West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
university of california, san diego
PREQUALIFICATION QUESTIONNAIRE
For
C-20, WARM-AIR HEATING, VENTILATING AND AIR-CONDITIONING CONTRACTOR
WEST CAMPUS CHILLED WATER IMPROVEMENTS
UNIVERSITY OF CALIFORNIA, SAN DIEGO
Project No. 5048/A4L-422
AND
MAIN CAMPUS CUP SITE WORK & MAKE READY
UNIVERSITY OF CALIFORNIA, SAN DIEGO
Project No. 5122/A4L-423
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: OCTOBER 4, 2016
MANDATORY PREQUALIFICATION MEETING: OCTOBER 11, 2016
MANDATORY MEETING LOCATION: FD&C Large Conference Room
SUBMITTALS DUE: OCTOBER 18, 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 at 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. If a Joint Venture, state name if JV Entity)
(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 WARM-AIR HEATING, VENTILATING AND AIR-CONDITIONING Contractor’s License, License Classification: C-20, 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 FOUR (4) 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
MECHANICAL SUBCONTRACTORPage 1 of 26Prequalification Questionnaire
P/Q Quest
(UCSD Rev. 01/26/2016)
West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
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-20, Warm-Air Heating, Ventilating and Air-Conditioning
YESNO
1.If the entity submitting this prequalification questionnaire is a Joint Venture, does the Joint Venture entity itself currently hold a (C-20, Warm-Air Heating, Ventilating and Air-Conditioning) 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 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.
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.
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
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 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 $7,000,000 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 $7,000,000of 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 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 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)
MECHANICAL SUBCONTRACTORPage 1 of 26Prequalification Questionnaire
P/Q Quest
(UCSD Rev. 01/26/2016)
West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
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
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
C.How long has the Prospective Contractor been with this insurer? years
MECHANICAL SUBCONTRACTORPage 1 of 26Prequalification Questionnaire
P/Q Quest
(UCSD Rev. 01/26/2016)
West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
university of california, san diego
- 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)
MECHANICAL SUBCONTRACTORPage 1 of 26Prequalification Questionnaire
P/Q Quest
(UCSD Rev. 01/26/2016)
West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
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 $7,000,000 or a total of $21,000,000 for the projects submitted, and the following example building types:
- Renovation to existing campus centralized plants serving multiple building to increase chilled water and condenser water system capacity
- Expansion to an existing central plant while the facility remains in full operation, including temporary equipment used for load demand and contingency backup
- Central plants that contain a high degree of technicalcomplexity
Such projects should have possessed one or more of the following construction challenges:
- Urban site work with limited construction and staging areas
- Major upgrade to existing chilled water systems that serve a fully operational campus where shutdown coordination is critical and scheduled down time for the plant is minimal or not allowed.
- Renovations/expansionsrequiring proactive and innovative solutions due to unknown and/or unforeseen field conditions.
- Project complexity requiring tracking of multiple functions and phases throughout the course of the project.
- Aging facility equipment and piping causing unforeseen conditions
- Working with existing unknown underground utilities
Such projects should include these specific components:
- Replacement of major chilled water equipment and associated piping of minimum 24” diameter within an operational plant.
- Individualchilled water equipment replacement in 2,000 tons or larger
- Solutions provided to resolve or mitigate unforeseen incidents including but not limited to: major pipe burst, main isolation valve leak, erroneously severing existing live utility lines serving critical facilities, accidental damage to existing operational equipment,
- Installation of all work within an operational plant and/or yard.
- Line stopand hot tap of large size pipes of minimum 24” diameter.
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 prequalification.
B.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.
C.Submit the following Project Data Sheets for each project submitted as evidence of your firm's Contractor expertise.
MECHANICAL SUBCONTRACTORPage 1 of 26Prequalification Questionnaire
P/Q Quest
(UCSD Rev. 01/26/2016)
West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
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): ______
- 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.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.How is this project comparable to the WEST CAMPUS CHILLED WATER IMPROVEMENTS and MAIN CAMPUS CUP SITE WORK & MAKE READY project? ______
______
9.Was the project completed within budget?
Cost At Bid:$
Cost At Completion:$
Explanation: ______
MECHANICAL SUBCONTRACTORPage 1 of 26Prequalification Questionnaire
P/Q Quest
(UCSD Rev. 01/26/2016)
West Campus Chilled water improvementsPROJECT NO. 5048/A4L-422/966030
main campus cup site work & ready PROJECT NO. 5122/A4L-423/966089
university of california, san diego
10.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:$
11.Was construction begun and completed within the last ten (10) years?
YES NO
12.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:
______
13.Did the project include occupied facilities?
YES NO
14.What communications strategies were used by your firm to assist the project team in mitigating the impacts of construction on the occupied facilities? ______
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 require a risk assessment and risk mitigation plan?
YES NO
If “Yes,” describe: ______
19.Did project involve replacement of water cooler chiller to achieve additional plant capacity?
YES NO
If “Yes,” what is the tonnage of each chiller: ______
20.Did the project involve major upgrade to existing chilled water and/or condenser water piping within an operational plant?
YES NO
If “Yes,” describe piping system and pipe size: ______
21.Did the project involve connection to a live piping system serving critical facilities?
YES NO
If “Yes,” describe piping system and pipe size: ______
Describe what contingency plan (if any) was implemented to mitigate risks: ______
22.Did the project involve line freeze of minimum 24” diameter piping?
YES NO
23.Did any major accidental or unforeseen incident occur on the project?
YES NO
If “Yes,” explain: ______
How was the incident resolved: ______
24.Did the project include a quality control/quality assurance program?
YES NO
If “Yes,” explain: ______
25.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
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.Name of Project Executive:______
Qualifications of this Project Executive:______
______
29.Name of Project Manager: ______
Qualifications of this Project Manager: ______
______
30.Name of Project Superintendent: ______
Qualifications of this Project Superintendent: ______
______
31.Name of Project Engineer: ______
Qualifications of this Project Engineer: ______
______
32.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:
______