HomeMy Public PortalAbout15-9072 (2) Sponsored by: City Manager
RESOLUTION NO. 15-9072
A RESOLUTION OF THE CITY COMMISSION OF THE CITY
OF OPA-LOCKA, FLORIDA, AUTHORIZING THE CITY
MANAGER TO ISSUE A REQUEST FOR PROPOSALS (RFP)
FOR ZONES 1 AND 2 STORMNWATER, DRINKING WATER
AND WASTE WATER IMPROVEMENTS; PROVIDING FOR
INCORPORATION OF RECITALS; PROVIDING FOR AN
EFFECTIVE DATE.
WHEREAS, The City of Opa-locka City Commission has received funds for
construction of storm water, waste water and drinking water improvements in Zones 1
and Zone 2; and
WHEREAS, Attached as exhibit "A" is the process to be used for this solicitation.
NOW THEREFORE BE IT RESOLVED THAT THE CITY COMMISSION OF
THE CITY OF OPA LOCKA, FLORIDA:
Section 1. The recitals to the preamble herein are incorporated by reference.
Section 2. The City Commission hereby directs the Manager to issue the RFP
using the process described in exhibit "A".
Section 3. This Resolution shall take effect immediately upon adoption.
PASSED AND ADOPTED this 29th day of September, 2015.
I � -
i
yrta�L. lylor
Mayor
Resolution No. 15-9072
Attest to: Approved as to form and legal sufficiency:
Joanna Flores Vincent T. Brown, Esq.
City Clerk The Brown Law Group, LLC
City Attorney
Moved by: VICE MAYOR HOLMES
Seconded by: COMMISSIONER SANTIAGO
Commissioner Vote: 5-0
Commissioner Kelley: YES
Commissioner Pinder: YES
Commissioner Santiago: YES
Vice Mayor Holmes: YES
Mayor Taylor: YES
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The City of Opa-locka
LOW BID
DESIGN-BUILD
REQUEST FOR PROPOSAL
for
2014 State Revolving Funds Program
Zones 1 & 2 Stormwater Improvements
Zones 1 & 2 Wastewater Improvements
Zones 1 & 2 Drinking Water Improvements
RFP No: XX-XXXXXXX
Pre- ua i lcation
Questionnaire
I. INFORMATION ABOUT DESIGN-BUILD TEAM MEMBERS
City of Opa-locka RFP No. XX-XXXXXXXX
Contact Information
Design-Builder Name:
General Contractor Member Name:
Principal Engineer Member Name:
Design-Builder Contact Person:
Address:
Phone: Fax:
Page 2 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
Design-Build Team Member(s)
(List all legal entities being pre-qualified, including subcontractors. You do not have to list
heavy and highway subcontractors if you are seeking to pre-qualify multiple heavy and
highway subcontractors)
Discipline(i.e. general Name Legal Entity (i.e. corporation,
contractor, architect, partnership, sole proprietor)
engineer, paving
subcontractor, etc.)
For all partnerships or other associations listed above that are not legal entities including the Design-
Builder, please provide a copy of the agreement creating the partnership or association.
Page 3 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
II. ESSENTIAL REQUIREMENTS FOR THE DESIGN-BUILD TEAM
The term"Associates" shall mean all of the following:
• The current qualifiers for all current Contractors State License Board contracting licenses held by the
contractor.
• All current officers of a contractor which is a corporation.
• All current partners of a contractor which is a partnership.
• All current joint venturers of the joint venture contractor which is seeking prequalification.
For City Reviewer
Only
1. Does the Design-Builder and each proposed Subcontractor possess a current ❑ Yes❑ No
Florida contractor's license for the project for which it intends to submit a proposal
or intend to obtain a license before commencing work?
2. Does the Design-Builder have a liability insurance policy with a policy limit ❑ Yes❑ No
of at least$5,000,000 per occurrence and $10,000,000 aggregate from a Florida
admitted company?
If yes, provide the following information. (Attach a separate page if more than one
policy.)
Insurance Company
Policy Number
Policy limit per occurrence
Aggregate policy limit
3. Does the Design-Builder and each proposed Subcontractor have current ❑ Yes❑ No
Florida workers' compensation insurance policies as required by the Labor Code or
are legally self-insured pursuant to Labor Code sections 3700 et. seq. or do they
intend to obtain such insurance prior to commencing work?
Provide the following information. (Attach a separate page if more than one policy)
Insured
Carrier
Page 4 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
Policy Number
4. Has the latest copy of an audited financial statement(no more than two ❑ Yes❑ No
years old) with accompanying notes been attached for the Design-Builder or each
member of the Design-Builder? (An audited financial statement with accompanying
notes of a parent company guarantor may be substituted.A financial statement that is
not audited is not acceptable. A letter verifying availability of a line of credit is not a
substitute for the required financial statement.).
5. Has a notarized statement from an admitted surety insurer(approved by the ❑ Yes IT No
Florida Department of Insurance) and authorized to issue bonds in the State of
Florida been attached, which states that the Design Builder's current bonding
capacity is sufficient to provide payment and performance bonds in the amount
required by the RFQ? (Statement must be from the surety company, not an agent or
broker.)
6. Has any contractor license held by the Design-Builder or its associates, the ❑ Yes❑ No
General Contractor Member(s) of the Design-Builder or their associates, or any of
the proposed Subcontractors or their associates,been revoked or suspended within
the last five(5) years?
7. Has a surety firm completed a contract or paid for completion of a contract ❑ Yes❑ No
on behalf of any member of the Design-Build Team because they were terminated by
the project owner within the last five(5) years?
8. Within the last five years was the Design-Builder,the General Contractor ❑ Yes❑ No
Member(s) of the Design-Builder or any proposed Subcontractor declared ineligible
to bid on a public works contract,to be awarded a public works contract, or to
perform as a subcontractor on a public agency contract?
9. Has any member of the Design-Build Team(contractors, architects, ❑ Yes❑ No
engineers, subcontractors or others) or any member's associates, ever been convicted
of a crime involving the awarding of a contract for a government project, or the
bidding or performance of a government contract within the last five (5) years?
10. Do all Architects and Engineers who are expected to work on the project ❑ Yes❑ No
possess current Florida professional licenses for the engineering services which they
intend to provide?
13. Has any professional license held by any Engineer who will provide services n Yes n No
been revoked at any time in the last five years?
15. Will the Design-Builder ensure that its subcontractors responsible for ❑ Yes❑ No
specialty construction work use only qualified skilled labor personnel (such as heat
and frost insulators, asbestos workers, boilermakers, iron shop builders, blacksmiths,
forgers,bricklayers, electrical workers, elevator constructors, iron workers,
plumbers, pipe fitters,plasterers, cement masons, painters, roofers, water proofers
and sheet metal workers)to perform such work?
Page 5 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
III. PRE-QUALIFICATION QUESTIONS
For City Reviewer
Only
A-1 How many years has the Design-Builder been licensed in Florida? ❑ Yes ❑ No
[Respondent must demonstrate a minimum of 5 years continuous experience
in the State of Florida.]
Years:
A-2. Is the Design-Builder or its associates currently the debtor in a bankruptcy ❑ Yes❑ No
case?
[If"yes," indicate the case number, bankruptcy court, and the date on which
the petition was filed.]
_Case Number Bankruptcy Court Date Filed
A-3. Was the Design-Builder or its associates in bankruptcy at any time during the ❑ Yes❑ No
last five years? (This question refers only to a bankruptcy action that was not
described in answer to question A-2, above)
[If"yes," indicate the case number, bankruptcy court, and the date on which
the petition was filed.]
_Case Number Bankruptcy Court Date Filed
A-4. At any time in the last five years has the Design-Builder or its associates been ❑ Yes❑ No
assessed liquidated damages of more than $50,000 on a construction contract
with either a public or private owner?
If yes, explain on a separate page, identifying all such projects by owner, owner's
address, name of entity against whom assessment was made, the date of
completion of the project, amount of liquidated damages assessed and all
other information necessary to fully explain the assessment of liquidated
damages.
A-5. Has the Design-Builder or its associates ever been declared by an owner, or ❑ Yes❑ No
found by an arbitrator or court to be in default on a construction contract?
n Yes n No
If"yes,"explain on a separate page.
A-6. In the last five years has the Design-Builder or its associates, been debarred, ❑ Yes❑ No
disqualified,removed or otherwise prevented from bidding on, or completing,
any government agency or public works project for any reason?
n Yes ❑ No
If"yes," explain on a separate page. State the name of the organization debarred,the
year of the event,the owner of the project, and the basis for the action.
A-7. Has the Design-Builder or its associates ever been denied an award of a n Yes❑ No
public works contract based on a finding by a public agency that they were
not a responsible bidder?
❑ Yes ❑ No
If"yes," on a separate page identify the year of the event, the entity denied the
award, the owner, the project, and the basis for the finding by the public
agency.
Page 6 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
(NOTE: The following two questions refer only to disputes between Design-Builders
and owners of projects. You need not include information about disputes
with suppliers, other contractors, or subcontractors. You need not include
information about"pass-through" disputes in which the actual dispute is
between a subcontractor and a project owner.)
A-8. In the past five years has any claim in excess of$50,000 been filed in court, ❑ Yes❑ No
arbitration, or other dispute resolution proceeding against the Design-Builder
or its associates concerning their work on a construction project?
❑ Yes ❑ No
If"yes," on a separate page identify the claim(s)by providing the project name, date
of the claim,name of the claimant, the name of the entity the claim was filed
against, a brief description of the nature of the claim,the court and case
number, and a brief description of the status of the claim(pending or, if
resolved, a brief description of the resolution).
A-9. In the past five years has the Design-Builder or its associates made any claim ❑ Yes❑ No
in excess of$50,000 against a project owner concerning work on a project or
payment for a contract and filed that claim in court or arbitration?
❑ Yes ❑ No
If"yes,"on a separate page identify the claim by providing the name of claimant,the
project name, date of the claim, name of the entity (or entities) against whom
the claim was filed, a brief description of the nature of the claim, the court
and case number, and a brief description of the status of the claim(pending,
or if resolved, a brief description of the resolution).
A-10. In the last five years has any insurance carrier,for any form of insurance, ❑ Yes❑ No
refused to renew the insurance policy for the Design-Builder or its associates
due to non-payment or contractor losses?
❑ Yes ❑ No
If"yes," on a separate page give name of the insured, name the insurance carrier,the
form of insurance, and the year of the refusal.
A-11. Has the Design-Builder or its associates ever been found liable in a civil suit ❑ Yes❑ No
or found guilty in a criminal action for making any false claim or material
misrepresentation to any public entity?
❑ Yes n No
If"yes,"explain on a separate page, including identifying who was found liable or
guilty, the court and case number, the name of the public entity, the civil or
criminal verdict,the date and the basis for the finding.
A-12. Has the Design-Builder or its associates ever been convicted of a crime n Yes n No
involving any federal, state, or local law related to construction?
El Yes n No
If"yes,"explain on a separate page, including identifying who was convicted,the
name of the victim,the date of the conviction, the court and case number, the
crimes, and the grounds for the conviction.
A-13. Has the Design-Builder or its associates ever been convicted of a federal or ❑ Yes❑ No
state crime of fraud, theft, or any other act of dishonesty?
❑ Yes ❑ No
If"yes," identify on a separate page,the person or persons convicted,the court and
Page 7 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
case number, the crimes, and the year convicted.
A-14. During the last five years,has there ever been a period of time when the ❑ Yes❑ No
Design-Builder or its associates had no surety bond in place during a public
construction project when one was required?
❑ Yes ❑ No
If yes, indicate the period during which no surety bonds were in place, name of
entity without the surety bond, the name of project owner, and if coverage
was denied the date coverage was denied and the name of the company that
denied coverage.
A-15. Has OSHA cited and assessed penalties against the Design-Builder or its
associates for any"serious," "willful" or"repeat" violations of its safety or
health regulations in the past five years?
(NOTE: If you have filed an appeal of a citation,and the Occupational Safety and ❑ Yes n No
Health Appeals Board has not yet ruled on your appeal, you need not include
information about it.)
❑ Yes ❑ No
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid,if any.
State the case number and date of any OSHAB decision.
A-16. Has the Federal Occupational Safety and Health Administration cited and
assessed penalties against the Design-Builder or its associates in the past five
years?
(NOTE: If an appeal of the citation has been filed and the Appeals Board has not yet ❑ Yes❑ No
ruled, or if there is a court appeal pending, you need not include information
about the citation.)
❑ Yes ❑ No
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any decision.
A-17. Has the EPA, any Air Quality Management District or any Regional Water
Quality Control Board cited and assessed penalties against either the Design-
Builder or its associates or the owner of a project during the time in which the
preceding parties were performing on a contract in the past five years?
(NOTE: If an appeal of the citation has been filed and there is no ruling yet, or if ❑ Yes n No
there is a court appeal pending, you need not include information about the
citation.)
❑ Yes ❑ No
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation, nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid,if any.
State the case number and date of any decision.
A-18. How often does the Design-Builder require documented safety meetings to be
held for construction employees and field supervisors during the course of a
Page 8 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
project?
A-19. List the Design-Builder's Experience Modification Rate (EMR) (Florida
workers' compensation insurance)for each of the past three premium years:
(NOTE: An Experience Modification Rate is issued to your firm annually by your
workers' compensation insurance carrier.)
Year: EMR:
Year: EMR:
Year: EMR:
If your EMR for any of these three years is 1.00 or higher you may attach a letter of
explanation.
A-20. Within the last five years has there ever been a period when the Design- ❑ Yes❑ No
Builder or its associates had employees 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 page. If"No," please provide a statement by your
current workers' compensation insurance carrier that verifies periods of
workers' compensation insurance coverage for the Design-Builder for the last
five years. (If the General Contractor has been in business for less than five
years,provide a statement by your workers' compensation insurance carrier
verifying continuous workers' compensation insurance coverage for the
period that your firm has been in business.)
A-21. Has there been more than one occasion during the last five years in which the ❑ Yes❑ No
Design-Builder or its associates was required to pay either back wages or
penalties for failure to comply with the state's prevailing wage laws?
❑ Yes ❑ No
If"yes," attach a separate page, describing the violator,nature of each violation,
name of the project, date of its completion,the public agency for which it was
constructed, the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
A-22. During the last five years,has there been more than one occasion in which the n Yes n No
Design-Builder or its associates have been penalized or required to pay back
wages for failure to comply with the Federal Davis-Bacon prevailing wage
requirements?
n Yes ❑ No
If"yes," attach a separate page, describing the violator,nature of each violation,
name of the project, date of its completion,the public agency for which it was
constructed; the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
A-23. If the Design-Builder operates its own State-approved apprenticeship
program, provide the following information on a separate page:
(a) Identify the craft or crafts in which you provided apprenticeship training in
the past year.
(b) State the year in which each such apprenticeship program was approved, and
Page 9 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
attach evidence of the most recent Florida Apprenticeship Council approval(s)
of your apprenticeship program(s).
(c) State the number of individuals who were employed by your firm as
apprentices at any time during the past three years in each apprenticeship and
the number of persons who, during the past three years,completed
apprenticeships in each craft while employed by your firm.
A-24. At any time during the last five years, has the Design-Builder or its associates ❑ Yes n No
been found to have violated any provision of Florida apprenticeship laws or
regulations, or the laws pertaining to use of apprentices on public works?
❑ Yes ❑ No
If"yes,"provide the date of the findings and attach a copy of the final decision.
Date of Findings
A-25. Do agreements exist between the Design-Builder and registered
apprenticeship programs which have been approved by the Florida
Apprenticeship Council and have graduated apprentices in the preceding five
years, for all apprenticable crafts which may be employed by the Design-
Builder on this project?
(This graduation requirement shall not apply to programs providing apprenticeship ❑ Yes❑ No
training for any craft that has not been deemed by the Department of Labor
and the Department of Industrial Relations to be an apprenticeable craft
within the period of October 1995 to October 2000.)
❑ Yes ❑ No
A-26. In the last 5 years, has the Design-Builder completed one or more contracts ❑ Yes❑ No
for construction of transportation facilities in the State of Florida comparable
to the project identified in the Request for Qualifications?
❑ Yes ❑ No
If"yes"how many?
A-27. In the past 5 years, has the Design-Builder completed one or more contracts ❑ Yes❑ No
for construction of transportation facilities in the United States comparable to
the project identified in the Request for Qualifications?
L Yes ❑ No
If"yes" how many?
A-28. In the last 5 years,has the Design-Builder completed one or more design- ❑ Yes n No
build contracts for construction of transportation facilities in the United States
(including Florida) comparable to the project identified in the Request for
Qualifications?
n Yes ❑ No
If"yes"how many?
A-29. Please fill in the following blanks based on the Design Builder's attached
financial statement. If each member of the Design-Builder attached financial
statements, add assets and liabilities for all.
Current Assets: $
Current Liabilities: $
Total Net Worth: $
Current Ratio(Assets/Liabilities):
Working Capital (Current Assets-Current Liabilities): $
Page 10 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
III(B) PREQUALIFICATION QUESTIONS FOR THE GENERAL CONTRACTOR MEMBER(S) OF
THE DESIGN-BUILDER.
B-1 How many years has the General Contractor been licensed in Florida?
Years:
B-2. Is the General Contractor or its associates currently the debtor in a bankruptcy ❑ Yes❑ No
case?
If"yes," indicate the case number,bankruptcy court, and the date on which the
petition was filed.
Case Number Bankruptcy Court
Date Filed
B-3. Was the General Contractor or its associates in bankruptcy at any time during ❑ Yes❑ No
the last five years? (This question refers only to a bankruptcy action that was
not described in answer to question A-2, above)
If"yes," indicate the case number, bankruptcy court, and the date on which the
petition was filed.
Case Number Bankruptcy Court Date Filed
B-4. At any time in the last five years has the General Contractor or its associates ❑ Yes❑ No
been assessed liquidated damages of more than $50,000 on a construction
contract with either a public or private owner?
If yes, explain on a separate page, identifying all such projects by owner, owner's
address,name of entity against whom assessment was made, the date of
completion of the project, amount of liquidated damages assessed and all
other information necessary to fully explain the assessment of liquidated
damages.
B-5. Has the General Contractor or its associates ever been declared by an owner, ❑ Yes❑ No
or found by an arbitrator or court to be in default on a construction contract?
If"yes,"explain on a separate page.
B-6. In the last five years has the General Contractor or its associates, been ❑ Yes❑ No
debarred,disqualified, removed or otherwise prevented from bidding on, or
completing, any government agency or public works project for any reason?
If"yes," explain on a separate page. State the name of the organization debarred,the
year of the event, the owner of the project, and the basis for the action.
B-7. Has the General Contractor or its associates ever been denied an award of a ❑ Yes❑ No
public works contract based on a finding by a public agency that they were
not a responsible bidder?
If"yes," on a separate page identify the year of the event,the entity denied the
award,the owner,the project, and the basis for the finding by the public
agency.
(NOTE: The following two questions refer only to disputes between contractors and
owners of projects. You need not include information about disputes with
Page 11 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
suppliers, other contractors, or subcontractors. You need not include
information about"pass-through" disputes in which the actual dispute is
between a subcontractor and a project owner.)
B-8. In the past five years has any claim in excess of$50,000 been filed in court, ❑ Yes❑ No
arbitration or other dispute resolution proceeding against the General
Contractor or its associates concerning their work on a construction project?
If"yes," on a separate page identify the claim(s)by providing the project name, date
of the claim, name of the claimant,the name of the entity the claim was filed
against, a brief description of the nature of the claim, the court and case
number, and a brief description of the status of the claim(pending or, if
resolved, a brief description of the resolution).
B-9. In the past five years has the General Contractor or its associates made any ❑ Yes❑ No
claim in excess of$50,000 against a project owner concerning work on a
project or payment for a contract and filed that claim in court or arbitration?
If"yes," on a separate page identify the claim by providing the name of claimant,the
project name, date of the claim,name of the entity (or entities) against whom
the claim was filed, a brief description of the nature of the claim,the court
and case number, and a brief description of the status of the claim(pending,
or if resolved, a brief description of the resolution).
B-10. In the last five years has any insurance carrier, for any form of insurance, ❑ Yes❑ No
refused to renew the insurance policy for the General Contractor or its
associates due to non-payment or contractor losses?
If"yes," on a separate page give name of the insured, name the insurance carrier,the
form of insurance, and the year of the refusal.
B-11. Has the General Contractor or its associates ever been found liable in a civil ❑ Yes❑ No
suit or found guilty in a criminal action for making any false claim or material
misrepresentation to any public entity?
If"yes," explain on a separate page, including identifying who was found liable or
guilty, the court and case number, the name of the public entity, the civil or
criminal verdict,the date and the basis for the finding.
B-12. Has the General Contractor or its associates ever been convicted of a crime ❑ Yes❑ No
involving any federal, state, or local law related to construction?
If"yes," explain on a separate page, including identifying who was convicted,the
name of the victim, the date of the conviction, the court and case number,the
crimes, and the grounds for the conviction.
B-13. Has the General Contractor or its associates ever been convicted of a federal ❑ Yes❑ No
or state crime of fraud, theft, or any other act of dishonesty?
If"yes," identify on a separate page, the person or persons convicted,the court and
case number, the crimes, and the year convicted.
B-14. During the last five years, has there ever been a period of time when the ❑ Yes❑ No
General Contractor or its associates had no surety bond in place during a
public construction project when one was required?
If yes,indicate the period during which no surety bonds were in place, name of
entity without the surety bond,the name of project owner, and if coverage
was denied the date coverage was denied and the name of the company that
Page 12 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
denied coverage.
B-15. Has CAL OSHA cited and assessed penalties against the General Contractor
or its associates for any"serious," "willful" or"repeat" violations of its safety
or health regulations in the past five years?
(NOTE: If you have filed an appeal of a citation, and the Occupational Safety and ❑ Yes❑ No
Health Appeals Board has not yet ruled on your appeal, you need not include
information about it.)
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any OSHAB decision.
B-16. Has the Federal Occupational Safety and Health Administration cited and
assessed penalties against the General Contractor or its associates in the past
five years?
(NOTE: If an appeal of the citation has been filed and the Appeals Board has not yet ❑ Yes❑ No
ruled, or if there is a court appeal pending, you need not include information
about the citation.)
If"yes,"on separate page describe the citations,the party against whom the citation
was made, date of citation, nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any decision.
B-17. Has the EPA, any Air Quality Management District or any Regional Water
Quality Control Board cited and assessed penalties against either the General
Contractor or its associates or the owner of a project during the time in which
the preceding parties were performing on a contract in the past five years?
(NOTE: If an appeal of the citation has been filed and there is no ruling yet, or if ❑ Yes❑ No
there is a court appeal pending, you need not include information about the
citation.)
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any decision.
B-18. How often does the General Contractor require documented safety meetings
to be held for construction employees and field supervisors during the course
of a project?
B-19. List the General Contractor's Experience Modification Rate(EMR) (Florida
workers' compensation insurance)for each of the past three premium years:
(NOTE: An Experience Modification Rate is issued to your firm annually by your
workers' compensation insurance carrier.)
Year: EMR:
Year: EMR:
Year: EMR:
If your EMR for any of these three years is 1.00 or higher you may attach a letter of
Page 13 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
explanation.
B-20. Within the last five years has there ever been a period when the General ❑ Yes❑ No
Contractor or its associates had employees but was without workers'
compensation insurance or state-approved self-insurance?
If"yes,"please explain the reason for the absence of workers' compensation
insurance on a separate page. If"No," please provide a statement by your
current workers' compensation insurance carrier that verifies periods of
workers' compensation insurance coverage for the General Contractor for the
last five years. (If the General Contractor has been in business for less than
five years, provide a statement by your workers' compensation insurance
carrier verifying continuous workers' compensation insurance coverage for
the period that your firm has been in business.)
B-21. Has there been more than one occasion during the last five years in which the ❑ Yes❑ No
General Contractor or its associates was required to pay either back wages or
penalties for failure to comply with the state's prevailing wage laws?
If"yes," attach a separate page, describing the violator, nature of each violation,
name of the project, date of its completion, the public agency for which it was
constructed, the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
B-22. During the last five years, has there been more than one occasion in which the ❑ Yes❑ No
General Contractor or its associates have been penalized or required to pay
back wages for failure to comply with the Federal Davis-Bacon prevailing
wage requirements?
If"yes," attach a separate page, describing the violator,nature of each violation,
name of the project, date of its completion,the public agency for which it was
constructed; the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
B-23. If the General Contractor operates its own State-approved apprenticeship
program, provide the following information on a separate page:
(a) Identify the craft or crafts in which you provided apprenticeship training in
the past year.
(b) State the year in which each such apprenticeship program was approved, and
attach evidence of the most recent Florida Apprenticeship Council approval(s)
of your apprenticeship program(s).
(c) State the number of individuals who were employed by your firm as
apprentices at any time during the past three years in each apprenticeship and
the number of persons who, during the past three years, completed
apprenticeships in each craft while employed by your firm.
B-24. At any time during the last five years, has the General Contractor or its ❑ Yes❑ No
associates been found to have violated any provision of Florida apprenticeship
laws or regulations, or the laws pertaining to use of apprentices on public
works?
If"yes," provide the date of the findings and attach a copy of the final decision.
Date of Findings
Page 14 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
B-25. Do agreements exist between the General Contractor and registered
apprenticeship programs which have been approved by the Florida
Apprenticeship Council and have graduated apprentices in the preceding five
years, for all apprenticable crafts which may be employed by the General
Contractor on this project?
(This graduation requirement shall not apply to programs providing apprenticeship ❑ Yes❑ No
training for any craft that has not been deemed by the Department of Labor
and the Department of Industrial Relations to be an apprenticeable craft
within the period of October 1995 to October 2000.)
B-26. In the last 5 years,has the General Contractor completed one or more ❑ Yes❑ No
contracts for construction of transportation facilities in the State of Florida
comparable to the project identified in the Request for Qualifications?
If"yes"how many?
B-27. In the past 5 years,has the General Contractor completed one or more ❑ Yes❑ No
contracts for construction of transportation facilities in the United States
comparable to the project identified in the Request for Qualifications?
If"yes"how many?
B-28. In the last 10 years, has the General Contractor completed one or more ❑ Yes❑ No
design-build contracts for construction of transportation facilities in the
United States (including Florida) comparable to the project identified in the
Request for Qualifications?
If"yes" how many?
Page 15 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
III(C) PRE-QUALIFICATION QUESTIONS FOR THE PRINCIPAL ENGINEER
C-1. How many years has the Principal Engineer been licensed and practicing in
Florida?
Years:
C-2. Is the firm currently the debtor in a bankruptcy case? ❑ Yes❑ No
If"yes," indicate the case number,bankruptcy court, and the date on which the
petition was filed..
Case Number Bankruptcy Court
Date Filed
C-3. Was the firm in bankruptcy at any time during the last five years? (This ❑ Yes❑ No
question refers only to a bankruptcy action that was not described in answer
to question C-2, above)
If"yes,"indicate the case number,bankruptcy court, and the date on which the
petition was filed.
Case Number Bankruptcy Court Date Filed
C-4. In the past five years has any claim in excess of$50,000 been filed in court, ❑ Yes❑ No
arbitration, or other dispute resolution proceeding against the Principal
Engineer or the firm concerning its engineering work on a project?
If"yes," identify the claim(s)by providing the project name, date of the claim, name
of the claimant, a brief description of the nature of the claim, the court and
case number, and a brief description of the status of the claim(pending or, if
resolved, a brief description of the resolution).
C-5. In the last five years has the Principal Engineer or the firm been debarred, ❑ Yes❑ No
disqualified,removed or otherwise prevented from bidding on, or completing,
any government agency or public works project for any reason?
If"yes,"explain on a separate page. State the name of the organization debarred,the
_ year of the event, the owner of the project, and the basis for the action.
C-6. Has the Principal Engineer or the firm ever been denied an award of a public n Yes❑ No
works contract based on a finding by a public agency that they were not a
responsible bidder?
If"yes," on a separate page identify the year of the event, the entity denied the
award,the owner,the project, and the basis for the finding by the public
agency.
C-7. In the past five years has the Principal Engineer or the firm made any claim in ❑ Yes❑ No
excess of$50,000 against a project owner concerning engineering work on a
project and filed that claim in court or arbitration?
If"yes,"on separate page 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 the nature of the claim, the court and case number, and a
brief description of the status of the claim(pending, or if resolved, a brief
description of the resolution).
Page 16 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
C-8. In the last five years has any insurance carrier,for any form of insurance, ❑ Yes❑ No
refused to renew an insurance policy for the Principal Engineer or the firm
based on non-payment or losses?
If"yes," on separate page give name the insurance carrier,the form of insurance and
the year of the refusal.
C-9. Has the Principal Engineer or the firm ever been found liable in a civil suit or ❑ Yes❑ No
found guilty in a criminal action for making any false claim or material
misrepresentation to any public agency or entity?
If"yes," on a separate page identify who was found liable or convicted, the name of
the public agency,the court and case number,the date of the investigation and
the grounds for the finding.
C-10. Has the Principal Engineer or the firm ever been convicted of a crime ❑ Yes❑ No
involving any federal, state,or local law related to construction?
If"yes," on a separate page identify who was convicted,the name of the victim,the
date of the conviction, the court and case number,the crimes, and the grounds
for the conviction.
C-11. Has the Principal Engineer or the firm ever been convicted of a federal or ❑ Yes❑ No
state crime of fraud,theft, or any other act of dishonesty?
If"yes," on a separate page identify who was convicted,the court and case number,
the crimes and the year convicted.
C-12. Has the Department of Consumer Affairs taken any disciplinary action against- ❑ Yes❑ No
the Principal Engineer?
If yes,please explain on a separate page.
C-13. In the last 5 years, has the Principal Engineer completed one or more - ❑ Yes❑ No
contracts for construction of transportation facilities in the State of Florida
comparable to the project identified in the Request for Qualifications?
If"yes" how many?
C-14. In the past 5 years, has the Principal Engineer completed one or more ❑ Yes❑ No
contracts for construction of transportation facilities in the United States
comparable to the project identified in the Request for Qualifications?
If"yes"how many?
C-15. In the last 10 years, has the Principal Engineer completed one or more design- ❑ Yes❑ No
build contracts for construction of transportation facilities in the United States
(including Florida) comparable to the project identified in the Request for
Qualifications?
If"yes"how many?
Page 17 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
III(D) SCORED QUESTIONS FOR HEAVY AND HIGHWAY SUBCONTRACTORS
All Heavy and Highway Subcontractors must be pre-qualified. The Design-Builder may prequalify
multiple alternative heavy and highway subcontractors, and later competitively bid out the subcontracts to
those prequalified.
Attach copies of III(D) for each alternative Heavy and Highway Subcontractor if multiple Heavy and
Highway subcontractors are being prequalified.
Subcontractor Name:
D-1. How many years has the Heavy and Highway Subcontractor been licensed in
Florida?
Years:
D-2. Is the Heavy and Highway Subcontractor or its associates currently the debtor ❑ Yes❑ No
in a bankruptcy case?
If"yes," indicate the case number,bankruptcy court, and the date on which the
petition was filed.
Case Number Bankruptcy Court Date Filed
D-3. Was the Heavy and Highway Subcontractor or its associates in bankruptcy at ❑ Yes❑ No
any time during the last five years? (This question refers only to a bankruptcy
action that was not described in answer to question D-2, above)
If"yes," indicate the case number,bankruptcy court, and the date on which the
petition was filed.
_Case Number Bankruptcy Court Date Filed
D-4. At any time in the last five years has the Heavy and Highway Subcontractor ❑ Yes❑ No
or its associates been assessed liquidated damages of more than$50,000 on a
construction contract with either a public or private owner?
If yes,explain on a separate page, identifying all such projects by owner, owner's
address, name of entity against whom assessment was made,the date of
completion of the project, amount of liquidated damages assessed and all
other information necessary to fully explain the assessment of liquidated
damages.
D-5. In the past five years has the Heavy and Highway Subcontractor or its ❑ Yes❑ No
associates ever been declared by an order or found by an arbitrator or court to
be in default on a contraction contract?
If"yes," explain on a separate page.
D-6. In the last five years has the Heavy and Highway Subcontractor or its ❑ Yes❑ No
associates been debarred, disqualified, removed or otherwise prevented from
bidding on, or completing, any government agency or public works project
_ for any reason?
If"yes," explain on a separate page. State the name of the organization debarred,the
year of the event, the owner of the project,and the basis for the action.
Page 18 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
D-7. Has the Heavy and Highway Subcontractor or its associates ever been denied ❑ Yes❑ No
an award of a public works contract based on a finding by a public agency
that they were not a responsible bidder?
If"yes," on a separate page identify the year of the event, the entity denied the
award,the owner,the project, and the basis for the finding by the public
agency.
(NOTE: The following two questions refer only to disputes between contractors and
owners of projects. You need not include information about disputes with
suppliers or other contractors.
D-8. In the past five years has any claim in excess of$50,000 been filed in court, ❑ Yes❑ No
arbitration, or other dispute resolution proceeding against the Heavy and
Highway Subcontractor or its associates concerning their work on a
construction project?
If"yes," on a separate page identify the claim(s)by providing the project name, date
of the claim,name of the claimant,the name of the entity the claim was filed
against, a brief description of the nature of the claim, the court and case
number, and a brief description of the status of the claim(pending or,if
resolved, a brief description of the resolution).
D-9. In the past five years has the Heavy and Highway Subcontractor or its ❑ Yes❑ No
associates made any claim in excess of$50,000 against a project owner or a
general contractor concerning work on a project or payment for a contract and
filed that claim in court or arbitration?
If"yes," on a separate page identify the claim by providing the name of claimant,the ❑ Yes❑ No
project name, date of the claim, name of the entity (or entities) against whom
the claim was filed, a brief description of the nature of the claim, the court
and case number, and a brief description of the status of the claim(pending,
or if resolved, a brief description of the resolution).
D-10. In the last five years has any insurance carrier, for any form of insurance, ❑ Yes❑ No
refused to renew the insurance policy for the Heavy and Highway
Subcontractor or its associates due to non-payment or contractor losses?
If"yes," on a separate page give name of the insured, name the insurance carrier,the
form of insurance, and the year of the refusal.
D-11. Has the Heavy and Highway Subcontractor or its associates ever been found ❑ Yes❑ No
liable in a civil suit or found guilty in a criminal action for making any false
claim or material misrepresentation to any public entity?
If"yes," explain on a separate page, including identifying who was found liable or
guilty,the court and case number,the name of the public entity, the civil or
criminal verdict,the date and the basis for the finding.
D-12. Has the Heavy and Highway Subcontractor or its associates ever been ❑ Yes❑ No
convicted of a crime involving any federal, state, or local law related to
construction?
If"yes,"explain on a separate page, including identifying who was convicted,the
name of the victim,the date of the conviction,the court and case number, the
crimes, and the grounds for the conviction.
D-13. Has the Heavy and Highway Subcontractor or its associates ever been ❑ Yes n No
Page 19 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
convicted of a federal or state crime of fraud,theft, or any other act of
dishonesty?
If"yes," identify on a separate page the person or persons convicted,the court and
case number,the crimes, and the year convicted.
D-14. During the last five years,has there ever been a period of time when the ❑ Yes❑ No
Heavy and Highway Subcontractor or its associates had no surety bond in
place during a public construction project when one was required?
If yes, indicate the period during which no surety bonds were in place, name of
entity without surety bond,the name of project owner,and if coverage was
denied the date coverage was denied and the name of the company that denied
coverage.
D-15. Has OSHA cited and assessed penalties against the Heavy and Highway
Subcontractor or its associates for any "serious," "willful"or"repeat"
violations of its safety or health regulations in the past five years?
(NOTE: If you have filed an appeal of a citation, and the Occupational Safety and ❑ Yes❑ No
Health Appeals Board has not yet ruled on your appeal, you need not include
information about it.)
If"yes," on separate page describe the citations, the party against whom the citation
was made, date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid,if any.
State the case number and date of any OSHAB decision.
D-16. Has the Federal Occupational Safety and Health Administration cited and
assessed penalties against the Heavy and Highway Subcontractor or its
associates in the past five years?
(NOTE: If an appeal of the citation has been filed and the Appeals Board has not yet ❑ Yes❑ No
ruled, or if there is a court appeal pending, you need not include information
about the citation.)
If"yes," on separate page describe the citations, the party against whom the citation
was made, date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any decision.
D-17. Has the EPA or any Air Quality Management District or any Regional Water
Quality Control Board cited and assessed penalties against either the Heavy
and Highway Subcontractor, its associates, or the owner of a project during
the time in which the preceding parties were performing on a contract in the
past five years?
(NOTE: If an appeal of the citation has been filed and there is no ruling yet, or if n Yes n No
there is a court appeal pending,you need not include information about the
citation.)
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation,nature of the violation,project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any decision.
D-18. How often does the Heavy and Highway Subcontractor require documented
safety meetings to be held for construction employees and field supervisors
Page 20 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
during the course of a project?
D-19. List the Heavy and Highway Subcontractor's Experience Modification Rate
(EMR) (Florida workers' compensation insurance) for each of the past three
premium years:
(NOTE: An Experience Modification Rate is issued to your firm annually by your
workers' compensation insurance carrier.)
Year: EMR:
Year: EMR:
Year: EMR:
If your EMR for any of these three years is or was 1.00 or higher you may attach a
letter of explanation.
D-20. Within the last five years has there ever been a period when the Heavy and ❑ Yes❑ No
Highway Subcontractor or its associates had employees but was without
workers' compensation insurance or state-approved self-insurance?
If"yes,"please explain the reason for the absence of workers' compensation
insurance on a separate page. If"No,"please provide a statement by your
current workers' compensation insurance carrier that verifies periods of
workers' compensation insurance coverage for the Heavy and Highway
Subcontractor for the last five years. (If the Heavy and Highway
Subcontractor has been in business for less than five years,provide a
statement by your workers' compensation insurance carrier verifying
continuous workers' compensation insurance coverage for the period that
your firm has been in business.)
D-21. Has there been more than one occasion during the last five years in which the ❑ Yes❑ No
Heavy and Highway Subcontractor or its associates was required to pay
either back wages or penalties for failure to comply with the state's
prevailing wage laws?
If"yes," attach a separate page, describing the violator,nature of each violation,
name of the project,date of its completion,the public agency for which it was
constructed; the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
D-22. During the last five years,has there been more than one occasion in which the ❑ Yes❑ No
Heavy and Highway Subcontractor or its associates have been penalized or
required to pay back wages for failure to comply with the Federal Davis-
Bacon prevailing wage requirements?
If"yes," attach a separate page, describing the violator, nature of each violation,
name of the project,date of its completion,the public agency for which it was
constructed; the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
D-23. If the Heavy and Highway Subcontractor operates its own State-approved
apprenticeship program, provide the following information on a separate
page:
(a) Identify the craft or crafts in which you provided apprenticeship training in
the past year.
Page 21 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
(b) State the year in which each such apprenticeship program was approved, and
attach evidence of the most recent Florida Apprenticeship Council approval(s)
of your apprenticeship program(s).
(c) State the number of individuals who were employed by your firm as
apprentices at any time during the past three years in each apprenticeship and
the number of persons who, during the past three years,completed
apprenticeships in each craft while employed by your firm.
D-24. At any time during the last five years, has the Heavy and Highway ❑ Yes❑ No
Subcontractor or its associates been found to have violated any provision of
Florida apprenticeship laws or regulations, or the laws pertaining to use of
apprentices on public works?
If"yes,"provide the date of the findings and attach a copy of the final decision.
Date of Findings
D-25. Do agreements exist between the Heavy and Highway Subcontractor and
registered apprenticeship programs which have been approved by the Florida
Apprenticeship Council and have graduated apprentices in the preceding five
years, for all apprenticable crafts which may be employed by the Heavy and
Highway Subcontractor on this project?
(This graduation requirement shall not apply to programs providing apprenticeship
training for any craft that has not been deemed by the Department of Labor
and the Department of Industrial Relations to be an apprenticeable craft
within the period of October 1995 to October 2000.)
Page 22 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
III (E) PRE-QUALIFICATION QUESTIONS FOR OTHER SUBCONTRACTOR(S)
If the Design-Builder chooses,other(non-heavy and highway) subcontractors may be pre-qualified as
part of the Design-Build Team. Attach copies of III(E) for each subcontractor.
Subcontractor Name:
E-l. How many years has the Subcontractor been licensed in Florida?
Years:
E-2. Is the Subcontractor or its associates currently the debtor in a bankruptcy ❑ Yes❑ No
case?
If"yes," indicate the case number,bankruptcy court, and the date on which the
petition was filed.
Case Number Bankruptcy Court Date Filed
E-3. Was the Subcontractor or its associates in bankruptcy at any time during the ❑ Yes❑ No
last five years? (This question refers only to a bankruptcy action that was not
described in answer to question F-2, above)
If"yes," indicate the case number,bankruptcy court, and the date on which the
petition was filed.
Case Number Bankruptcy Court Date Filed
E-4. At any time in the last five years has the Subcontractor or its associates been ❑ Yes❑ No
assessed liquidated damages of more than$50,000 on a construction contract
with either a public or private owner?
If yes, explain on a separate page, identifying all such projects by owner, owner's
address, name of entity against whom assessment was made, the date of
completion of the project, amount of liquidated damages assessed and all
other information necessary to fully explain the assessment of liquidated
damages.
E-5. In the past five years has the Subcontractor or its associates ever been ❑ Yes❑ No
declared by an order or found by an arbitrator or court to be in default on a
construction contract?
If"yes," explain on a separate page.
E-6. In the last five years has the Subcontractor or its associates been debarred, ❑ Yes n No
disqualified,removed or otherwise prevented from bidding on, or completing,
any government agency or public works project for any reason?
If"yes," explain on a separate page. State the name of the organization debarred,the
year of the event, the owner of the project, and the basis for the action.
E-7. Has the Subcontractor or its associates ever been denied an award of a public ❑ Yes❑ No
works contract based on a finding by a public agency that they were not a
responsible bidder?
If"yes," on a separate page identify the year of the event, the entity denied the
Page 23 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
award,the owner,the project, and the basis for the finding by the public
agency.
(NOTE: The following two questions refer only to disputes between contractors and
owners of projects. You need not include information about disputes with
suppliers, or other contractors.
E-8. In the past five years has any claim in excess of$50,000 been filed in court, ❑ Yes❑ No
arbitration,or other dispute resolution proceeding against the Subcontractor or
its associates concerning their work on a construction project?
If"yes," on a separate page identify the claim(s)by providing the project name, date
of the claim, name of the claimant, the name of the entity the claim was filed
against, a brief description of the nature of the claim, the court and case
number, and a brief description of the status of the claim(pending or, if
resolved, a brief description of the resolution).
E-9. In the past five years has the Subcontractor, or their associates, made any ❑ Yes❑ No
claim in excess of$50,000 against a project owner or a general contractor
concerning work on a project or payment for a contract and filed that claim in
court or arbitration?
If"yes,"on a separate page identify the claim by providing the name of claimant,the
project name, date of the claim, name of the entity (or entities) against whom
the claim was filed, a brief description of the nature of the claim,the court
and case number, and a brief description of the status of the claim(pending,
or if resolved, a brief description of the resolution).
E-10. In the last five years has any insurance carrier,for any form of insurance, ❑ Yes❑ No
refused to renew the insurance policy for the Subcontractor or its associates
due to non-payment or contractor losses?
If"yes,"on a separate page give name of the insured,name the insurance carrier,the
form of insurance, and the year of the refusal.
E-11. Has the Subcontractor or its associates ever been found liable in a civil suit or ❑ Yes(l No
found guilty in a criminal action for making any false claim or material
misrepresentation to any public entity?
If"yes,"explain on a separate page, including identifying who was found liable or
guilty, the court and case number, the name of the public entity, the civil or
criminal verdict, the date and the basis for the finding.
E-12. Has the Subcontractor or its associates ever been convicted of a crime ❑ Yes n No
involving any federal, state, or local law related to construction?
If"yes,"explain on a separate page, including identifying who was convicted, the
name of the victim, the date of the conviction,the court and case number,the
crimes, and the grounds for the conviction.
E-13. Has the Subcontractor or its associates ever been convicted of a federal or ❑ Yes❑ No
state crime of fraud,theft, or any other act of dishonesty?
If"yes," identify on a separate page the person or persons convicted,the court and
case number,the crimes, and the year convicted.
E-14. During the last five years,has there ever been a period of time when the ❑ Yes❑ No
Subcontractor or its associates had no surety bond in place during a public
construction project when one was required?
Page 24 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
If yes, indicate the period during which no surety bonds were in place, name of
entity without surety bond,the name of project owner, and if coverage was
denied the date coverage was denied and the name of the company that denied
coverage.
E-15. Has OSHA cited and assessed penalties against the Subcontractor or its
associates for any "serious," "willful" or"repeat" violations of its safety or
health regulations in the past five years?
(NOTE: If you have filed an appeal of a citation, and the Occupational Safety and ❑ Yes❑ No
Health Appeals Board has not yet ruled on your appeal,you need not include
information about it.)
If"yes," on separate page describe the citations,the party against whom the citation
was made,date of citation,nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid,if any.
State the case number and date of any OSHAB decision.
E-16. Has the Federal Occupational Safety and Health Administration cited and
assessed penalties against the Subcontractor or its associates in the past five
years?
(NOTE: If an appeal of the citation has been filed and the Appeals Board has not yet ❑ Yes❑ No
ruled, or if there is a court appeal pending, you need not include information
about the citation.)
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation, nature of the violation,project on which the
citation was issued, owner of project,and the amount of penalty paid, if any.
State the case number and date of any decision.
E-17. Has the EPA or any Air Quality Management District or any Regional Water
Quality Control Board cited and assessed penalties against either the
Subcontractor, its associates, or the owner of a project during the time in
which the preceding parties were performing on a contract in the past five
years?
(NOTE: If an appeal of the citation has been filed and there is no ruling yet, or if ❑ Yes❑ No
there is a court appeal pending, you need not include information about the
citation.)
If"yes," on separate page describe the citations,the party against whom the citation
was made, date of citation, nature of the violation, project on which the
citation was issued, owner of project, and the amount of penalty paid, if any.
State the case number and date of any decision.
E-18. How often the does the Subcontractor require documented safety meetings to
be held for construction employees and field supervisors during the course of
a project?
E-19. List the Subcontractor's Experience Modification Rate(EMR)(Florida
workers' compensation insurance)for each of the past three premium years:
(NOTE: An Experience Modification Rate is issued to your firm annually by your
workers' compensation insurance carrier.)
Page 25 of 33
City of Opa-locka RFP No. XX-XXXXXXXX
Year: EMR:
Year: EMR:
Year: EMR:
If your EMR for any of these three years is or was 1.00 or higher you may attach a
letter of explanation.
E-20. Within the last five years has there ever been a period when the Subcontractor ❑ Yes❑ No
or its associates had employees but was without workers' compensation
insurance or state-approved self-insurance?
If"yes," please explain the reason for the absence of workers' compensation
insurance on a separate page. If"No,"please provide a statement by your
current workers' compensation insurance carrier that verifies periods of
workers' compensation insurance coverage for the Subcontractor for the last
five years. (If the Subcontractor has been in business for less than five years,
provide a statement by your workers' compensation insurance carrier
verifying continuous workers' compensation insurance coverage for the
period that your firm has been in business.)
E-21. Has there been more than one occasion during the last five years in which the ❑ Yes❑ No
Subcontractor or its associates was required to pay either back wages or
penalties for failure to comply with the state's prevailing wage laws?
If"yes," attach a separate page, describing the violator, nature of each violation,
name of the project, date of its completion,the public agency for which it was
constructed;the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
E-22. During the last five years,has there been more than one occasion in which the ❑ Yes❑ No
Subcontractor or its associates has been penalized or required to pay back
wages for failure to comply with the Federal Davis-Bacon prevailing wage
requirements?
If"yes," attach a separate page, describing the violator, nature of each violation,
name of the project,date of its completion,the public agency for which it was
constructed; the number of employees who were initially underpaid and the
amount of back wages and penalties that were assessed.
E-23. If the Subcontractor operates its own State-approved apprenticeship program,
provide the following information on a separate page:
(a) Identify the craft or crafts in which you provided apprenticeship training in
the past year.
(b) State the year in which each such apprenticeship program was approved, and
attach evidence of the most recent Florida Apprenticeship Council approval(s)
of your apprenticeship program(s).
(c) State the number of individuals who were employed by your firm as
apprentices at any time during the past three years in each apprenticeship and
the number of persons who, during the past three years,completed
apprenticeships in each craft while employed by your firm.
E-24. At any time during the last five years,has the Subcontractor or its associates ❑ Yes❑ No
been found to have violated any provision of Florida apprenticeship laws or
regulations, or the laws pertaining to use of apprentices on public works?
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City of Opa-locka RFP No. XX-XXXXXXXX
If"yes," provide the date of the findings and attach a copy of the final decision.
Date of Findings
E-25. Do agreements exist between the Subcontractor and registered apprenticeship
programs which have been approved by the Florida Apprenticeship Council
and have graduated apprentices in the preceding five years,for all
apprenticable crafts which may be employed by the Subcontractor on this
project?
(This graduation requirement shall not apply to programs providing apprenticeship ❑ Yes❑ No
training for any craft that has not been deemed by the Department of Labor
and the Department of Industrial Relations to be an apprenticeable craft
within the period of October 1995 to October 2000.)
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City of Opa-locka RFP No. XX-XXXXXXXX
IV. RECENT CONSTRUCTION PROJECTS COMPLETED
1. How many design-build projects have the General Contractor and Principal Engineer involved in this
Design-Build Team ever worked together on?
2. List the total value of all design-build contracts and the value of the largest design-build project which the
General Contractor and Principal Engineer have worked together on.
Total Value Largest Contract
3. General Contractor member of the Design-Builder's three largest design-build projects within the last ten
years. The design-build projects may be public or private and located anywhere in the United States.
Names and references must be current and verifiable. (Copy additional sheets)
General Contractor Name and Current Telephone Number:
Project Name:
Location:
Owner Name and Current Telephone Number:
Principal Engineer Name and Current Telephone Number:
Construction Manager Name and Current Telephone Number:
Description of Project, Scope of Work Performed:
Value of Original Contract:
Value of Contract including change orders:
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City of Opa-locka RFP No. XX-XXXXXXXX
Original Scheduled Completion Date:
Time Extensions Granted(number of days):
Actual Date of Completion:
4. General Contractor Member of the Design-Builder's six most recently completed public works projects.
Names and references must be current and verifiable. (Copy additional sheets)
General Contractor Name and Current Telephone Number:
Project Name:
Location:
Owner Name and Current Telephone Number:
Principal Engineer Name and Current Telephone Number:
Construction Manager Name and Current Telephone Number:
Description of Project, Scope of Work Performed:
Value of Original Contract:
Value of Contract including change orders:
Original Scheduled Completion Date:
Time Extensions Granted(number of days):
Actual Date of Completion:
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City of Opa-locka RFP No. XX-XXXXXXXX
5. Principal Engineer's three largest design-build projects within the last ten years. The design-build
projects may be public or private and located anywhere in the United States. Names and references must
be current and verifiable. (Copy additional sheets)
Principal Engineer's Name and Current Telephone Number:
Project Name:
Location:
Owner Name and Current Telephone Number:
General Contractor Name and Current Telephone Number:
Construction Manager Name and Current Telephone Number:
Description of Project, Scope of Work Performed:
Value of Original Contract:
Value of Contract including change orders:
Original Scheduled Completion Date:
Time Extensions Granted(number of days):
Actual Date of Completion:
6. Principal Engineer's six most recently completed public works projects. Names and references must be
current and verifiable. (Copy additional sheets)
Principal Engineer's Name and Current Telephone Number:
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City of Opa-locka RFP No. XX-XXXXXXXX
Project Name:
Location:
Owner Name and Current Telephone Number:
General Contractor Name and Current Telephone Number:
Construction Manager Name and Current Telephone Number:
Description of Project, Scope of Work Performed:
Value of Original Contract:
Value of Contract including change orders:
Original Scheduled Completion Date:
Time Extensions Granted (number of days):
Actual Date of Completion:
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City of Opa-locka RFP No. XX-XXXXXXXX
V. ORGANIZATION AND MANAGEMENT APPROACH
Description of Design-Build Management Approach
Please include a narrative description of the Design-Builders' management and organizational approach
for accomplishing the design-build project. The narrative description should describe the methodology
for integrating the Design-Build Team and the different areas of expertise within the team into an efficient
and effective organization. The management approach must reflect an understanding of the use of the
design-build project delivery methodology for transportation projects. The narrative description shall also
provide a brief description of the significant functional relationships among participants outlined in the
organization chart below and how the proposed organization will function as an integrated Design-Build
Team.
This description, along with the organization chart(s), shall be limited to no more than ten pages.
Organizational Chart(s)
Please include organization chart(s) for the Design-Build Team showing the flow of the"chain of
command" with lines identifying participants who are responsible for performing the major functions to
be performed, and their reporting relationships, in managing, designing and constructing the project. The
chart(s) must show the functional structure of the organization down to the design discipline or
construction superintendent level, and must identify, as a minimum,those Key Personnel identified by the
request for qualifications.
The chart(s) should identify all of the members of the Design-Build Team and identify the project
management, project administration, construction management,cost estimator, quality assurance and
quality control, safety, environmental compliance and subcontractor administration.
Information About Key Personnel
Please include resumes of and reference information for the Key Personnel proposed for the project as
required by the request for qualifications for all the categories listed in the previous section, i.e . project
management, project administration, construction management, cost estimator, quality assurance and
quality control, safety,environmental compliance and subcontractor administration.
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City of Opa-locka RFP No. XX-XXXXXXXX
CERTIFICATION
NOTE: All members of the Design-Build Team must sign. Copy this certification page for each legal
entity.
I, the undersigned , certify and declare that I have
read all the foregoing answers to this Pre-Qualification Questionnaire; that all responses are correct and
complete of my own knowledge and belief. I declare under penalty of perjury under the laws of the State
of Florida,that the foregoing is true and correct.
(Signature)
(Printed name)
(Place of Execution)
(Date)
(Design-Build Team Member
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