Mch Membrane Roofingproject No. 4958/964920

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

PREQUALIFICATION QUESTIONNAIRE

For

C-39 ROOFING CONTRACTOR

MCH MEMBRANE ROOFING

UCSD MEDICAL CENTER – HILLCREST

UNIVERSITY OF CALIFORNIA, SAN DIEGO

PROJECT NO. 4958/964920

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: Friday, November 4, 2016

RE-ISSUED: Tuesday, November 15, 2016

2nd MANDATORY PREQUALIFICATION MEETING: Monday, November 21, 2016, at 10:00 A.M.

MANDATORY MEETING LOCATION: Conference Room Large, 10280 North Torrey Pines Road, #466, La Jolla, CA 92037

SUBMITTALS DUE: Tuesday, November 29, 2016

(Where a time period is given, such as the last ten [10] years, the period is to be measured backwards from the date this prequalification questionnaire is required to be submitted to the University of California San Diego.)

Note: Submission of an incomplete and/or unclear Prequalification Questionnaire may result in the determination of the prospective Contractor as NON-PREQUALIFIED.

SUBMITTED BY:

(Name and Title) Printed or Typed

(Signature)

(Firm Name. )

(Contact Name for all notices and correspondence)

(Address)

(City, State, Zip Code)

______

(Telephone Number)(Facsimile Number)

(E-mail Address)

Each prospective Contractor must have the following California Roofing Contractor’s License, License Classification: C-39, 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 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. Each prospective Contractor must submit six (6) printed sets and one (1) flash drive with complete submittal of the questionnaire. All Contractors that have submitted a Prequalification Questionnaire will be notified in writing of either successfully or not successfully achieving 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 PREQUALIFICATION CONFERENCE

Did a representative of your firm attend the Mandatory Prequalification Conference at the University of California, San Diego, La Jolla?

YES NO

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

Name/names of those attending: ______

Date of 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 Classification: C-39, Roofing Contractor

YESNO

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:

______

1. License Classification: ______

1. License Number: ______

4.Date Issued: ______

5.Expiration Date: ______

C.Is your firm registered with the State of California Department of Industrial Relations (DIR)?

YESNO

Public Works Contractor Registration Number: ______

D.Can you truthfully state that your firm's contractor's license hasn’t 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.

E.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

4.SURETY

Prospective Contractor desiring to be prequalified are informed that they will be subject to and must fully comply with all bid conditions including 100% payment and 100% performance bonds.

Prospective 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 surety(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 Contractor able to obtain bonding up to and including the cost for this construction contract estimated at $750,000 of which no more than 50% is currently committed to other projects?

YES NO

C.Is it true that the surety has not paid out any monies for the construction activities of the prospective Contractor whatsoever within the last ten (10) years?

YES NO

If answer is “No,” explain on attached additional sheets.

D.How long has the Prospective 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])

(Surety License Number)

(Firm Name)

(Address)(City, State, Zip Code)

______

(Telephone Number)(Facsimile Number)

(Email Address)

(ATTACH NOTARIZATION of SURETY REPRESENTATIVE’S SIGNATURE)

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

5.INSURER

Prospective Contractor desiring to be prequalified are informed that they will be subject to and must fully comply with all bid conditions including the following insurance coverage and associated limits.

Prospective Contractor shall submit the below form, signed by representative of insurer and notarized. If firm has used current insurer for less than ten 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 Contractor able to obtain insurance in the following limits for each of these construction contracts?

YES NO

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

C.How long has the Prospective Contractor been with this insurer? years

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

1. 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])

(Insurer’s License Number)

(Firm Name)

(Address)(City, State, Zip Code)

(Telephone Number)(Facsimile Telephone Number)

(Email Address)

(ATTACH NOTARIZATION of INSURER REPRESENTATIVE’S SIGNATURE)

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

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 $500,000 or a total of $1,500,000 for the projects submitted, and the following example building types:

• Acute Care Hospital in California
• Clinical Laboratory or Biotech facility and

Such projects should have possessed the following construction challenges:

• Urban site with limited construction and staging areas
• Repair of buildings requiring proactive and innovative solutions due to noise, dust, and pedestrian traffic while building is occupied
• Renovations/expansions requiring proactive and innovative solutions due to unknown and/or unforeseen field conditions
• Project complexity requiring tracking of multiple functions and phases
• Project complexity requiring critical path construction scheduling to complete on time

Such projects should include these specific components:

• Roofing repairs or replacement at fully operational Acute Care hospital in California
• Coordination of mechanical, plumbing, electrical trades with roofing trades
• Multiple phases or sequences of roofing installation

A.Listed projects must have been managed and constructed under the business name submitted for prequalification. Projects completed by employees for former employers are not acceptable.

B.Submit the following Project Data Sheets for each project submitted as evidence of your firm's Contractor expertise.

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

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 square feet): ______

1. What was your company’s role on this project?

Prime (General) Contractor

Subcontractor to GC

2nd Tier Subcontractor

3rd Tier Subcontractor

Prime Subcontractor to Owner

Other: ______

List the Business Entity (name) your company used to perform work for this project: ______

7.How is this project comparable to the MCH Membrane Roofing project? ______

______

8.Was the project completed within budget?

Cost At Bid:$

Cost At Completion:$

Explanation: ______

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

9.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:$

10.Was construction begun and completed within the last ten (10) years?

YES NO

11.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:

______

12.Did the project include occupied facilities?

YES NO

13.What communications strategies were used by your firm to assist the project team in mitigating the impacts of construction on the occupied facilities? ______

14.What Infection Control measures were carried out on the project? Describe Infection Control means and methods, types of filtration/containment barriers, ICRA Permit process, monitoring and maintenance of filtration/containment barriers for the project. Include whether infection control specialty subcontractor was used, or whether in-house personnel performed infection control.

______

______

______

15.Was the project for a university or public institution?

YES NO

16.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.)? ______

17.Did the project include adherence to critical path scheduling?

YES NO

18.Did the project contain complicated roofing repairs or roofing replacement at a fully operational Acute Care hospital in California?

YES NO

19.Did the project include multiple phases or sequences of roofing installation?

YES NO

20.Did the project include a quality control/quality assurance program?

YES NO

If “Yes,” explain: ______

21.Did the Owner assess any back-charges?

YES NO

If answer is “Yes,” explain: ______

22.Did the Owner assess any liquidated damages?

YES NO

If answer is “Yes,” explain: ______

23.Name of Project Executive:______

Qualifications of this Project Executive:______

______

24.Name of Project Manager: ______

Qualifications of this Project Manager: ______

______

25.Name of Project Superintendent: ______

Qualifications of this Project Superintendent: ______

______

26.Name of Project Engineer: ______

Qualifications of this Project Engineer: ______

______

27.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:

______

______

______

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

(Attach additional pages with other pertinent project information as necessary.)

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

7.NOT USED

8.NOT USED

General ContractorPage 1 of 20Prequalification Questionnaire

GC P/Q Quest Revised November 15, 2016

(UCSD Rev. 01/26/2016)

MCH MEMBRANE ROOFINGPROJECT NO. 4958/964920

UCSD MEDICAL CENTER – HILLCREST

university of california, san diego

9.STAFF EXPERIENCE AND PROJECT SAFETY

The Project Manager and Project Superintendent listed will be considered qualified if he/she has successfully completed at least one (1) comparable project.

A.Contractor hereby commits as a minimum to assignment of the specific field staff as outlined below. Contractor to submit a complete staffing chart as part of this package.

• One Project Superintendent or Foreman (full-time on site) during construction

The Contractor will assign one Project Superintendent or Foreman to manage, coordinate and facilitate the field supervision staff for each of the various components of the project construction process. The major function of this position will be in addition to the normal superintendent’s daily workload, subcontractor interaction and production, and various field related coordination issues.

B. At the time of bid, the successful Contractor will be required to reconfirm staff assignments to the project based on this submittal. If any of the named staff submitted are no longer employed by the firm at the time the project starts, or are otherwise unavailable, the firm's bid may be considered non-responsive. Substitution of other individuals with equivalent experience may be considered by the University, however resumes, comparable project history and other relevant information must be submitted to the University prior to the determination of the bid results.

The Contractor shall keep on the job throughout its duration a competent Project Superintendent/Foreman, all of whom must be satisfactory to the University. The Project Superintendent/Foreman shall be the same individuals proposed by the Contractor during the procurement process for this project. The Project Superintendent/Foreman shall represent the Contractor, and all communication given to the Project Superintendent/Foreman shall be as binding as if given to the Contractor. The Contractor shall not change either the Project Superintendent/Foreman on the project from those originally proposed for the project without the prior written consent of the University. The University will only grant written consent for such change in the case of undue hardship on the individual or if the Project Superintendent/Foreman shall leave the employ of the Contractor.

By submitting a proposal for this project, the Contractor agrees to pay a training fee of $2,000 should they change Project Executive, Project Manager, or Project Superintendent/Foreman without the written consent of the University.

C.Safety Program

The safety of the Contractor employees, employees of the University and other visitors to the Project are of the utmost importance to the University. The Contractor shall take whatever steps are necessary to maintain a clean and safe work environment for their employees, the employees of their Subcontractors and vendors, and any other visitors to the project.

D.Full-Time Project Superintendent/Foreman: MCH Membrane Roofing Project

1.The name of the specific Project Superintendent/Foreman to be committed to this project on a full-time basis and continuously retained throughout this project is:

(Attach resume)

2.Total years of experience: years

3.Years at this position: years

4.Years with this firm: years

5.The Project Superintendent/Foreman named above was assigned to the following comparable projects for which data sheets have been included in this questionnaire: