Quality Control Checklist s2

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Section V, Quality Control Checklist/Certification – Process I (2 pages) 12/19/06

This certification is submitted electronically as part of the Back-Up material submitted separately from the NYSDOT255C.

This certifies that the information submitted has been reviewed and is in accordance with the following checklist. The current forms and instructions are at our website: https://www.nysdot.gov/portal/page/ portal/main/business-center/consultants/general-info/electronic-consultant-selection-(process-1).

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□  We have revisited the website and obtained the latest version of the advertisement.

NYSDOT255C

□  The NYSDOT255C is a single file in Adobe Acrobat (.pdf) format.

□  It does not include these three pages of instructions.

□  No cover letter or other sheet has been added. (i.e., sheet with firm name and logo).

□  The only graphics used are in the organization chart.

□  The team members, their roles, their proposed tasks and %work are the same as proposed in the E-EOI

(unless the advertisement specifies otherwise).

Item 8. Resumes

□  Each resume does not exceed one page

□  The font is no smaller than 10 point.

□  Includes the key staff according to the advertisement

□  Includes no more than the number of resumes specified in the advertisement.

Item 9. Familiarity

□  NYSDOT Item 9 does not exceed four pages.

Item 12. Project Experience

□  Does not exceed four pages.

□  Includes no more than ten projects.

Section A1

□  If NYSDOT indicates Section A1 is required, it is submitted electronically as an attachment to the NYSDOT 255C and it contains not more than the permitted number of pages.

□  Section A1 responses to issues are numbered and addressed individually.

□  The font is no smaller than 10 point.

Certification: Availability date of key Construction Inspection staff

□  For Construction Inspection – The “Certification: Availability date of key Construction Inspection staff” includes all staff (either currently employed by the firm, currently employed by another firm or currently unemployed) that the advertisement described as key staff.

The Electronic Back-Up material includes —

□  Section II, NYSDOT Current Remaining Work Disclosure Form (CONR 386)

□  Section III, Certification of D/M/WBE status, is required for any consultants that are a Disadvantaged/Minority/Women Business Enterprise (D/M/WBE)

□  Section IV, Proofs of Authority - the consultant will print, for each Team Member, the information from the New York State Education Department and/or New York State Department of State websites or sign the affidavit within a week before the submittal to NYSDOT. Refer to “Proofs of Authority” document at the NYSDOT Business Center website “How to Do Business With DOT” under “Electronic Consultant Selection System (Process II)”.

□  Section V, Quality Control Checklist/Certification.

□  Procurement Lobbying Law Forms, “Offerer’s Affirmation of Understanding Form” and “Offerer’s

Disclosure of Prior Non-Responsibility Form”

This certifies that the information submitted has been reviewed and is in accordance with the above. Submittals found inconsistent with this certification may affect the firm’s selection.