CITY OF ALTURAScityofalturas.us/City of Alturas FINAL Request For...The City is a California Municipal Corporation and was formed in 1901 as a General Law City to provide a range of

CITY OF ALTURAS

Solicitation to identify and prequalify companies to provide design-build services for the design and construction of a

New Aquatic Facility

in the City of Alturas, California

Notice is hereby given that the City of Alturas (“City”) seeks to prequalify design-build service providers (“Builders”) to submit a proposal for the construction of a new aquatic facility. The City has determined that all Builders must be prequalified to be eligible to submit a proposal for the Aquatic Facility Project (“Project”) pursuant to Public Contract Code section 22164, and by this notice solicits statements of qualification. Once prequalified, those builders will receive proposal documents and be invited tosubmit proposals for the project.

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The purpose of the solicitation is to comply with the requirements of the California Public Contract Code section 22160, et seq., and provide the best possible project for the best value to the community by identifying the maximum number of companies that have the financial, technical and construction experience to work with the City to design and build the highest quality project at the best cost. This step in the process requires companies to submit information about their company’squalifications, experience and licenses to demonstrate that they are capable of designing and constructing this type of facility and to prequalify as many companiesas possible that will then be able to submit proposals for the actual project.

I. DESCRIPTION OF PROJECT

The City is a California Municipal Corporation and was formed in 1901 as a General Law City to provide a range of municipal services including recreation and aquatic services and is undertaking to design, construct and operate a new aquatic facility and associated facilities at property owned by the city on the northwest corner of West 4th Street and North Nagle Street (address to be assigned), Alturas, California. The location of the project is approximately ¼ mile to the east of the the city’s existing pool and is part of a collection of government owned (multiple owners) properties totaling approximately 75 acres which currently host a range of existing amenities, including two schools, baseball complex, livestock arena and will be the site of additional recreation and community use facilities that have been proposed for future construction.

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Alturas is the county seat of Modoc County, has a population of just over 2,500 and has an elevation of 4,370 feet. The City is located in California’s northeast corner in an expansive alpine valley that straddles the north fork of the Pit River and is located to the west of the picturesque Warner Mountain Range. The rural nature of the community and relatively small population have not stopped the community from coming together to provide a wide range of amenities that help maintain the great quality of life that many come to the area to experience. The first phase of this particular project has been made possible through a generous donation from the estate of a local benefactor that has contributed over two million dollars to the project with funding for future phases coming from the City, private individuals and other community organizations. The new aquatic facility will be situated and occupya parcel approximately 3 acres in size. The existing pool is approximately 60 years old and is in need of significant rehabilitation and is not situated in the most ideal location. A pool committee working under the direction of the City Council has elected to build a new facility in a more prominent location facilitating the creation of an activity hub and allowing the existing pool to remain in operation during the construction of the new facility. The City intends to procure the new aquatic facility as a design-build project pursuant to Public Contract Code section 22160- et seq., using the best-value method specified in Public Contract Code section 22164(f).

This project will require the completion of the project design, which will include design for the entire 3 acre site (though only the aquatic facility and associated facilities are anticipated to be constructed under this project), creation/approval of architectural and engineered plans and specifications for the aquatic facility and associated facilities, preparation of a Guaranteed Maximum Price (GMP), and upon the City Council’s acceptance of the GMP, construction of the aquatic facility and associated facilities in conformance with approved project plans, including but not limited to the following:

Scope A: public swimming pool, therapy pool, pool drainage and filtration, and pool perimeter deck.

Scope B: bathhouse, mechanical building with equipment storage, concession area, site utilities (including connection to off-site geothermal service line), security fencing, vehicle parking, landscaping and landscape irrigation, patio and pathways, geothermal heated patio, floor and pathways and frontage improvements along West 4th Street and North Nagle Street. (Geothermal water from the local joint agency geothermal utility project in partnership with the Modoc Joint Unified School District will be used as the primary heating source for the pool and building and will be supplemented by electrical heating.)

This prequalification solicitation is designed to identify a qualified builder(s), who will then be invited to submit proposals for the project. In evaluating the qualification questionnaires, a committee consisting of City and contract staff will evaluate the builder’s proposed design-build team, history of work on similar projects, safety record, financial ability to undertake the project, and responses to

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other questions in the prequalification questionnaire. All builders who meet the minimum requirements will be prequlaified. The selected builder will be responsible for the work of its own forces and designating project subcontractors in compliance with all public contracting laws. The builder shall manage project design, planning, development of plans and specifications and construction by effectively working in close association with the City’s Public Works Director, Project Manager or designee.

II. ANTICIPATED SCOPE OF WORK

Though subject to change prior to issuance of the Request for Proposals for this project, the anticipated scope of work will generally include the creation of a complete design for the 3 acre site, preparation of architectural and engineered plans and specifications, preparation of a GMP, and upon the City Council’s acceptance of the GMP, construction of the following:

Scope A:

A 75’ 1” by 42’, 6 lane, 25 yard certifiable competition pool meeting USA Swimming requirements with 12’ by 3’ stair entrance and permanent handicap accessible lift. The 25 yard competition swimming pool will facilitateboth lap and free swimming with a depth ranging from approximately 3’ 6” toapproximately 9’. A 40’ 6” by 19’ 10” therapy pool with 35’ by 5’ ramp (beach) entrance. The therapy pool will range in depth from 0’ to 5’ and be compatible with related on and off-site improvements. Both pools will be turn-key including all permitting, pool drainage, pool perimeter decking and associated plumbing and mechanical facilities.

Competition pool approximately 3,114 square feet approved for USA Swimming competitive 25 yard events

Sanctioning requirements such as lane lines, touch pads, timing equipment & scoreboards.

Therapy pool approximately 980 square feet

Approximately 4,500 square feet of decking, including deck drainage

Adequately sized heating, drainage, filtration and plumbing system

Pool to be fully operational once water, sewer, electrical and heating services are provided.

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Scope B:

Construction of an approximately 2,500 square foot bathhouse building, including related on and off-site improvements, including a check-in area, men’s and women’s locker room with showers and restrooms, a family restroom, office and storage space.

Construction of an approximately 2,250 square foot mechanical building with equipment and operations area, chemical and equipment storage with additional plumbing conduit(s) for addition of future splash park.

Site utilities for the entire project (sanitary sewer facilities, geothermal, water, propane and electrical, etc.), parking, fencing, and landscaping. All improvements to be sized to serve and be compatible with on and off-site improvements included in Scope A.

Bathhouse – 2,500 square feet

Site Utilities – water, sewer, gas, electrical and geothermal

Parking – approximately 70 parking spaces

Fencing – approximately 1,500 linear feet including service gates

Landscaping & Irrigation

Site Lighting

Patio & Pathway – approximately 7,000 square feet

Radiant heating under decks, patio and building

Emergency access roads

Frontage Improvements

III. EXPECTED COST RANGE OF PROJECT

Preliminary project cost calculations estimate a total project cost of approximately 2.5 million dollars for the creation of a complete design for the 3 acre site, preparation of architectural and engineered plans and specifications, preparation of a GMP, and upon the City Council’s acceptance of the GMP, construction of the workdescribed in Section II, Scopes A and B above.

IV. PREQUALIFICATION PROCEDURE

It is mandatory that all builders who intend to submit a proposal for the project fully complete the prequalification questionnaire, provide all materials requested herein, and be approved by the City to be on the final qualified proposer list. No proposal

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will be accepted from a builder that has failed to comply with these requirements. If two or more business entities submit a bid as part of a joint venture, or expect to submit a bid as part of a joint venture, each entity within the joint venture must be separately qualified to submit a proposal. The last date to submit a completed questionnaire is 3:00pm on Friday March 23, 2018. Completed questionnaires will be opened and evaluated as soon as they are received and builders are encouraged to submit prequalification packages at their earliest convenience so that they may be notified of omissions of information to be remedied or of their prequalification status well in advance of the release of the notice inviting proposalsfor the project. No preference will be given to early submissions. A list of all prequalified builders will be available on March 28, 2018.

Answers to questions contained in the attached questionnaire, information about current bonding capacity, notarized statement from surety, and the most recent reviewed or audited financial statements, with accompanying notes and supplemental information, are required. The City will use these documents as the basis for prequalifying builders. The City reserves the right to check other sources available. The City’s decision will be based on objective evaluation criteria with all builders meeting the minimum prequalification requirements being eligible to participate in the project proposal process.

The City reserves the right to adjust, increase, limit, suspend or rescind the prequalification review based on subsequently learned information. Builders whose eligibility changes sufficient to disqualify them will be notified and given an opportunity for a hearing consistent with the hearing procedures described below for appealing a prequalification rating.

While it is the intent of the prequalification questionnaire and documents required therewith to assist the City in determining builder responsibility prior to bid and to aid the City in ultimately selecting a builder in accordance with Public Contract Codesection 22160, et seq, neither the fact of prequalification, nor any prequalification review, will preclude the City from a post-bid consideration and determination of whether a bidder has the quality, fitness, capacity and experience to satisfactorily perform the proposed work, and has demonstrated the requisite trustworthiness.

The prequalification packages should be submitted under seal and marked “CONFIDENTIAL” to Public Works Director, 200 West North Street Alturas, CA 96101.

Pursuant to Public Contract Code section 22164(b)(4)(B), prequalification packages (questionnaire answers and supporting documents) submitted by builders are not public records and are not open to public inspection. All information provided will bekept confidential to the extent permitted by law. However, the contents may be disclosed to third parties for purpose of verification, or investigation of substantial allegations, or in the appeal hearing. State law requires that the names of builders applying for prequalification status shall be public records subject to disclosure, and the first page of the questionnaire will be used for that purpose.

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Each questionnaire must be signed under penalty of perjury, in the manner designated at the end of the form, by an individual who has the legal authority to bind the builder on whose behalf that person is signing. If any information provided by the builder becomes inaccurate, the builder must immediately notify the City andprovide updated accurate information in writing, under penalty of perjury.

The City reserves the right to waive minor irregularities and omissions, request additional information to supplement information contained in the prequalification application submitted, to make all final determinations, and to determine at any time that the prequalification procedures will not be applied to a specific future public works project.

Builders may submit prequalification packages during regular working hours on any day that the offices of the City are open. Contractors who submit a complete prequalification package will be notified of their qualification status no later than tenbusiness days after submission of the information or March 28, 2018, whichever is earlier.

The City may refuse to grant prequalification where the requested information is notprovided by the submittal deadline referenced above. There is no appeal from a refusal for an incomplete or late application, but re-application for a later project is permitted. The closing time for proposals will not be changed in order to accommodate supplementation of incomplete submissions or late submissions.

V. APPEAL PROCEDURE

Where a timely and completed application results in a rating below that necessary to prequalify, an appeal can be made. An appeal is begun by the builder delivering notice to the City of its appeal of the decision with respect to its prequalification rating no later than five business days after receipt of notice of the builder’s prequalification status. Without a timely appeal, the builder waives any and all rights to challenge the decision of the City, whether by administrative process, judicial process or any other legal process or proceeding.

If the builder gives the required notice of appeal and requests a hearing, the hearing shall be conducted so that it is concluded no later than five business days after the City’s receipt of the notice of appeal. The hearing shall be an informal process conducted by a panel to whom the City has delegated responsibility to hearsuch appeals (the “Appeals Panel”). At or prior to the hearing, the builder will be advised of the basis for the City’s prequalification determination. The builder will be given the opportunity to present information and present reasons in opposition to the rating. Within one day after the conclusion of the hearing, the Appeals Panel willrender its decision.

The procedure and time limits set forth in this section are mandatory and are a builder’s sole and exclusive remedy in the event of a prequalification rating protest. Builder’s failure to comply with these procedures shall constitute a waiver of any

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right to further pursue a prequalification rating protest, including filing a Government Code Claim or legal proceedings.

It is the intention of the City that the date for the submission and opening of proposals will not be delayed or postponed to allow for completion of an appeal process.

Note: A builder may be found not prequalified for bidding on a specific publicworks contract to be let by the City, or on all contracts to be let by the City until the contractor meets the City’s requirements. In addition, a builder may be found not prequalified for either:

(1) Omission of requested information or

(2) Falsification of information

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Note: To builders who are using subcontractors for this project, please be advised that the City may require, as to subcontractors, post-bid qualification review.

VI. TENTATIVE PROJECT AWARD SCHEDULE

1. Issuance of RFPQ: February 23, 2018

2. Deadline to submit Prequalification Packets: March 23, 2018

3. Issuance of Prequalification List: March 28, 2018

4. Issuance of RFP April 6, 2018

5. Final day to request RFP clarifications in writing: April 17, 2018

6. Deadline to submit a Proposal: May 4, 2018

7. Selection Committee scores proposals: May 11, 2018

8. Oral interview/presentation (if necessary): May 15, 2018

9. Notification of selection of builder: May 22, 2018

10. Contract negotiations concluded: June 5, 2018

11. City Council approval: June 12, 2018

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CITY OF ALTURAS

PREQUALIFICATIONQUESTIONNAIRE

DESIGN-BUILDSERVICES FOR NEWAQUATIC FACILITY

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CONTACT INFORMATION

Firm Name:___________________________________

(as it appears on license)

Check One: □ Corporation □LLC □ Sole Prop. □ Partnership

Contact Person: _______________________________

Address: _______________________________________

Email: __________________________________________

Phone: ___________________________ Fax: ___________________________

If firm is a sole proprietor or partnership:

Owner(s) of Company: ___________________________________________________

Contractor’s License Number(s): _______________________________________

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PART I. ESSENTIAL REQUIREMENTS FOR QUALIFICATION

Builder will be immediately disqualified if the answer to any of questions 1through 5 is “no.”

Builder will be immediately disqualified if the answer to any of questions 6, 7, 8 or 9 is “yes.” If the answer to question 8 is “yes,” and if debarmentwould be the sole reason for denial of prequalification, any prequalification issued will exclude the debarment period.

1. Builder possesses a valid and current California Contractor’s license for the project for which it intends to submit a proposal.

Yes □ No □2. Builder has attached evidence that it possesses a liability insurance policy

with a policy limit of at least $1,000,000 per occurrence and $2,000,000 aggregate.

Yes □ No □3. Builder 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 □ No □ □ Builder is exempt from this requirement

because it has no employees

4. Have you attached your latest copy of a reviewed or audited financial statement with accompanying notes and supplemental information?*

Yes □ No □NOTE: A financial statement that is not either reviewed or auditedis not acceptable. A letter verifying availability of a line of credit may also be attached; however, it will be considered as supplemental information only and is not a substitute for the required financial statement.

*Contractors who have qualified as a small business pursuant to Government Code section 14837(d)(1) are exempt from this requirement, if the bid will be "no more than 25 percent of the qualifying amount provided in Section 14837(d)(1)." As of January1, 2001, the qualifying amount is $10 million, and 25 percent of that amount, therefore is $2.5 million.

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5. Have you attached a notarized statement from an admitted surety insurer (approved by the California Department of Insurance) and authorized to issue bonds in the State of California, which states that your current bonding capacity is sufficient for the project (minimum of $2,500,000.00) for which you seek prequalification?

Yes □ No □Note: Notarized statement must be from the surety company, not an agent or broker.

6. Has your contractor’s license been revoked at any time in the last five years?

Yes □ No □7. Has a surety firm completed a contract on your behalf, or paid for

completion because your firm was default terminated by the project owner within the last five (5) years?

Yes □ No □8. At the time of submitting this prequalification 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 the beginning and ending dates of the period of debarment:

9. At any time during the last five (5) years, has your firm, or any of its owners or officers been convicted of a crime involving the awarding of a contract of a government construction project, or the bidding or performance of a government contract?

Yes □ No □PART II. ORGANIZATION, HISTORY, ORGANIZATIONAL PERFORMANCE, COMPLIANCE WITH CIVIL AND CRIMINAL LAWS

Current Organization and Structure of the Business

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10.If the proposed design-build entity is a corporation, limited liability company, partnership, joint venture, or other legal entity, attach a copy of the organizational documents or agreement committing to the form of the organization.

a. For firms that are Corporations:

i. Date incorporated: ___________________

ii. Under the laws of what state: __________

iii. Provide all the following information for each person who is either (a) an officer of the corporation (president, vice president,secretary, treasurer), or (b) the owner of at least ten percent of the corporation’s stock.

Name Position Years with Comp.

% Ownership Social Security #

iv. Identify every construction firm that any person listed above hasbeen associated with (as owner, general partner, limited partneror officer) at any time during the last five years.

Note: For this question, “owner” and “partner” refer to ownership of 10% or more of the business, or 10% or more of its stock, if the business is a corporation.

Person’s Name Construction Firm Dates of Person’s Participation with Firm

b. For firms that are Limited Liability Companies or Partnerships:

i. Date of formation: ____________________

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ii. Under the laws of what state: ___________

iii. Provide all the following information for each partner who owns 10% or more of the firm.

iv. Identify every construction firm that any person listed above hasbeen associated with (as owner, general partner, limited partneror officer) at any time during the last five years.



c. For firms that are Sole Proprietorships:

i. Date of commencement of business: ______________________

ii. Social security number of company owner: _________________

iii. Identify every construction firm that the business owner has been associated with (as owner, general partner, limited partneror officer) at any time during the last five years.



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d. For firms that intend to make a bid as part of a Joint Venture:

i. Date of commencement of joint venture: _________________

ii. Provide all of the following information for each firm that is a member of the joint venture that expects to bid on one or more projects:

Name of firm % Ownership of Joint Venture

e. If the design-build entity is a privately held corporation, limited liability company, partnership, or joint venture, provide a listing of all of the shareholders, partners, or members known at the time of statement of qualification submission who will perform work on the project, and include a summary of their background which demonstrates that the proposed personnel possess sufficient training and experience to competently manage and complete the design and construction of the proposed Project.

History of the Business and Organizational Performance

11.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 □ If “yes,” explain on a separate signed page.

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

NOTE: Include information about other firms if one firm owns 50% or more of another, or if an owner, partner, or officer of your firm holds a similar positionin another firm.


13.Are any corporate officers, partners or owners connected to any other construction firms.

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


14.State your firm’s gross revenues in US dollars for each of the last three years:

_____________________ ________________________ _____________________

15.How many years has your organization been in business in California as a contractor under your present business name and license number? ____________ years

16.Is your firm currently the debtor in a bankruptcy case?

Yes □ No □ If “yes,” please attach a copy of the bankruptcy

petition, showing the case number, and the date on which the petition was filed.

17.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,” please attach 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 any other document that ended the case, if no discharge order was issued.

Licenses

18.List all California construction license numbers, classifications and expiration dates of the California contractor licenses held by your firm:

________________________________________________________________________

________________________________________________________________________

19.If any of your firm’s license(s) are held in the name of a corporation or partnership, list below the names of the qualifying individual(s) listed on the CSLB records who meet(s) the experience and examination requirements for each license.

________________________________________________________________________

________________________________________________________________________

20.Has your firm changed names or license number in the past 5 years?

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

including the reason for the change.

21.Has any owner, partner or (for corporations) officer of your firm operated a construction firm under any other name in the last five years?


including the reason for the change.

22.Has any CSLB license held by your firm or its Responsible Managing Employee (RME) or Responsible Managing Officer (RMO) been suspended within the last five years?

Yes □ No □ If “yes,” please explain on a separate signed sheet.

Disputes

23.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?


identifying all such projects by owner, owner’s address, the date of completion of the project, amount of liquidated damages assessed all other information necessary to fully explain the assessment of liquidated damages.

24.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 project 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 1c or 1d on this form.

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

whether the firm involved was the firm applying for prequalification here or another firm. Identify by name of the company, the name of the person within your firm who was associated with the company the year of the event, the owner of the project, the project and the basis for the action.

25.In the last five years has your firm been denied an award of public works contract based on a finding by a public agency that your company was not a responsible bidder?

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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: The following two questions refer only to disputes between yourfirm and the owner of a project. You need not include information aboutdisputes between your firm and a supplier, another contractor, orsubcontractor. You need not include information about “pass-through”disputes in which the actual dispute is between a sub-contractor and aproject owner. Also, you may omit reference to all disputes about amountsof less than $50,000.

26.In the past five years has any claim against your firm concerning your firm’swork on a construction project, it’s labor practices, or alleging discrimination,been filed in court or arbitration or administrative proceedings?

Yes □ No □ If “yes,” on separate signed sheets of paper identify

the claim(s) by providing the project name, date of the claim, name of theclaimant, a brief description of the nature of the claim, the court in which thecase was filed and a brief description of the status of the claim (pending or, ifresolved, a brief description of the resolution).

27.In the past five years has your firm made any claim against a project ownerconcerning work on a project or payment for a contract and filed that claimin 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 thenature of the claim, the court in which the case was filed and a briefdescription of the status of the claim (pending, or if resolved, a briefdescription of the resolution).

* * * * *

28.At any time during the past five years, has any surety company made anypayments on your firm’s behalf as a result of a default, to satisfy any claimsmade against a performance or payment bond issued on your firm’s behalf, inconnection with a construction project, either public or private?

Yes □ No □ If “yes,” explain on a separate signed page the

amount of each such claim, the name and telephone number of the claimant,the date of the claim, the grounds for the claim, the present status of the

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claim, the date of resolution of such claim if resolved, the method by whichsuch was resolved if resolved, the nature of the resolution and the amount, ifany, at which the claim was resolved.

29.In the last five years has any insurance carrier, for any form of insurance,refused to renew the insurance policy 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.

Criminal Matters and Related Civil Suits

30.Has your firm or any of its owners, officers or partners ever been found liablein a civil suit or found guilty in a criminal action for making any false claim ormaterial misrepresentation to any public agency or entity?

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

including identifying who was involved, the name of the public agency, thedate of the investigation and the grounds for the finding.

31.Has your firm or any of its owners, officers or partners ever been convicted ofa crime involving any federal, state, or local law related to construction?


including identifying who was involved, the name of the public agency, thedate of the conviction and the ground for the conviction.

32.Has your firm or any of its owners, officers or partners ever been convicted ofa 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 districtor location of the federal court), the year and the criminal conduct.

Bonding

33.Bonding capacity: Provide documentation from your surety identifying thefollowing:

Name of bonding company/surety: ________________________________________

Name of surety agent, address and telephone number:

____________________________________________________________________

34.If your firm was required to pay a premium of more than one percent for aperformance and payment bond on any project(s) on which your firm worked

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at any time during the last 3 years, state the percentage that your firm wasrequired to pay. You may provide an explanation for a percentage rate higherthan one percent, if you wish to do so.

____________________________________________________________________

35.List all other sureties (name and full address) that have written bonds foryour firm during the last five years, including the dates during which eachwrote the bonds:

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

36.During the last five years, has your firm ever been denied bond coverage bya surety company, or has there ever been a period of time when your firmhad no surety bond in place during a public construction project when onewas required?

Yes □ No □If yes, provide details on a separate signed sheet indicating the date whenyour firm was denied coverage and the name of the company or companieswhich denied coverage; and the period during which you had no surety bondin place.

Worker’s Compensation Experience History and Worker Safety Program

37.Has CAL OSHA cited and assessed penalties against your firm for any“serious,” “willful” or “repeat” violations of its safety or health regulations inthe past five years?

NOTE: If you have filed an appeal of citation, and the Occupational Safety andHealth Appeals Board has not yet ruled on your appeal, you need not includeinformation about it.

Yes □ No □ If “yes,” attach a separate signed page describing

the citations, including information about the dates of the citations, thenature of the violation, the project on which the citation(s) was or wereissued, the amount of penalty paid, if any. If the citation was appealed to theOccupational Safety and Health Appeals Board and a decision has beenissued, state the case number and the date of the decision.

38.Has the Federal Occupational Safety and Health Administration cited andassessed penalties against your firm in the past five years?

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NOTE: If you have filed an appeal of a citation and the Appeals Board has notyet ruled on your appeal, or if there is a court appeal pending, you need notinclude information about the citation.


each citation.

39.Has the EPA or any Air Quality Management District or any Regional WaterQuality Control Board cited and assessed penalties against either your firm orthe owner of a project on which your firm was the builder, in the past 5years?

NOTE: If you have filed an appeal of a citation and the Appeals Board has notyet ruled on your appeal, or if there is a court appeal pending, you need notinclude information about the citation.


each citation.

40.How often do you require documented safety meetings to be held forconstruction employees and field supervisors during the course of a project?

______________________________________________________________________________

41.List your firm’s Experience Modification Rate (EMR) (California workers’compensation insurance) for each of the past three premium years:

NOTE: An Experience Modification Rate is issued to your firm annually by yourworkers’ compensation insurance carrier.

Current Year: _____________________

Previous Year: ____________________

Year prior to previous year: _________________________

If your EMR for any of these three years is or was 1.00 or higher you will notbe deemed prequalified pursuant to Public Contract Code section 22164(b)(3)(g).

42.Within the last five years has there ever been a period when your firm hademployees but was without workers’ compensation insurance or state-approved self-insurance?

Yes □ No □ If “yes,” please explain the reason for the absence

of workers’ compensation insurance on a separate signed page. If “No,”please provide a statement by your current workers’ compensation insurancecarrier that verifies periods of workers’ compensation insurance coverage for

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the last five years. (If your firm has been in the construction business for lessthan five years, provide a statement by your workers’ compensationinsurance carrier verifying continuous workers’ compensation insurancecoverage for the period that your firm has been in the construction business.)

Prevailing Wage and Apprenticeship Compliance Record

43.Has there been more than one occasion during the last 5 years in which yourfirm was required to pay either back wages or penalties for your own firm’sfailure to comply with the state’s prevailing wage laws?

NOTE: This question refers only to your own firm’s violation of prevailingwage laws, not to the violations of the prevailing wage laws by asubcontractor.

Yes □ No □ If “yes,” attach a separate signed page or pages

describing the nature of each violation, identifying the name of the project,the date of its completion, the public agency for which it was constructed, thenumber of employees who were initially underpaid and the amount of backwages and penalties that you were required to pay.

44.During the last five years, has there been more than one occasion in whichyour own firm has been penalized or required to pay back wages for failure tocomply with the federal Davis-Bacon prevailing wage requirements?

Yes □ No □ If “yes,” attach a separate signed page or pages

describing the nature of the violation, identifying the name of the project, thedate of its completion, the public agency for which it was constructed, thenumber of employees who were initially underpaid, the amount of backwages you were required to pay along with the amount of any penalty paid.

45.Pursuant to Public Contract Code section 22164(c)(2), in order to beprequalified, you must do one of the following:

(1) I hereby certify that I and my subcontractors at every tier will comply withthe requirements of this subdivision and will provide the City withevidence, on a monthly basis while the project or contract is beingperformed, that I and my subcontractors are complying with therequirements of this subdivision;

Or,

(2) I have provided documentary evidence with this prequalificationquestionnaire that I have entered into a project labor agreement thatincludes the requirements of this subdivision and that will bind thebusiness and all its subcontractors at every tier performing the project orcontract.

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______________________________________ ________________________________

Signature Date

46.Provide the name, address and telephone number of the apprenticeshipprogram (approved by the California Apprenticeship Council) from whom youintend to request the dispatch of apprentices to your company for use on anypublic works project for which you are awarded a contract by the City.

____________________________________________________________________________________________________________________________________________________________

47.If your firm operates its own State-approved apprenticeship program:

a. Identify the craft or crafts in which your firm provided apprenticeshiptraining in the past year.

b. State the year in which each such apprenticeship program wasapproved, and attach evidence of the most recent CaliforniaApprenticeship Council approval(s) of your apprenticeship program(s).

c. State the number of individuals who were employed by your firm asapprentices at any time during the past three years in eachapprenticeship and the number of persons who, during the past threeyears, completed apprenticeships in each craft while employed by yourfirm.

________________________________________________________________________________________________________________________________________________________________________________________________________________________

48.At any time during the last five years, has your firm been found to haveviolated any provision of California apprenticeship laws or regulations, or thelaws pertaining to use of apprentices on public works?

NOTE: You may omit reference to any incident that occurred prior to January1, 1998, if the violation was by a subcontractor and your firm, as generalcontractor on a project, had no knowledge of the subcontractor’s violation atthe time they occurred.

Yes □ No □ If “yes,” provide the date(s) of such findings, and

attach copies of the Department’s final decision(s).

PART III. RECENT CONSTRUCTION PROJECTS COMPLETED

49.Builder shall provide information about a minimum of five public worksprojects, completed within the last 10 years, that demonstrate that builderand proposed design-build personnel have the experience, competency,capability and capacity to complete projects of similar size, scope, and

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complexity to the proposed project. Builder should list projects in order ofrelevance with aquatic facilities being listed first. Names and references mustbe current and verifiable. Use separate sheets of paper that contain all of thefollowing information:

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):

____________________________________________________________________________________________________________________________________________________________

Names of design-build team members for the proposed project who had aprimary responsibility in completed project being described, and a shortdescription of the scope of their responsibility for the proposed project andthe completed project:

____________________________________________________________________________________________________________________________________________________________

Description of project and scope of work performed:

____________________________________________________________________________________________________________________________________________________________

Total value of construction (including change orders): _______________________

Original scheduled completion date: ________________________________________

Time extensions granted (number of days): _________________________________

Actual date of completion: __________________________________________________

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Pursuant to Public Contract Code section 22164(c), the undersigned,acknowledge that any contract let for this Project will be required to conformwith Public Contract Code section 22164(c), which is incorporated herein byreference.

I, the undersigned, further certify and declare that I have read all theforegoing answers to this prequalification questionnaire and know theircontents. The matters stated in the questionnaire answers are true of my ownknowledge and belief, except as to those matters stated on information andbelief, and as to those matters I believe them to be true. I declare underpenalty of perjury under the laws of the State of California, that the foregoingis correct.

Dated: ____________ ___________________________________________

Signature

___________________________________________

Name and Title

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Documents

CITY OF ALTURAScityofalturas.us/City of Alturas FINAL Request For...The City is a California Municipal Corporation and was formed in 1901 as a General Law City to provide a range of