HomeMy WebLinkAboutAgenda Bill 5.C-Attch1 08/16/2004Request for Qualification from,.Interested
General Contractos and Electrical Subcontractors
and.
Invitatioft,to :Submit Prequalification Packages
for
THE CITY OF PETALVMA
ELLIS CREED WATER R:ECYCLING"FACILIT'Y
August 2004
Requ.estlor Qual iications: from 'Interested�
General. Contractors Electrical Subcontractors
For .the City of Petaluma;
Ellis Creek Water Recycling Facility
NOTICE IS HEREBY GIVEN that Prequalification,Packages will.be,r', ,ceived on Oetober.,7;
2004 at the hour of 2 00 P' M." by the ,,City Clerk of the City of ;Petaluma at the City Clerk's
office ,at City Hall, 1.1 English, `'Sfreet; Petaluma CA :94952 =2 "610; for prequalif cation to
Participate in bidding; -for, the ;con, act to con_'st . - the - .. I I Creek Water `Recycling Facility, 4100
Lakeville Highway, Petaluma, CA (Project No C500402) (herea
ft'er "Project "). General
Contractors and
construct the Pro ec, must'submit completed P.re uahfi ation Packa es ( hereafter pa kage) to lectncal subcontracto who wish to, artici ate. in din g .bi( for me "c ontrac on
the forms , included herein. Only 'general contractors and, electrical subcontractors that . submit
completed n biddin .and meet the City',s pr equal' ification requirements will be eligible. .to
part' p g for the contract to construct the : Project. General, `contractors; will only be
able' to list prequalified "'subcontractors in their bid for the electrical portion -of 'the project.
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Completed Packages; incqud it one original' and -six co ies of the'Package, may be delivered or
mailed "to Petaluma `s City " Clerk' s office,at the above address, and :mustbe received, by the date
and time above in order to be, considered. Subject to conditions ;prescribed in the Package,
,general contractors, electrical : subco are invited 'to apply ,for prequalification to bid
on the Prod ect.
PROJECT: A single contract will be awarded fo_r construction of the :Project. The proposed
work is generally described as follows• Ellis Creek Water Recycling Facility (WRF) including; a
complete new 'facility for wastewater treatment including screening and vortex grit removal,
disinfection, exshesg, pSeoondary � t and l olshin wetl e ands. P onechypochiorite
Oxidations Drtc
tin and improvements p g ncludes all
architectural, civil, mechanical structural, electrical and:' ,instrumentation elements for new
facility. Otherwork includes: Lakeville Highway improvements, SCADA and PLC system. The
construction cost, of the WRF is estimated: at -$60 to $70 million.
Pro g ess .S ecifcatior an
d
gr p Drawing "s for 'the;WRF _are , available,for review °at the City's Water
Reso
p _ _ g Ptaluma, CA 94952. Ms. Darlene
Rile Y is acce 1 D
pting appoinappointments nappointments to review the document forthe City ,of Petaluma. ''Her 'phone
number is (707) 778:=45 &5. Review ,can ;also be . conducted at the offices of the Construction
Manager, The Covello - Group, Inc.,, '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 is° (92 :5) 933 =23.00: Review can" also be ,conducted at the offices of the Designer,
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Carollo Engineers, 2700 Y ? acio Valley Road, Suite 300, Walnut Creels, CA 94598. Review
hours are 8:00 am 5:00 pm Mondaylhrough Friday on a first come first serve basis.
Date: 'Milestone:
October 1, 2004 Pr& . qualification Packages Due
November 2, 2004. Notices to PreQualified. Firms
December 1, 2004 Advertise, for Bids
February, f,, 2005 'Opew-Bids
March 7, 2005 Award Constructiontoniract
March 2'008' Construction/Startup Complete
ffl - to the Project, ands qualification for
Thi.s'Prequalification Packa I r
a is speci ic performing
otherCity, pfoj'ects� or City pro Toj ct5 in general.
Each
general cbritractbrand electrical subcontractor wishing to submit a for the Prqjett
.
;f ully complete the, Package, provide dlLmaterials requested and sati0yth e minimum,
prequalificatioit criteria.,
The City has determined that general contractors biddin on the.Yk "ect fhtigt have a Class A ,
din oj k
contractor's license m ,order ,to be eligible for, an - award of the,colitract., El6ctri"cal subcontractors
bidding-onifie.Project inust.have a C40 contractor's 1icense." Any bidder or coriffattor'n
I -_ 1., - dt so
licensed maybe subject to 'afflegal penaltie"& 'unposed by lawjilpluding, b4t ji0t limited to, an
appropriate disciplinary action bythe Contractors' State License Board.
The com Packages, are fioi records' and afe -not o public insp ection. . All
nip pen to
information ,provided will be kept confidential to the extent permitted.by'law. The City ,of
Petaluma reserves, the right to re ny an d 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 w h o has the, legal
authority to bind `the entity submitting the Package or on whose behalf at person is :st gm ng.
The , City itust'.receive 'all PacIcAgesand.-maten"aIs requested ztherein' bythe date Arid time ls , set forth
above. A, Pa6kdgereceived ' after that time will not be coil idered and the _contractor on whose
beflal`fitissiibinitted e to participate in bidding -for I the,ddritfact to construct the
I p ip
Project.
Prospective - General' Contractors and Electrical Contractor may obtain, one :set of
prequalificatiori at no cost at the Water-, Resources . and
Cdmervati'64. Department
off 1 1 Engh sh Street Petaluma, CA You 949�2-2610 Y '. ` also
-. , . may - order 4 copy by - collin'the
n .
Department of Water Resources and Conservatio.at (707) 778- , 4304.
The City shall,not be liable ifor costs.incurie&by contractors in the preparation-, and submittal
of responses to this,ke4uest for!Qualifications.'
Amandatory PreqUalification Package Conference held on.9epte e
.m. at the " mb r 155, 2.0 at 10: 00
a City of Petdlumcs Council Chambers at 11 English -Street, Petaluma,
California Representatives' from the City,, The Covello Group (the tCity's, Construction
'Manager.) afid CArallo Engineers (the City'sDesi "Engineer
gn ) will be . available to discuss the
Project at this conference. All interested contractors are required to attend. No, site visits will be
given but an overview of the ro' °ect site, wrll P
'be resented at'the .Conference.
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The City of Petaluma greatly appreciates your 'interest'' in this project and looks forward to
receiving your responses.
Date Michael. J. Ban R.E_ Director
Water Resources and, Conservation Department
a .
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CITY OF PETALUMA
ELLIS CREEK WATER RECYCLING FACILITY
Yr,equalif cation. Package
Table of Cofttents'
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Instructions
Questionnaire
Part I; Essential Requirements for' Qualification
Part II:
A: Current Organization andj Structure: of Business
B. History of the Business °and `Organizational Perforrriance
C: Licenses
D. Disputes
E. Criminal Matters and„R6lated Civil Suits
F. Bonding
p p y
G. Compliance with Occu ational, Safety and Health Laws ,
H. Prevailing Wage anG,Appren iceship Cornplikice Record
Part III: Recent ConstructionProjeets Completed
Part IV: Current Status of Open Contracts
Part V: Project Personnel Experience
Part VI: Project Personnel Experience (Backup). -
Affidavit
Attachments:
No. 1: Liability and Insurance
No. 2: EMR Criteria
No. 3: Affidavit of Safety Compliance
Prequalification Evaluation
Project Experience Interview Questions'
(I) Complete and submit this page with, the prequalification, package
to indicate completion and incorporation .of each of the listed items
with this package.
Page
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6
7
9
9
1.0
11,
12
14
14.
15
1.6
1.8
20
21
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Initial Each
Item (1)
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Instructions! for Coinpletion,of
General'Contractor and Electrical Subcontractor
Prequalifieation 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 Pub lie Contract § 201 completed Packages: and financial information are
not public records and will not be open 'to public 'inspection. All information provided wilF 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 Ito 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 materials 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 Project.
The prequalif cation ,of prospective bidders will be determined by evaluation of the information
submitted by prospective bidders. The City may - venfy any or all information provided in
completed Prequalif cation 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 :prequalifi6ation 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
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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 upon its review of the contractor's
experi ence, technical and financial capabilities, or failure to, provide information . requested
relating such determination.
The .Cit reserves the right to det y g ermine 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 (generdl ,and electrical) who do not.meet. the following, criteria are. not qualified to
submit b'i'ds' for the. contract to construct the Project and will not be found responsible:
(1) have the, .correct.lcerise, and
(2) have not had a surety finish work on any contract in the 'past ve.(5) years, and
(3) provide at least the ininimum insurance ,requirements called for n,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:
"5) have successfully completed 'in the past five (5) years at least one ,contract„ for
.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, rnechamtal :and - .m8trumeiitation .systems must have been part of that.
contract; and
(6) provide a written commitment from a 'corporate surety licensed to 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 aproject manager and superintendent for the_'Proj'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 SMGD
with complexities similar. to the Project utilizing treatment processes similar. to
'those of theProiect,.and
(8) identify an individual 'project scheduler .and backup who have performed
scheduling services in the last five (5) years for constr of.a wastewater or
other public facility of a, size; complexity and duration similar-. to the _Project. In
lieu, of.identifying such individuals, identify an entity meeting the criteria that will
provide those services.
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In addition to requirements ;l: through; 4, 'above, electrical., subcontractors must also:
5 have succ d �essfull corn lete in e „;th '.past ,five (5) years at least one contrac for
t;
( ) y ti- P
consiructioii. and :startup: of the electrical system of a wastewater or other water
treatment' plant o f''at least 5MGD' with a, minimum electrical bid amount of $5
Million , and com plexities isimilar to, the, :Project utilizing treatment processes
similar'to those of fihe Prod ect, and
(6) identify a ns m the, ,superintendent and foreman, for the Project who..have held similar
positio treatment' lant construction project 5 of at ears on at leas least one wastewater or other water
- st five
p, t 5MGD,with complexities similar to
the Project utilizing treatment processes similar to those of the Pr oj ect.
y p g s. Contractors must meet all of
the criteria in order to ass. Contractors who do: not' meet 'alli of t
The Cit will evaluate all com feted Packa es �on a P;ass/Fail base
p
` � he •criteria will fail and will not
be ualified to participate in;bidding for the contract to coinstruct the Project.
q p ' Pat
Causes for disqualification or rejection. may ,include; but are °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..
2. Lack of ability, capabrlity or skill,, of Contractor to perform the contract or to
prrovide'” 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. made
quatefperfdtniahce of previous contracts or services by Contractor.
5. Lack of�complance „previous or existing, by Contractor-with laws and ordinances
relating to eoritractsi ;or services,
6. Insufficient. financial resources of Contfactor perform the contract and provide
the services.
7. Unacceptable ,numli`er or scope of any conditions attached to the Package by
Contractor
8, Unacceptable, safetyrecord.
The evaluation-,, is solely for the purpose of determining which bidders: are qualified to
successfully perform the type of work mclud'ed m the;Project in .a.timely manner. 'The contract
for construction-of'the';;Project will be awarded, if at ;to the „responsible, pre - qualified bidder.
g p ., Neither _issuing the; Invitation to 'Submit .Prequalfication
submitting the lowest �res onsiue
Packages ;nor reviewing ,responses', to; ahe invitation;, nor any other activity related to the
prequalification process, obligates the City to award; a contract, for construction of the Proj ect to a-
particular contractor; or'at all.
waive any irregularities m any,Package submittal or bid received.
Packages, any or all 'bids, and to
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The-,City of.' Petaluma .reserves the right,to reject any or all
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If any information provided by a prospective bidder becomes ;inaccurate,pthe :party who provided
the information :must .immediately notify the City and provide updated 'accurate information in
writing; and under penalty .of perjury.
The. City, will notify prospective. contractors of the result of the pre
gualfication process in
w An y, contractor who is disqualified q d may' appeal the determination to the ' City. The
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a eal rocess is as follows:
Within two (2) business, days'.. of receipt of written notice t6f disqualification, the
prospective contractor shall notify the City of its intent to appeal. The'rotice of appeal shall be
:made writin&and delivered to the City Clerk of Petaluma at the address° in the Notice Inviting
Subission.ofPrequalification Packages. Ifrequested byahe prospective contractor in, the notice
of appeal, the :City shall. provide .notification in writing of the basis of the 'disqualification 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 ofiappeal:
Within two (2) business days of receipt' of the City's information, the prospective
contractor shall' submit any and all evidence it,vants' the City to. consider in support of its
qualification to perform the. Project: or submit. a written request' for a hearing at which.to, present
evidence. The: evidence orrequest for hearing §hall'be 'in writing and delivered to the City Clerk
of Petaluma at the address'in. the Notice Inviting'Subm ssion of Prequalification'Packages.,
- If the City receives :a fimely.request fora 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 b:e
recorded on audio and/or videotape. The prospective- contractor may request that the- liearing, be
recorded stenographically. If the prospective contractor requests a stenographic record, it shall
be solely responsible for arranging the stenographer and paying ,, al' 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 'the hearing:M concluded.: The City's decision will
be final and binding.
If a prospective bidder or subcontractor does not appeal a ' determination of disqualification or
denial •of prequalification through the process described above the - City's.' decision. on
prequalifi , ion;may.be adopted without further proceedings: Failure to appeal within the_ time
set forth.above'shalfbe deemed. failurelo exhaust administrative remedies and ad as a.bar
to subsequent litigat on.or other' claims procedures.
Because of rthe 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 determation of contractor
a
qualifications, and the bid date will not `be extended .on account of any 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— be 'requested in
writing by first -class mail, e -marl 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 Creel, CA 94596
Fax (925) 933 -0434
Phone (925) 933 -2300
Email bpresser @covello'group.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 document is signed:
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Questionnaire
Contractor Prequalification Package for (check,one): General Contractor
( Electrical Contractor
Contact Information
.A. Full -naive of Contractor (as it appears on license):
Type of organizations (corporation, partnership, ,etc )
If corporation, indicate state �of United States `of incorporation:
Corporate Tax Identification Number:
Is the corporation currently'-registered 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:
Tp
C'. ele hone Number;.
D. Fax Number:
E. Contact Person
F. Email Address;
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PART I. ESSENTIAL REQUIREMENTS FQR.QUALIFICATIbN
Contractor will be immediately disqualified if the answer to any of question's 1
through, 5 Is "no:"
Contractor will, be immediately disqualified 'if the answer to any of questions '6 7, .8
or 9 is `-`yes:'-'
L. Contractor possesses a valid and ,current California. Contractor's 1i (,General Class A
Electrical C10) f6r'the project for Which it intends to submit a,bid.
❑ Yes ❑ No
2. Contractor will coinpl— witlh, and provide all insurance as defined in Attachment No. 1,
Liability and Insurance.
0 Yes F No
NOTE Provide a notarized statement from the insurance carrier(s) you will utilize
on the project certifying that the. specified 'insurance r..equirements will, be met. The
carrier(s) must be admitted hi `the state of California or ,.permitted to do business
under, the Surplus Line Law of the 'state -of California and 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 to Labor'Code section 3700 et. seq.
❑ Yes F No
4. Have you attached your latest copy of a reviewed or' audited fin ancial.,statement" with
accompanying notes and. supplemental. information?.
❑ Yes E 7 1 No
NOTE': A .financial statement that is not either reviewed or audited is not
acceptable. .A letter, verifying av y of a; line of :credit may also be attached;
however, it will 'be considered as supplemental information only, and i& not, a
substitute for the required "financial statement.
5. Have you attached a ,notarized statement from an admitted surety insurer (app "roved by
the California Department of Insurance.) and`, authorized °to issue bonds in thy, State of'
California, which state& that your current bonding, capacity is sufficient for - the ,project for:
which ,you seek pre - qualification?
❑ Yes ` 0 No
NOTE: Notarized statement must ;be from the surety company; not :an [agent or
broker.
6. Has your contractor's license, been revoked at anytime in the last fiv&years?
❑ Yes ❑ No
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y p . y p •completion because
y completed a contract on our behalf,. or aide for
7. Has a Buret firm com lef
our firm was default termnated.by the�pro�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 works contract, or 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
If the answer is "Yes ;," state ithe beginning and. ending,dates ofthe period of debarment:
9. A t any time. during five` years, has your fmn,' -or any of its owners or officers been
convicted of a�;crnme lastvmg the awarding of a ,contract. of a ;governmetnt construction
e involving
project the bidding or•perform' nce offa contract?
❑ ❑ No
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PART II. ;ORGANIZATION; HISTORY, ORGANIZATIONAL PERFORMANCE,
COMPLIANCE WITH CIVILAND CRIMINAL LAWS
A. current Organization and Structure of the�gusiness
For Firms That Are Corporations:
la. Date= incorporated:
lb. Under theJaws' of what staie:_
1c. Provide all the following.,inforniation for each - person who is either '(a) officer of the
corporation (president, vice president; , se'efe - tary, treasurer), or (b) the owner �of At least - ten
per cent of the cotpOratibils stock
Name Position Years with Co. % Ownership
ld. Idenfj ,every construction firm 'that ,any person listed above has been associated with f as
owner, er, gen . eral'p'artner, limited partner or officer) at anytime during the Jast fiV6 years
NOTE; For this question, "ownerll,and "Partner` refer to ownership oFten per cent
or' more. of the 9, or & busint' s U per or more. of its :stock, ." the hugfiiegs' is a
corporation.
Dates of Person's Participation
Person's Name Construction Firm with Firm
For Firms That Are Partnerships:
I a. Date of formation:'
lb. Under the laws:of What state_::
Ic. . Provide all the following information nfor.m.ation for each partner who owns 1 0 percent or more of
the firm.
Name Position Years with Co., %o° Ownership
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- 1 d. Identify everywnstruction company. that any partner has beeii associated with (as, owner,
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general artner, limited partner or officer) at any time du ring . five yqam.
_p uri, g the fast .
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NOTE: For'this question, "owner" and "partner" refer°to ownership'of ten percent
or more of the business; or ten'per cent or more, of'i_ts stock, if the business is a
corporation.
Dates of Person's Participation
Person's Name " Construction Company. with Company
L
For Firms That Are Sole' Proprietorships
.1 a. Date of commencement of,business.
lb. Social' security number. of'compai y owner.
lc. Identify every, construction- firm that the business owner ;has been 'associated with (as
owner, general partner, limited partnerbr officer) at °any during the,Iast five years.
or more of the business { ` or ten. ' er cent or more of its 96& P
' ne P and artner refer-to ownership of ten per cent
- if the business is a
NOTE: For thgs , uestion ow
corporation.
Dates of Person'''s Participation
Person's Name C6ns"truetion Comp ,. ari y - with•ComDany
.-
For Firms That Intend to. Make :a Bid �as'Part of a joint: Venture
1 a.' Date of commencement o f j oint venture.
lb. Provide all of the following 'information for each. firm. is a member. of the joint
venture that expects to bid.on,one or more projects:
Name of firm % o Ownership :ofloint Venture -
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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 subsidi ary, parent, company or affiliate of ' another construction
ho„
firm?
NOTE- Include information about other1irms if one firm owns, 50 per or` more
u.another, or if an owner artner, or officer of your firm holds lds a ; similar position in
another..firm.
F-1 Yes, ❑ No
yes;" explain on a separate signedpage.
Are any corporate officers, partners or owners connected to y other construction'firms?
NOTE; Include information about other ,firms if an owner; partner,- or officer of
your firm holds :a similar position "in another rf '
❑ . Yes ❑. No
If "yes;" explain on. a separate signed -page.
5. State your firm's gross'revenues for.each:of.the lastthree fiscal years:
(20.03 .= 20;04) (2002— 2003) (2001— 2002)
6. How many years hasi your organization been in business 'in California as a contractor
under present business name and license number? years "
7. Is your firm currentlythe 'debtor-in a bankruptcy case?
❑ Yes ❑ .No
If` "yes, ` please attach acopy -of the bankruptcy 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 last five years? (This question refers
only to a bankruptcy <action that_ was not described in answer to question 7,. above)
❑. Yes ❑ No
If "yes; "' pleases attach a copy of the banluptcy petition, sho..wing„ the case number, and
'the: date ,on which the petition was il'ed, rapd a copy of the Bankruptcy Court's discharge
order, or of any °other_document that ended the case, if no discharge order. Was 'issued.
C. Licenses
9. List all `California.construction license numbers, classifications. ana7 expiration dates of
the California contractor licenses held by your firm:
is
11
10. If ,any your firm's'; license(s)'are.held in the name of a corporation or partnership, list
below' the names of the qualifying mdiv1.dua'1(s) listed on the CSLB records who meet(s)
the experienceand examination requirements for each license.
11 Has your firm changed names license 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 in the last five years?
❑ Yes ❑ 'No .
If "yes," explain on a separate signed page, including the reason for the change_
13. Has any CSLB license: held by your firm or its Responsible Managing Employee (RME)
or Responsible. Managing 'Officer (RMO) been suspended .or revoked within the last five
years?
❑ Yes ❑ No
If "yes," please explain on a.separate signed sheet.
14: Within the, past -five (5) years,;has.,the California Contractors State License Board taken
disciplinary action_ against 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 on a. separate signed page, identifying, all such proj'e`cts "by,owner, owner's
address, the:date of completion of the project, amount of li'qu'idated damages assessed and
all other - inforrnaton`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 Ic or 14 on this form.
❑ Yes ❑ No
12
If "yes;" explain on a separate signedpage. State whether` the firm involved was, the firm
applying!for pre- qualification.here or another'firm. Identify-by °name o.f the company,, the
he eve event the o of the pe
wner you e tl the ro.�ect and the with that company, the year of
the J p e basis for the action.
17. In the last five years has our f= been denied, an award of a public works contract:based
Y Y
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 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 ." ass - throughl' disputes in Whichf the. actual dispute is
between a sub- contractor and a project owner., Also, you may omit'reference to all
disputes about amounts than $1100,000.
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 tr-ation
Yes. 0 No
If "yes, "' on separate'signed. sheets of doer identify claims) by providing ,the project
name, date of the claim, -name of the claimant' a brief description of the :.riature� of the
claim„ the court in which the case was filed and a brief description of the status of the
J
claim if not limited by a confidentiality agreement (pending, ,or, if resolved, a brief
description of the resolution).
19, Tn the past Ave years has your' firm made ary claim against a project 'owner concerning
work on a project or payment for a contract and- that claim in court or arbitration ?
❑ Yes ❑ No
If "yes on. separate signed sheets of paper identify, the claim by providing the project
name, da_t_e._of the claim, name of the entity(or ehtities) 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, or -if resolved, a brief description of the resolution).
20. . At any time during the past five years, has; an sus e c y ty p y made any payments on
your :firm'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
coristruction,proj ect either public or private,?
FT Yes ❑ No
•
13
If "yes," explain on' a separate signed page thei amount, of each ;such. claim, the name and
telephone number of the c
p f 'claimant, , the date of the claim,: the ound's 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 i "f resolved the nature of the resolution and the amount, if any,
at which the claim,, was resolved:
0
21. In the last ;five years has aqy2 insurance carrier, for any form. of insurance, °refused to
renew the insurancepoli'cy'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 "ther'efusal.
E. Criminal Matters;and Mated Civil Suits
22. Has your firm- or any of its ;owners, officers _or partners ever beeni found liable in a civil
suit or found guilty in a criminal action for making any false claim or material
misrepresentation t'a any�public agency or entity?
F 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?
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 ❑ .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:
Name of surety agent, address and telephone number:
a. Current bonding capacity?
1.4
b. Unericumbered bonding' capacity?
26. If your firm was;require-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 year "s, 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 been :4 period of time: when your firm had. no surety bond in.
place during a public construction project when one was required?
❑ Yes ; . ~❑ No
If yes, provide details on separate signed sheet indicating the .date when your firm was
denied coverage and the name of the company or companies w.hicl denied coverage; and
the, period -during which you,had no" surety bond in.place.
G., Compliance with Occupational Safety and' ,Health Laws and with Other Labor
Legislation Safety
29. Has `CAL OSHA cited and assessed penalties against `your firm for arty "serious,"
"willful::" or" `iep'eat 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 Appeal ,..
s Board has not yet ruled_ on your appeal you need not include
information about it.
Yes ❑' No _
if "yes," attached a separate signed page describing the citations 'including' inforriatori
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 decision. ,
30. Has the federal Occupational Safety and Health Administration cited and .assessed
penalties against your firm in the past five years?
I
35. Has there, been more. °than.
One occasion during`the.last five years in which your firm was
s e s r prevailing wage wages;' or penalties for your own. firm's failure to comply
th with
' p laws?
`NOTE: This question refers only to your own firm's violation , of prevailing wage
laws, not to violations of the;pr"evailing wage laws; by: a subcontractor. }
Yes ❑ 'No'
If "yes, "' attach! a separate,si ed. page or pages, describing the nature of each violation,
rdentif _ ng the name of't. he number of employees who were in , the public agency for
yi he project the date of its completion,
which it was constructed• t tially underpaid- and the
amount of back wage's and' penalties that you were'required to pay.
16
NOTE: 'If o
y filed ?an appeal,o, a citation« _ pp, has not yet
Boa
�; tend d
,P. R g �e�ls
, f N, P
, n our aa I
ruled , peal ,
o y ppeal or if there is, : a co urt a ou need not include
:
ation aboutrth e : �citation: I
nform
Yes ❑ No
.
;
If "yes; "' attach, a separate :signed; page, deschbing
31.
Has the EPA or. any. Aif� Qtuality Management r or. any Regional Water�Quality
Control
oJtrol Board cityd� and assessed penalties am
mst firm or .the owner of a
rm': was the contractor
on which our fir the past five years?
NOTE: If you'have filed an:appe,al of a citation. and`theAppeals Board.'has not yet
ruled on our
y °a PP cal or if there is a court a pP cal 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 AttachmentNo., 2
33.
Affidavit of Safety Compliance: - Complete Attachment No. 3.
34.
Within the - last five years hasahere.ever been,« period when your firm had employees but
was without workers' compensation,insurance or, state- approved.self- insurance?
❑ Yes ❑ Nc
If "yes,' please) explain the reason for the absence of workers' compensation insurance on
"No,"
a separate signed page. If please provide °:a statement by your current workers'
compensation insurance carrier.il at verifies periods' ofVorkers compensation insurance
coverage for the last five years. (If your firm. has been in the construction business for
p statement by your wort 8, compensation. insurance carrier
less than:five rovi'de a st
verifying continuous kers
ymg s� w,or� � "' insurance coverage 'for the period that your
firm has been in the construction'business.)
H.
Prevailing Wage and Compliance Record
35. Has there, been more. °than.
One occasion during`the.last five years in which your firm was
s e s r prevailing wage wages;' or penalties for your own. firm's failure to comply
th with
' p laws?
`NOTE: This question refers only to your own firm's violation , of prevailing wage
laws, not to violations of the;pr"evailing wage laws; by: a subcontractor. }
Yes ❑ 'No'
If "yes, "' attach! a separate,si ed. page or pages, describing the nature of each violation,
rdentif _ ng the name of't. he number of employees who were in , the public agency for
yi he project the date of its completion,
which it was constructed• t tially underpaid- and the
amount of back wage's and' penalties that you were'required to pay.
16
36. During the last five ,years, has there been.morethan;one occasion in which your own firm
has been penalized 'or required. to pay back wages for failure to comply with Alie federal
Davis -Bacon prevailing wage requirements?
❑ I''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
which 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; ha's 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 bnlit reference to any incident that occu"r"red prior to January,
'2903, if the violation was by a subcontractor; and your firm, as general contractor on
a`project, had. no , ' knowled'ge. ofthe subcontractor's violation at tht 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 CONSTRUCTIONIPROJECTS COMPLETED
Contractor- shall provide inforir ation about six pullil c works projects completed within
the last five years. At least three (3) of the projects must be wastewater or water projects
'Of sunilar size and complexity. The general contractor must list at least one project with
a minimum completion value of' million. The electrical contractor must list at least
one project with a minimum completion value' of'$5.0 million. Names and references
must be current and verifiable.. Use separate sheets of paper that contain all of the
f o llowing information:
Project Name-
Location-
Owner:
Owner Contact (name and cufrent phone number):.
Architect. or. Engineer:
Architect or Engineer Contact (name and current phone number):
Construction Manager (name and. current phone number):
Description of Project Scope'of Wofk Performed:
Original Bid Amount:
Total Value of Construction (including change. order,$)
W3
Original Scheduled Completion -Date:
Time Extensions ,Granted (number of days)
Date of Substantial Compl'eiioi'
Electrical Contractor Only:
General Contractor:
General Contractor (name and current phone. number): '
Part IV Current Status of Open C
$10.0 million; electrical subcontracto
ifter 9/1/04. -(Make Copies A& Require
tracts valued at $2.0 million or more.
Project Name & Owner " Owner Original Dollar Value Percent Original Estimated
Type of Work Name Representative Contract Value Complete to Date Physically Completion Completion
Phone Complete Date Date
Name No.
20
Part:V= ProiectTersonnel Proiect Experience . .
Please summarize the construction experience :of the propose&project manager,'superintendent, and scheduler of - your organization and the backups .to these ke
positions (ggnerdl_contractor). Electrical subcontractors; please provide information.for project managers: and foreman.
Individual's Name Position Construction Constructon.Experence During the Last 5 Years
Experience '
'Total Employed b.y
Years Your Firm
Y/N Yrs Project Name Value of Type of Work In What No.
Work '(WWTP,, Other) Capacity? Yrs..
r
Part VI- Proiect Personnel Pro'je'ct Experience (Backup)
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
Y/N Yr >s Project Name. Value of Work
- -Type of Woork_, In What No.
(Road, Capacity? Yrs.
Underground)
22
AFFIDAVIT
We, the undersigned, (name) as the. authorized
representatives for (company) .an
interested contractor for the City of Petalurna'.s 'E llis .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 of the: State of California that the foregoing is correct.
We acknowledge:that we have received, Addendum through
ty' g p
We understand that the Gi will investigate ari y and' all statements and representations made by
us and our firm this Statement of Qualifications .and, we freely give our_ permission for them to
do so. Should releases, `required by any of '�our professional, financial; or bondmg `institutions
to release verification Of ' the enclosed' data,' we have provided them. We, agree 10 waive any
clai ins ,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- thisk'Statement of
Qualifications.
We further understand that Many false, statement or representations made: - in this application will
result.in disqualification of`our firm as a bidder for the Project. If it is determined thatbese1alse
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'r n to, qualify for any City of Petaluma contracts for a
minimum,peri`od of one, (1)' year sand a, maxi mum. 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 for cause
and to seek legal remedy under the prevailing statutes,.
(Name).
(Signature)
(Title)
Attested: Corporate Seal
(Name)
(Signature)
(
Date 5 2004
23
ATTACHMENT NO. 2
SAFETY QUALIFICATION WO I RKERS` COMPENSATION EXPERIENCE
MODIFICATION CRITERIA
The following information will be used to determine if you meet the minimum safety
requirements for this prqj'oct. 'To- qualify to bid and be Awarded the project, the Contractor's
three year average Workers' Compensation Experience Modification (EMIR), must not be greater
#idn .95 (95%), Please obtain a letter from your insurance carrier (or state fund if applicable)
with your interstate EMWs for - the 'lastthree full rating petiod§. If you do not have an interstate
rating, 6btain iiitrasidte:EMR'� . 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).
YEAR EMR
•
Three % Year Average
Are the above rates interstate oTint,rastate?
If intrastate, which state?
*NOTE': My of the following '
met hods of "obtaining a, letter" are acceptable
• Furnish ajetter from your insurance agen insurance, carrier or state' fund (on their
,
letterhead
ven'fyirig,thelEMR data listed above-, tor'
• Furnish z Photostat of the last , three yearg' Experience Rating Cale . ulation Sheets, which
your insurance carrier- should forward'fo, you ,annu'ally; or
• If you are in a "state fund" state, such'a:s Ohia or West Virginia fart Photostat ofihe
state's last three years annual` statement page "' that shows the modification and the
coverage period.
i
"T "'C ENT NQ: 3
SECTION Or0490
AFFIDAVIT OF SAFETY COMPLIANCE'
The Contractor hereby, acknowledges City, concerns regarding, safety at its facility and at the Project
worksite. The Contractor shall conduct its operations�to eliminate-or reduce hazards and risks associated
with Contractor's activities, to prevent accidents and. in and to prevent propertyd`amages.
Therefore, strict compliance with all of the most current safety; health and environmental regulations
(federal, state and local), is, required. Non - compliance with these regulations may result in suspension or
termination of work in progress.
The Contractor's Safety P,rograrns must' aecomplish.,the foregoing objectives. The Contractor certifies
tha "t its, Safety Programs coinply;and. will satisfy these requirements. The Contractor also certifies, that
each.:Subcontractor and Sub- subcontractors and, other parties with which it has agreements to perform
work on the Project works ite will also comply°and will satisfy these °requirements.
The mandatory (and other). Contractor Safety 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 Contractor further
ackrnowledges that its Subcontractors and Sub - subcontractors will provide all
Safety Compliance documents in accordance, with Specification' S'ection.00490.
Signature Name of Bidder
Title Date
Attach, a Certificate of Acltiiowledgement for the Notary,to the Affidavit.
Petaluma Prequal
0049,0 -1
•
•
I
CITY OF PETALUMA
ELLIS CREEK- WATER RECYCLING FACILITY
PREQUALIFICATION' EVALUATION
General
Electrical
Contractor Name:
Evaluation :Criteria-
Pass /Fail
Pan I:
Essential Re uirements
Part II:
A. Current Or anzat`on
.B. Business History
CAicenses,
D., Disputes,'
E. Crinnnal Matte - m
F. Bonding
G. Safety .
H. Prevailing Wage , arid Apprenticeship
Part -III:
Recent Constructed. Projects Com "p leted . and
Reference Chock
Part IV:
Open Contracts'
Part V & VI
Project Personnel,
Attachments
No. 1.= Liab'ility;and Insurance,
No. ,2 — EMR Criteria
"No. 3 - Affidavit.of Safety Compliance
�. ..�-PROJECT EXPERIENCE
INARVIEWQUESTIONS
The followingqiiesfibins will; 'be. used. to interview randomly selected contacts from completed
I w
projects The City, will.condubt 'the niervi& s. No qoiici,n,,,6ii.the�-&dntr.-dotor's is necessary.
These questions th,econtractor-f6r information only.
The highest,possible. sc&&is I 30;°points- �A- score less l ihan 60 points disqualifies a contractor
from bidding on the Project. X score of,'betwe.en 66 arid. 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 giveta.briie p., Aioff
'- of the project.
it. Are., there any outstanding -, stop notices, liens, or - claims -by the 'contractor that are
currently -unresolved on, contracts, for which notices of completion were recorded' more
than 12'0 days " go? " p
a �Q �- oint for each is deducted fIbm,.overall score; maximum amount to
be deducted is 5 points).
2.- On a scale: of did the contractor provide ;adequate personnel?
(Max. 10 points)
3. On a scale of 1 40, With 10 being the best, Aid the contractor provide adequate .
supervision? -(Max., 10 points)
4. On a scale- of 140, With 10 being the best, was there adequate equipment provided on the
job? (Max. 10
5. On a scale of 1-10, with 10 being the best, was the contractor timely in providing reports
and other paperwork-, including, change order paperwork and scheduling updates? (Max.
.10 points)
6. On 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 proj ect:c.ompleted onfirrie? (10 points if 'the answer is "Yes")
Or, if 'the, answer is "no", on a. scale of 1--10, with 10 being the best, to what extent Was
the.contrador,responsible for the deJayin oompletion?
8. On a scale of 1 -1 0, 'with '1 0 being 'the best, rate, thb,dohtractOr on. the timely submission of
reasonable, cost and time estimates to perform change.order work. (1\4ax 10 points)
9. On a scale of" 1 -lb, with 10 being, the best, rate the ,contractor on how well the contractor
performed the work after a change order was issued and how well the contractor
integrated the change order gr g erwork , existing .work: (Max. 10.points) .
10. On a scale of 1 -,10, with 1'0 " being, the best, cafe how the contractor performed .in training
trainin .hand taken care of warrant items? Max. 1 points)
g
in O erations� ,& Mauitenance manuals . corn letin as built drawin 's , ; providing -required .
g g Y ( p )
11. On a scale'of I -I0 with 1. 0 beinge the'bes't, rate the. contractor on whether there were an
unusually high: number of claims; given "the nature 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, scale. of `l -10, with 10. being ; the ` best, rate the contractor with respect to: afety. Was
shoring provided properly, were lock Pout tag out :procedures followed, did the contractor
provide safetytrairing ?'
14. On a scale of 1 -10,, with 10 being the best, how would "you rate the overall quahty�of the
contractor's work? (Max. 10 points)
•
r
I „
1
.ATTACHMENT NO'. 1
SECTION 00800
'SUPPLE'ME'NTARY GENERAL CONDITIONS'
2..0 LIABILITY AND INSURANCE
, 2.1 Insurance
Within ten (10) after award of the Contract, the Contractor - shallpromptlyobtain, at its own
expense, all the insurance;required by Section 00800- 2,0,:LIABILITY AND IN and
submit coverage verifi'cation;for review and'approval by the City prior to the City's execution of
the Contract.
i. The Notice to Proceed with the Work°under this 'Contrac - willnotbe issued,,,and the Contractor
shall not commence'work, until such insurance has been approved .b'ythe City.. Such insurance
shall remain in full force and effect 0,all times during the prosecution of the 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 her
The Contractor shall not allow any subcontractor to commmence work on its,subcontract until all
similar insurance required of the :subcontractor, except Builder's Risk Insurance, has been
obtained and verified bythe Contractor and submitted to the!Construction- Manager for the City's
review and records. Subcontractors shall furnish onginal.cert ficates� nd "required didorseinents
as verification of insurance coverage: 'The insurance liabilitylimits specif'ed in Section 00800-
2.0, LIABILITY AND INSURANCE, shall also applyfor all. subcontractors, listed in Section
00430, DESIGNATION OF SURCONTRACTORS'. The Contractor shall designate the
required- insurance liability limits, for a ll, other subcontractors.
Cornpanies4riti,4 the insurance under this article shall "be licensed to°do`business inthe State of
California or be ermitted tondo busines
p sunder. the Line - -`Law of theState of California.
Insurance into. be p faced with insurers with a-current. A.M.- Best's rating; of no Iess A;_VII•:
All.policies of insurance, required herein shall provide that'they may be suspended' voided,
canceled, reduced iii coverage or in limits only after thfi y.(30) days' prior notice by certified
mail return receipt 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.construedzs imiting;the extent of
Contractor's responsibility for payment of damages resulting from its operations under this
Contract. Coverage required :hereunder shall operate as Primary insurance.
Petal uma_Prequalification
00800-1
The Contractor shall.take out payfor' and mainta n throughout the duration of this Contract and
for such ,additional periods as more specifically required' herein.. the .following insurance
coverage:
.1 Commercial General Liabilityaild Automobile Liabilit lnnsurance = This insurance shdlI
2.1 , `
protect the Contractor from claims for bodily injury' and property damage which may arise
because of 'the nature of the work or from operations under this Contract. The Commercial
General Liabihty`Insurance shall be maintained for five: (5 ) -years after'final completion and shall
provide coverage on an occurrence basis.
a A
p Commercial General Liabilitypohcy:ofmsur
as add tional insureds the Cit of ance shall';include
alum each of its officers, officials employees,
agents and volunteers; the Design Consultant the Construction Manager and each of
theirpartners, officers; employees, andagerits and coverage provided'to such additional
insured, This policy shall provide coverage to each of the said insuredS'uVlfh respect ,to
said work. ;Said policy shall,provide primary coverage to °the fultlim `t of liability stated
in the declarations.
b.(1) Amount of COVerage (General Contractor)` The bodily injury; personal i in jury and
property damage liability of the Commercial General Liability insurance shall provide
coverage4m the following limits of liabihty: $2,000 on account.of anyone =occurrence
for•bodilyinjury and.property damage, $2,000,000 personal and advertising injury limit
with an annual ;general aggregate limit of not less than $1.0 milliorn; and. $1 million
products and completed. operations aggregate;, combined single;;limi't-. The Automobile
Liability nsurance.pol cy shah ` Vide minimum limits of $1,000,000 peraccident, for
bodily injury and property damage ,and $5,,000 ; 000 policy aggregate arising out of the
ownership,, or use of any owned or non - owned vehicles.
b.(2) Amount of Coveraae(Electrical Subcontractor) The bodily injury, personal,injury and
property damage liability of the Commercial General Liability insuranceshall provide
coverage in the following limits.of liabihty:'$2 •on account one occurrence
for bodily injury and property damage, $2 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 rnininum limits of $i 3 O00,00Uper accident and
$2,000,000 policy aggregate arising- out of the maintenance, •or of any
owned or non -owned vehicles.
c.: Subcontractors — ;T lie.bodilyinjury and property damage -liability'insurance shall notbe
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
whic1m ay 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 Injury - ( False Arrest, Libel, Wrongful Eviction, etc.)
Advertising _Iniury
Broad Form Property:Damage, Including, Completed Operations
Separation of Insureds /Cross - Liability Provision
Duty to Defend all Insureds
Deletion of grgy Limitation on Coverage for Bodi1" Injury or Property Damage Arising
out of Subsidence 'or Soil o`r Eait 'MV vement
Separate Aggregate 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..
r
XCU - (Explosion, Collapse, Underground Damage) XCU may be deleted when not
applicable to operations performed by the Contractor or its subcontractors.
Environmental
Blanket Contractual Liabilit,
e: Umbrella-Policy - 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 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 2 (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
Petaluma 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 withsuch 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 personswhom 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
arise.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
basis, including coverage for "soft costs" such as design and engineering fees .and delayed
completion. Such insurance shall also cover the perils 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, Bail, explosion, riot, riot attending a strike civil,cornmotion, 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 Cityshall be namedos an insured.
(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, thewCityrequires 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 furnish the City with certf cate(s) evidencing issuance of all
insurance mentioned herein copies of the policy declaration: or; information page(s) and
additional insured: endorsements. The certificate(s) and endorsements for each insurance policy
gn
; are to be si ed p
b y a � erson authorized by that insurer to bind coverages on its.behalf. The
endorsements are to be on forms A -1,and B -1 as included it Section •00650, GENERAL,
LIABILITY' ENDORSEMENT,,and Section 00651, AUTO LIABILITY ENDORSEMENT,
or equivalent endorsementforrns acceptable to the City. Theecertificate(s) policydeclaration or
information,page(s), and endorsements are,to be •received and approved by the Citybefore work
,commences. Except for the waiver of ;subrogation rights endorsements,. as required under
Sections 00800 2 1,.2 an X00800 2'.1:3, no other - endorsements are required for Workers
'Compensation- or Builder
s Risk Insurance. Such certificates of_ nsurance shall provide that the
be c
insurance olic , shall not an
p y celable;be subject 10 nonrenewable,br otherwise>be subject to
material modification' thirty (36) days prior written 'no'tice to the City and
Contractor. Contractor 'shall also provide certifibate(s) evidencing .renewal'st of all - insurance
required herein, at east ten,(3,0) days prior to the expiration date of any such insurance.
Any deductibles or self - insured retentions; must be ;declared to and approved bylhe City. At the
option of the City, either: the insurer shallreduce or eliminate such deductibles or self-insured
retentions as respects. the'. City, the Design Consultant,and the Construction Manager and - their
officers, officials employees agents and 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
rec e i void:which option,, indicates any required insurance coverage will be diminished or.. canceled, City.at .
its o " , ma
p y, hstanding 'any other provisions of thi s Agreerrierit to the contrary,
notwit
immediately declare a material breach this Agreementand suspend all further work pursuant
to this Agreement.
2.1.5 Indonihificatioh - To the, fullest extent permitted by Law,,the Contractor shall:indemn fy,
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 (I) is attributable to bodily
injury, sickness, disease, or death (including 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 sole negligence or
willful misconduct of a party indemnified hereunder: Such obligation shall not.be,construed to
negate abridge, or otherwise reduce aiiy other right or obligation of indemnity which would
otherwise exist.
2.1 Injury or Illness Reports - The: Contractor shall furnish the Construction Manager with a
copyof the Employer's Re Injury immedia any incident,requiringIthe filing
ofsaid report during the'prosecution of the work under this _Contract..The Contractor "shall also
furnishAlie Construction Manager -with a copyof theaErnployer's Report of injury involving any
subcontractor -on this project.
11.7 Notification of ;Insurance Companies The, Contractor shall advise ;all' insurance
cornparuess,,to familiarize tl ernselves with all of the Conditions and provisions of.this.Contract,
and they shall waive the'xight of special notification of any change or modification of this
Coritract,:or, of,extension oftime or.of decreased or'increased work, or'of theicancellation of the
Contract or act or�acts by the.Cityor its; authorized :employees and agents; 4under the
teritslof ihis.Contract, and,failure to so notifythe aforesa d insurance companies of charigesahall
in noway relieve -the insurance companies of their obligation under this Contract:.
2.2 Insuranee:During: Guarantee Period
For a11 work th&CoAtraptor or itssubcontractors perform during; he guarantee period, worker's
compensation, and commercial general liability insurance and, insurance m the - amounts ,and'
format rq
e uired herein shall remain in force and be maintained for ,five (5) years after final
completion'
The`C_ontractors anddnsurance companies are; again „advised that thework site is located within
the 100 year floodplane as defined by theFederal Emergency Management Authority (FENIA).
f
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Petaluma_0requalification 00800-6
a -
CORATION REQ U IREMENTS
. , CONTRACTOR'S SAFETY
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 project. Other safety programs may be requested if it is later determined that they are appli=able to the Project, and as
such, must be made available for review`upon request.
u �,v� i vci �uvriac tau, Nr kjLGI .LR/1.1 by GQJUI cJ k 01111 FUL UG UJCU.
Petal uma- PrequaIification 00490-2
Do you
Program
Sub will
Have project
Is the training
Program❑
have a
meets
provide
employees
:documented?'
Comments0.
written. I
Ca00SHA.,
been
_
program?
Criteria;
trained?
Mandatory'
Yes 'No J
Yes No
Yes No.
Yes - No ;
t
YES lnjury and 1114ess
Prevention
YES
Hazard Communication
YES
Confined Space
_
operations"
Respiratory. Protection
Emergency R es p onse'
Hearing, Conservation
YES
Lockout/Tagout
YES
N`ew Employee
orientation__
YES
Excavation Safety
-
Code of'safe Practices,-
'-
YES
Personal Protective`
Equipment (PPE)=
YES.
Drugs /Alcohol
YES
Traffic-Control Safety
YES
Fall Pte,Ven Plan
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Petal uma- PrequaIification 00490-2
'CONTRACTOR'S SAFETY OPERATIONS REQUIREMENTS
PART B - Safety �Eqthpment - IdOntif What seffety'equipment Will be-a\jail;jble and used for this project.
Type De",diri P tion/Gomments
_
j Gas detectors
.
f i Ventilation'eq'
equi
I Appr6ved harnes§es,and lanyard.&
M6ch-anical hbists.
Fire exting u
First aid kits
Respirators
Hard hats
Hearing protectorsf
Safety goggles.
Steel toed
Hand - prWO(tion,
Fail protection
Confin Space Rescue, Equipment
PART C - Specialized Training and Certification - Identify. the , areas of specialized. training or certification, that will have
been completed. bvemDlovees who 'will b assigned to .this nmip-rt Rp-nrp.'nAtp-(i tnhrr)vidp-rinf-iiMphfqfintir;:icr6rfiiinizfg:iii
Petaluma-Prequalif * ication
•
CPR/first aid
Con Ki bd.s and
Scaffolding
'I
Fdirk lift operation;
Respirators Air - Suppl
Flagging
Air-Putifyi' ng
Cranes/h'oisfspp.(jration
Trenching shoring
Traffic-Control
comp etent °person
Heavy equipment operation
Welding
F: tools: use
Asbestos abatement
Petaluma-Prequalif * ication
•
CONTRACTOR'S SAFETY OPERATIONS REQUIREMENTS
PART D - Jobsite Safety Practices,
P p y j y
1.. Name of pe rson who will. have res � onsibilit for ; 'obsite. safet
2. Who will be responsible for,conducting and'documenting accident investigations?
Does your company perform, near-miss investigations? .
Please provide sample copy of investigation forms.
3. How often a re jobsite S a fet y g u d lts.or inspections performed?
and by whom? m
4. Does the person who is responsible for jobsite safety have auth'o"rity to take immediate
action to correct unsafe: conditions of practices?
5. How often are jobsite tailgate or toolbox safety rneetings held?
B. Briefly describe how you will .ensure that workers comply with safety programs and
Cal /OSHA requirements?
7. Please list any Cal /O'SHA citations and penalties you. have received,in the last three years.
8..
Have . there been any on.-the fob fatalities::in the last five years?
if yes, please ,explain.
9. Does your company have a safetyincentive grog "rare?
If yes, please explain.
Petaluma -Prequ a)ification 00490-4
CONTRACTOR'S SAFETY OPERATIONS REQUIREMENTS,
PART E': Evaludtion, W6rksheet
(FOR, USE BY THE CITY ONLY)
- Company Name
Con-tact, Person
Item
Mn
E 0,
M,
0), C
C 'n
- M �'
C
L) CD Cu
Cu j)
2 7 E 0
15 �'
0 co C)
0 0
E
E
-0
PART A:. Safety Programs
Injury and llln Protection
Yes
,Hazard Communication
Ye
Confined S pace, Ope rations
Yet
Lockout Ta.gou-t
iYet
New Empl0yee on
...
Yes
Drug and Al'cohol'Policy
Yos
Excavation Safety
Yes
Traffic:Cqntr.ol
Yes
01her-Pro'grams: PPE, Fal
PART B* Safety Equipmeft
PART ,C: Ttaihing and
Certiftations
PART D J.'
obsite Safety Practices
Responsible Person'Named
Accident, jr nyestiga.tions
Wot �S-afety,lnsp,ections
Safety Meeting s -
Compliance With'Safety Req-Ljirqm'en
Cal/OSHA Citations /Penalties
Fatalities,
Safety Incentives
END OF SECTION**
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Petal uma�-Preq ual ification 0049G —5