GILMAN DRIVE REALIGNMENT (AND BRIDGE UTILITY INSTALLATION)4912/A4L-388
university of california, san diego
PREQUALIFICATION QUESTIONNAIRE
For
GILMAN DRIVE REALIGNMENT (AND BRIDGE UTILITY INSTALLATION)
UNIVERSITY OF CALIFORNIA, SAN DIEGO
4912/A4L-388
SUBMITTED BY:
please enter your company name here
UNIVERSITY OF CALIFORNIA, SAN DIEGO
FACILITIES DESIGN & CONSTRUCTION
10280 NORTH TORREY PINES ROAD
LA JOLLA, CA 92037
ISSUE DATE: 9/3/14
MANDATORY PREQUALIFICATION MEETING: 9/8/14
SUBMITTALS DUE: 9/22/14
LEVEL 1
PREQUALIFICATION QUESTIONNAIRE
For
GILMAN DRIVE REALIGNMENT (AND BRIDGE UTILITY INSTALLATION)
(Where a time period is given, such as the last ten [10] years, the period is to be measured backwards from the date this Level I prequalification questionnaire is required to be submitted to the University of California at San Diego.)
Note: Submission of an incomplete and/or unclear Level I Prequalification Questionnaire may result in the determination of the prospective Construction Manager/Contractor (CM/Contractor) as NON-PREQUALIFIED.
SUBMITTED BY:______
(Name and Title) Printed or Typed
______
(Signature)
______
(Firm Name. If a Joint Venture, state name if JV Entity)
______
(Contact Name)
______
(Address)
______
(City, State, Zip Code)
______
(Telephone Number) (Facsimile Number)
______
(E-mail Address)
Each prospective CM/Contractor must have the following California General Building Contractor’s License, License Code: A, current, active and in good standing with the California Contractor’s State License Board on the date and time of the Prequalification Questionnaire submittal is due and must submit this Prequalification Questionnaire with all portions completed, including required attachments.
Each prospective CM/Contractor must answer all of the following questions and provide all requested information, where applicable. Any prospective Contractor failing to do so may be deemed to be not responsive and not responsible with respect to this Prequalification at the sole discretion of the University. All CM/Contractors that have submitted a Level I Prequalification Questionnaire will be notified in writing of either successfully or not successfully achieving Level I prequalification status. The decision of the University is final and is not appealable within the University of California system.
All information submitted for Prequalification evaluation will be considered official information acquired in confidence, and the University will maintain its confidentiality to the extent permitted by law.
It is critical that the prospective Contractor fills out all information required accurately, completely, truthfully and to the best of their knowledge. Ambiguous or incomplete information may lead to an unfavorable rating and subsequent status as non-prequalified.
WHERE NECESSARY, COPY THE FORMS IN THIS PACKAGE. USE ONLY THESE FORMS.
1.PREQUALIFICATION DECLARATION
I, ______, hereby declare that I am the
(Printed Name)
______of ______
(Title)(Name of Firm)
Submitting this Prequalification Questionnaire; that I am duly authorized to sign this Prequalification Questionnaire on behalf of the above named firm; and that all information set forth in this Prequalification Questionnaire and all attachments hereto are, to the best of my knowledge, true, accurate and complete as of its submission date.
The undersigned declares under penalty of perjury that all of the prequalification information submitted with this form is true and correct and that this declaration was executed in
______(County), ______, (State)
on ______(Date).
______
(Signature)
2.ATTENDANCE AT MANDATORY LEVEL I PREQUALIFICATION CONFERENCE
Did a representative of your firm attend the Mandatory Level I Prequalification Conferenceat Facilities Design & Construction, 10280 N. Torrey Pines Road, University of California, San Diego, La Jolla, CA 92037?
YES NO
Name/names of those attending: ______
Date Meeting Attended: ______
3.LICENSE
A.Does your firm hold the following California contractor's license, which is current, valid, and in good standing with the California Contractor's State License Board?
License Code: A
License Classification: General Engineering Contractor
YESNO
1.If the entity submitting this prequalification questionnaire is a Joint Venture, does the Joint Venture entity itself currently hold a (A – General Engineering Contractor) California contractor's license, which is current, valid, and in good standing with the California Contractor's State License Board?
YESNON/A
B.Provide the following information about your firm's contractor's license:
1.Name of license holder exactly as on file with the California Contractor's State License Board:
______
- License Classification: ______
- License Code: ______
- License Number: ______
5.Date Issued: ______
6.Expiration Date: ______
C.Can you truthfully state that your firm's contractor's license has never been suspended or revoked by the California Contractor's State License Board within the last five (5) years?
YES NO
If answer is “No,” explain on attached additional sheets.
If the entity submitting this prequalification questionnaire is a Joint Venture, can the Joint Venture entity truthfully state that no member of the Joint Venture has ever had their firm's contractor's license suspended or revoked by the California Contractor's State License Board?
YES NO N/A
If answer is “No,” explain on attached additional sheets.
D.Has a complaint ever been filed with the Contractor’s State License Board against your company that required a formal hearing or inquiry?
YES NO
E.Will your firm use computers with ability to log on to the Internet for this project?
YES NO
F.Does your firm have experience utilizing CPM logic, Primavera Project Planner scheduling software on your projects and would you utilize this experience on this project?
YES NO
If “No,” name the software application(s) used or the software application you would propose for use on this project for scheduling. ______
4.SURETY
Prospective CM/Contractor desiring to be prequalified are informed that they will be subject to and must fully comply with all fee bid conditions including 100% payment and 100% performance bonds.
Prospective CM/Contractor shall submit the below form, signed by representative of surety and notarized. If firm has used current surety for less than ten years, list sureties (ies) previously used and indicate number of years used to demonstrate ten (10) complete years of surety history.
A.Is the surety to be used listed in the latest published State of California Department of Insurance list of Insurance Organizations Authorized by the Insurance Commissioner to Transact Business of Insurance in the State of California?
YES NO
B.Is the prospective CM/Contractor able to obtain bonding up to and including the cost for this construction contract estimated at $ 10MM of which no more than 50% is currently committed to other projects?
YES NO
1.If the entity submitting this prequalification questionnaire is a Joint Venture, is the Joint Venture entity itself able to obtain bonding up to and including the cost for this construction contract estimated at $ 10MM of which no more than 50% is currently committed to other projects?
YES NO N/A
C.Is it true that the surety has not paid out any monies for the construction activities of the prospective CM/Contractor whatsoever within the last ten (10) years?
YES NO
If answer is no, explain on attached additional sheets.
1.If the entity submitting this prequalification questionnaire is a Joint Venture, is it true that the surety has not paid out any monies for the construction activities of any member of the Joint Venture within the last ten (10) years?
YES NO N/A
D.How long has the Prospective CM/Contractor been with this surety? years
E.Surety Declaration:
Provide this Declaration of your surety (ies) for completion. Do not have the surety submit this information directly to the University.
The undersigned declares under penalty of perjury that all of the above surety information is true and correct and that this declaration was executed in
County, California, on (date).
(Signature)
(Name and Title - Printed or Typed)
(Representing [Surety Name])
(Firm Name)
(Address)(City, State, Zip Code)
______
Telephone Number)(Facsimile Number)
(Email Address)
(ATTACH NOTARIZATION of SURETY REPRESENTATIVE’S SIGNATURE)
5.INSURER
Prospective CM/Contractor desiring to be prequalified are informed that they will be subject to and must fully comply with all fee bid conditions including the following insurance coverage and associated limits.
Prospective CM/Contractor shall submit the below form, signed by representative of insurer and notarized. If firm has used current insurer for less than ten (10) years, list insurer(s) previously used and indicate number of years used to demonstrate ten (10) complete years of insurer history.
A.Is the insurer to be used listed by Best with a rating of A- or better and a financial classification of VIII or better (or an equivalent rating by Standard & Poor’s or Moody's)?
YES NO
Indicate Best Rating:
Indicate Best Financial Classification:
B.Is the prospective CM/Contractor able to obtain insurance in the following limits for each of these construction contracts?
YES NO
1.If the entity submitting this prequalification questionnaire is a Joint Venture, is the Joint Venture entity itself able to obtain insurance in the following limits for each of these construction contracts?
YES NO N/A
Minimum
Comprehensive or Commercial Form General Liability Insurance - Limits of LiabilityRequirement
Each Occurrence - Combined Single Limit for Bodily Injury and Property Damage$1,000,000
Products - Completed Operations Aggregate$2,000,000
Personal and Advertising Injury$1,000,000
General Aggregate - Not Applicable to Comprehensive Form$2,000,000
Business Automobile Liability Insurance - Limits of Liability
Each Accident - Combined Single Limit for Bodily Injury and Property Damage$1,000,000
Professional Liability Insurance
Each Occurrence$2,000,000
Aggregate$1,000,000
C.How long has the Prospective CM/Contractor been with this insurer? years
- Insurance Declaration:
Provide this Declaration to your insurance carrier for completion. Do not have the carrier submit this information to the University.
The undersigned declares under penalty of perjury that all of the above insurer information is true and correct and that this declaration was executed in
County, California, on (date).
(Signature)
(Name and Title - Printed or Typed)
(Representing [Insurer Name])
(Firm Name)
(Address)(City, State, Zip Code)
(Telephone Number)(Facsimile Telephone Number)
(Email Address)
(ATTACH NOTARIZATION of INSURER REPRESENTATIVE’S SIGNATURE)
6.CONSTRUCTION EXPERIENCE
Submit Project Data on a minimum of three (3) and a maximum of five (5) comparable projects successfully completed within the last ten (10) years constructed in the United States of America one of which was constructed in the State of California.
A comparable project is defined as having a construction cost at the bid date of at least
$ 10MM or a total of $40MM for the projects submitted, and one of the following example building types:
- Highway construction
- Freeway on-ramp/off-ramp construction
- Utility infrastructure construction and
Such projects should have possessed the following construction challenges:
- Urban site with limited construction and staging areas
- High traffic volume
- Major utility relocation and tie-ins
- Project complexity requiring tracking of multiple functions and phases
- Compressed construction schedule
- Coordination with many entities including Caltrans
- Experience in Preconstruction Services
One (1) of the projects submitted must include experience as CM/Contractor providing both pre-construction services and acting as General Contractor during construction phase on the same project.
A.If the entity submitting this prequalification questionnaire is a Joint Venture, the Joint Venture entity itself must demonstrate adequate previous construction experience. Joint Venture teams newly formed to pursue this prequalification opportunity are not eligible for Level I prequalification.
B.Listed projects must have been managed and constructed under the business name submitted for Level I prequalification. Projects completed by employees for former employers are not acceptable.
C.Submit the following Project Data Sheets for each project submitted as evidence of your firm's CM/Contractor experience.
PROJECT DATA SHEET
(A separate sheet must be prepared for each project submitted.)
1.Project Name:______
2.Project Location:______
3.Project Description:______
4.Constr. Type:
5. Size (gross sq. ft.): ______
6.Business name of entity which constructed and managed this project: ______
______
7.If the entity submitting this prequalification questionnaire is a Joint Venture, did the Joint Venture entity itself construct and manage this project?
YES NO N/A
8.Did your firm act as a CM/Contractor during the entire construction phase of this project, providing both pre-construction services and acting as General Contractor during the construction phase for this project? (At least one (1) of the submitted projects must have included pre-construction services.)
YES NO
9.Was the project completed under a CM/Contractor construction contract?
YES NO
10.Describe Pre-Construction Service Experience
______
11.How is this project comparable to the GILMAN DRIVE REALIGNMENT (AND BRIDGE UTILITY INSTALLATION) project?
______
______
______
12.Was the project completed within budget?
Cost At Bid:$
Cost At Completion:$
Explanation: ______
13.For any differing amount between cost at completion and cost at bid, distribute the sources and/or causes of these changes into the following categories:
Document Problems:$
Unforeseen Conditions:$
Owner Generated Scope:$
Regulatory Agency:$
Other:$
14.Was construction begun and completed within the last ten (10) years?
YES NO
15.Was the project completed within the original contract time or the adjusted contract time?
YES NO
If completion did not occur within the original or the adjusted contract time, indicate elapsed time in whole calendar days between original or adjusted contract time and actual final completion. For projects that have not reached final completion, indicate current status with respect to contract time:
______
16.Did the project include occupied facilities adjacent to the project?
YES NO
17.What communications strategies were used by your firm to assist the project team in mitigating the impacts of construction on the adjacent occupied facilities? ______
18.Was the project for a university or public institution?
YES NO
19.What strategic decisions did your firm contribute to the project which supported the project’s success (e.g. value engineering, phasing, innovation, new technology, etc.)? ______
20.Did the project include adherence to critical path scheduling?
YES NO
21.What strategies did your firm use to adjust and/or correct for non-Owner generated slippage in the critical path schedule?
______
22.Did the project include finishes and work elements requiring craftsmanship and workmanship?
YES NO
23.Did the project include a quality control/quality assurance program?
YES NO
If “Yes,” explain: ______
24.Did the project include California State Fire Marshal review and approval (planning, scheduling and obtaining State Fire Marshal approval of materials, shop drawings, and systems testing)?
YES NO
25.Did the project include California Division of State Architect Handicapped Accessibility Compliance review and approval?
YES NO
26.Did the Owner assess any back-charges?
YES NO
If answer is yes, explain: ______
27.Did the Owner assess any liquidated damages?
YES NO
If answer is yes, explain: ______
28.Describe your firm's claim-avoidance strategy and/or philosophy: ______
______
______
29.Name of Senior Project Manager/Project Executive:______
Qualifications of this Senior Project Manager/Project Executive:______
______
30.Name of Project Manager: ______
Qualifications of this Project Manager: ______
______
31.Name of Pre-Construction Manager: ______
Qualifications of this Pre-Construction Manager: ______
______
32.Name of Project Superintendent: ______
Qualifications of this Project Superintendent: ______
______
33.Name of Project Engineer: ______
Qualifications of this Project Engineer: ______
______
34.Did your firm self-perform any of the work?
YES NO
If yes, please specify the trades you self-performed or have the capability to self-perform:
______
______
______
Client Firm Name:
Client Contact: Title:
Client Address:
ClientCity: State: _____Zip:
Client Phone:( ) Fax: ( )
Client E-mail Address:
Architect/Engineer/
Consultants:
Architect/Engineer
Contact Name: Phone:
Architect/Engineer
E-mail Address:
(Attach additional pages with other pertinent project information as necessary.)
If this project is UNDER $5M, delete this following section (“Current Projects for the Regents of the University of California”):
7.PROJECTS FOR THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
Submit the following Projects for The Regents of the University of California Project Data Sheet for each project (regardless of project delivery strategy) between your firm and The Regents of the University of California. If none, indicate none (do not leave blank).
PROJECTS FOR THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
PROJECT DATA SHEET
(A separate sheet must be prepared for each project submitted.)
1.Project Name:
2.Project Location (which campus?):
- Type of Facility: ______
- Project Delivery Method (e.g., Lump Sum, Guaranteed Maximum Price, etc.)
5.Did your firm act as a CM/Contractor, providing both pre-construction services and acting as General Contractor during the construction phase for this project?
YES NO
6.Project Description:
7.Constr. Type:
8. Size (gross sq. ft.): ______
9.Was the project completed under a CM/Contractor construction contract?
YES NO
10.Did the CM/Contractor construction contract include a General Contractor contingency?
YES NO
11.Were General Contractor contingency funds remaining at the completion of the project?
Contingency At Bid: $______
Contingency At Completion: $______
12.Did the construction contract include a stipulated general conditions cost?
YES NO
13.Were general condition funds remaining at the end of the project?
YES NO
14.Is this project comparable to the GILMAN DRIVE REALIGNMENT (AND BRIDGE UTILITY INSTALLATION)project? If yes, explain how:
______
15.Project Status:
16.Anticipated Completion Date:
17.Description of Firm’s Performance:
a.With Respect To Time:
b.With Respect To Budget:
18.For any differing amount between cost to date and cost at bid, distribute the sources and/or causes of these changes into the following categories:
Document Problems:$
Unforeseen Conditions:$
Owner Generated Scope:$
Regulatory Agency:$
Other:$
19.Business name of entity that performed this project:
20. If the entity submitting this prequalification questionnaire is a Joint Venture, did the Joint Venture entity itself perform this project?
YES NO N/A
UC Client Contact: Title:
UC Client Phone:( ) Fax: ( )
UC Client E-mail Address: