.and volunteers, the Design
Consultant, the Construction.Manager and their agents, consultants and employees which might
aris'e.by reason of any payment under the policy. This insurance shall be in accordance with the
requirements of the most current and applicable State Workers' Compensation Insurance Laws.
2.1.3 Builder's Risk Insurance -"All Risk or Special, Form" Builder's Risk .Insurance *on the
replacement cost basis, -in an amount equal to the full replacement cost on a completed value S
basis, including coverage for "soft costs" such as design and engineering fees .and delayed
completion. Such insurance shall also cover theperils of flood and terrorism and shall be
obtained, paid for, and maintained by the Contractor and shall cover, but shall not be limited to,
fire, lightning, windstorm, hail, explosion, riot, riot attending a strike, civil commotion, smoke
damage, damage, by aircraft, or vehicles, vandalism and malicious mischief, theft, collapse,
terrorism and flood.. The Contractors and insurance companies are advised that the work site is
located within the 1.00-year flood plane as defined by the Federal. Emergency Management
Authority (FEMA). This insurance shall name the City, the Design Consultant, the Construction
Manager and.the Contractor as insureds, as their interests may appear and shall include coverage,
but not by way of limitation, for _all damages of loss to the Work and to appurtenances, to
materials and equipment to be.incorporated into the Project while the same are in transit, stored
on or off the Project site, to construction plant and temporary structures.
Builder's Risk Insurance policies shall contain the following provisions:
(1) The City'shall be namedos aninsured.
(2) The insurer. shall waive all rights of subrogation against the City.
Builder's Risk Insurance may have a deductible clause not to exceed the following limits:
(1) If, pursuant 'to Section 7105 of the Public Contract Code, the°City requires coverage. for
any damage to the work caused by an.Act of God, as defined by Section 7105(b)(2)-of
that Code, and has set forth the amount of the work to be covered and the insurance
premium for such coverage as a separate bid item, the deductible -for such coverage shall
Petaluma_ Prequalification ' 00800 -.4
not exceed five percent of the value at risk at the time of the loss. The City shall be
named.as an 'insured.
(2) All Other Perils: $5,000
The Contractor shall be responsible for paying any and all deductible, costs. The policy shall,
provide the City the right. 'to occupy the premises without termination of the policy until
acceptance of the Project.
2.1.4 Proof of Coverage -.Before the,Notice'to,'Proceed with the Work'under this Contract is
issued, the Contractor, shall fiuiu'sh ,the City With certificate(s) evidencing issuance of all
insurance mentioned herein, copies of the policy declaration, or., information page($) and
additional insured :endorsements. The certificate(s) and endorsements for each insurance policy
,are to be signed by a,person, authorized by that insurer to bind coverages on its,behalf. The
endorsements are to be *on forms" A- and B-1 .as included in Section 00650, GENERAL,
LIABILI-rY ENDORSEMIENT,, and Section IT 00651, AUTO LUBILY ENDORSE1VIENT,
or equivalent endorsement`forrns acceptable to the City. The certificate(s)"policy.declarationvor
information page($); and. endorsements are o.be,•received' acid approved by the City before work
commences. Except for ,the waiver of ;subrogation, rights endorsements, as required' under
Sections 00800-2.;1.2 ;and b0800- 2'.13, no other, endorsements are required for. Workers
Compensation or Build'er'sRi"sk Insurance. Such certificates of-insur-ance shall provide that the
insurance policy,shall not be cancelable be subject to nonrenewable, `or otherwise be subject to
.. t
a
material modification' excep with thirty (36) days prior written notice to the City and
Contractor. Contractor i.shall "a'lso provide certiff6ate(s);. evidencing, renewal's of all insurance
required herein, at -least ten.;(3,0) days prior to the expiration date of anysuc'h insurance.
Any deductibles or self,irisured retent ons.must:be'declared to and approved by"the City. At the
option of the City, either: the insurer shall,reduce,or'eliminate such deductibles or self -insured
retentions as respects: the ;City, the Design Consultant, and theConstruction Manager and -'their
officers, officials employees,- agents .arid volunteers; "or the Contractor"shall procure a bond
guaranteeing payment of losses and, related investigations, claim administration and defense
expenses.
In ,the event of. the !breach of .any provision of this paragraph, :or in the. event of any notices
received which indicates any;required insurance=coverage will be diminished°or. canceled, City;,at
its option,, may, notwithstandingany other provisions of this Agreement to the contrary,
immediately declare a material breach of this Agreement and suspend all further work pursuant
to this Agreement.
2.1.5 Indemnificafi'on - To°the, fallest extent permitted:by Law;,the Contractor shall indemnify,
defend and hold harmless, ,the City, its elected or appointed officials, employees, agents and
volunteers, the Design Consultant and- the Construction Manager and their agents, consultants
and employees from and against all liability, claims, damages, losses and expenses,_'including but
not limited to attorneys' fees, arising out of or resulting from the performance of 'the Work,
provided that any such liability, claim, damage, loss or expense (1) is attributable to bodily
injury, sickness, disease, or deaih'( ncluding that sustained by Contractor's. or Subcontractor's
Petaluma_Prequalification 60800 - 5
employees), or to injury to or destruction of tangible property (other than the Work itself)
including: the loss of use. resulting therefrom, and (2). is not caused by the sole negligence or
willful misconduct of a party indemnified hereunder, Such obligation shall not.be construed to
negate; abridge, or otherwise reduce any other right or obligation of indemnity which would
otherwise exist.. , .
2.14 Iniury or llness Reports - The: Contractor shall furnish the Construction Manager with a
copyof the Employer's Rep6 of Injury immediately following any incident,requiring',the filing
of said report ,during the prosecution of the work under this Contract. The Contractor "shall also
furnishAhe- Construction M inagerwith a copy:of thelinployer's Reportof Involving any
subcontractor - on this project.
2.1.7 Notification of ;Insurance Companies - The. Contractor shall"advise ,all insurance
cornpariies,to familiarize tliemselves:with all of the Conditions and.provisions of this.;Contract,
and they shall waive the .right of special. notification of any change or modification of this
Cor tract..or of;exterision oftime; or.of decreased or'increased work, or,of theicancellationof the
Contract;: or of;any, other act or acts by the: City or its; authorized :employees. and agents; Kunder the
terYris�of this Contract, and,failure to so notify the°aforesaid insurance companies!of changesshall
in noway relieve -the insurance companies of their obligation under this Contract.
2.2 Insuranee:Durine Guarantee Period
For all work the':Contractor or itsrsubcontractors perform during;the,guarariteegeriod, worker's
coin ensation and comme p _ _ _ rcial general liability insurance and, insurance in the amounts .and
.format required herein, shall remain in forCeL and be maintained for ,five (5) years after final
completion'.
The Contractors an&insurance companies are, again,advised ihaf'the work site"" located within
the 100 year. flood -plane as defined. bythe.Federal Emergency Management Authority (FEMA).
f
•
Petaluma_Prequalification 00800 - 6
CONTRACTOR'S SAFETY RATIO.IVS REQUIREMENTS i
PART A - Safety Programs = _ -
Please indicate below whether your -firm -has the following written safety programs. If any -of the programs listed do not apply to your
operations or this project, please make note of this in the "Comments" column. Include any information that you think would be helpful _
to us in making this assessment. Those programs that are indicated as mandatory must be available for review before commencing - -
work on this pnoject. Other safety, programs may be requested if it is later determined that they are applicable to the Project, and as
such, must,be made available for review upon request.
Do you Program Sub will Have project Is the training
Program❑, h a V e, a rneets provide employees : docum_ ented?* C07—n ments0.
- written - Cal/,,OSHA., been
3 program? Criteria, trained?' t
Mandatory - I .Yes I" :No I, Yes I No Yes I' No I Yes I -.No
I
YES' Injury
YE `and Illness
Preventiorn
- S I Hazard Communication I I I I I I I
YES I Confined, Space I I I I I I =
Operations"
Respiratory. Protection
Emergency Response I I- . -I I
Hearing Conservation
YES I Lockoutffeagouf
YES Mew Employee
Orientation__
YES I Excavation Safety
Code of'Safe Practices.
YES Personal Protective
,Equipment (PPE)- I =
YES I Drugs/Alcohol
YES I Traffia-Contro[gafety
YES I ,Fall PtbVention Plan
' If conventional fall. protection 'measures cannot be used.
Petaluma-Prequalification 00490 -2
r
'CONTRACTOR'SSAFETY OPERATIONS REQUIREMENTS
PART B - Safety Equipment - Identify what safety equipment will be-available,and used for this project,
Type_ I Description/Comments
[ j Gas detectors
Ventilation e qui rnent
[ ]
Approved harnesses,and Ian ards
.Mechanical hoists -
[ ] 'Fire extinguishers
[ ], First aid kits I J
[ ]' Respirators
[ ] Hard hats
[ ] Hearing protectors
[ ] Safety goggles:
[ ] .Steel toed footwear
[ ] Hand -protection,
[ j, _Fall protection
[ j Confined Space Rescue, Equipment I'
PART C - Specialized Trainingand Certification - Identify., the°areas of:specialized.training or certification that will have
been completedby employees who will be assigned to .this project.
Be- prepared to provide documentation as requested._
[ ] CPR/first aid ' [ ]
j'Conf1hbd.sp6ce,o,perbtiorfs and
[ ] Scaffolding
rescue
IFork- lift operation, [ ]
Respirators [ ] Air -Supplying I[
] Flagging
I
[ ] Air -Purifying'
[ ] Cranes/hoists. pperation [ ]
J'Trenching and shoring
[ ] Traffic Control
competent person
[ j J Heavy equipment operation I [ ]
I Welding I
[ ]
[ ] I Powder -actuated tools. use I [ ]
I Asbestos abatement: I
[ ]
Petaluma-Prequalification
00490 —
CONTRACTOR'S SAFETY O.PE'RATI,ON'S REQUIREMENTS
PART D - Jobsite Safety Rractices,
1.
Name of person who will have responsibility for job'site. safety.
2.
Who will be responsible for, tonducting and; documenting accident investigations?
Does your company perform, near -miss investigations? .
Please provide`sample copy of;investigation forms.
3.
How often are jobsite safety audifs or inspections performed?
and by whom? m
4.
Does the person who is responsible ,for jobsite safety- have auth'drity to take immediate
action to correct unsafe: conditions ofwork practices?
5.
How often are jobsite tailgate or toolbox safety meetings held?
B.
Briefly describe how, you will ensure that workers comply with safety programs and
Cal/OSHA requirements?
7.
Please list any Cal/OSHA citations and penalties you. have received,in the last three years.
8..
... . .
Have there been any on. -the -fob fata_ lities::in the last five years? _
if,
f yes, please ,explain.
9.
Does your company have a,'safety incentive program?
If yes, please,explain.
Petal uma-Prequalification, 00490 —4
CONTRACTOR'S SAFETY OPERATIONS REQUIREMENTS,
PART E: Evaludtion,Wcirksheet
(FOR, USE BY THE CITY ONLY)
Company Name
Con -tact, Person
Item
E 16
M
E E
CLO, 2, CLO, .2 E2 Z. U) '8
tm - w tm,a) 0Z
'it-
E
C
0 M
-,C
C: 0 65 0 E :::: — .
0 0
. E
-0
L)
PART A:. Safety Programs
Injury and llln-ess Protection
lNes I
Hazard Communication
Yes s
Confined' Space, Operations
I
Yet
Lock.011i /Tagou.t
Yes
New EmplOyee,Orientati,on
I Yes
Drug and Alcohol Policy
I
Yes
Excavation Safety
I
Yes
Traffic Control
01fier-Programs: PPE, Fall ,Protection -
PART 13 - , SafetyEquipment;
PART.C: Traihing and
Certifications
PART D- Jobsite Safety Practices
Responsible Person'Nam'ed.
Accident. Ir ny�esfigations
Wot.ktit:e Safetyinspections,
Safety Meetings -
Compliance With 'Safety Recl-Wrelments,
Cal/OSHA Citations/Ponalties
Fatalities
Safety Incentives
END'
OF SECTION"
0
0.
E
Petal uma= Preq ual ification 00490' —5