INITIAL ASSESSMENT QUESTIONNAIRE

Transcription

1 INITIAL ASSESSMENT QUESTIONNAIRE In order to achieve the objectives of the Disadvantaged Business Enterprise Supportive Services Program (DBESS), the New York State Department of Transportation (NYSDOT), Office of Civil Rights must determine which services can increase the participation of DBE firms in the agency's federally-funded highway construction projects. Your responses from this questionnaire will be used to develop trainings and additional services that will assist firms that wish to increase their capacity to bid and compete on NYSDOT s projects. Completion of this questionnaire is voluntary. However, firms who complete the questionnaire within fourteen (14) days will be entered into a drawing, in which the selected firm will be highlighted in NYSDOT s bi-monthly News Bulletin. Business Name: Business Owner: Address: City: County: State: Zip: Date of Incorporation: Years in Operation: Telephone: Fax: Address: Mobile #: Federal Tax ID #: DUNS # (Dunn & Bradstreet): Number of Employees: Licensed to do Business in what States? Number of Hourly: Number of Salaried: 1

2 Business Type: Corporation ( C Corporation) LLC Sub-Chapter S Corporation General Partnership Limited Partnership Limited Liability Partnership Sole Proprietorship Other: NAICS code(s) you are certified under and related 2015 Gross Revenue: Code Description 2015 Gross Revenue Identify the type(s) of work you generally perform. Please check all categories that apply: Asphalt Concrete Paving & Incidentals Earthwork, Base & Sub-base Fencing Hauling Lighting & Signal Maint. Landscaping Major Structures Minor Struct/ Misc. Concrete Painting & Striping Rest Areas (Construction) Traffic Control Devices Guardrail Repair Debris Clearing/ Removal Mowing Litter Pickup & Disposal Cleaning & Sweep Hwys. Building Construction Rest/Picnic Area Maint. Hazardous Material Pavement Markers Engineering Wholesale Material Supply Surveying Other: Annual Gross Receipts for the Entire Company (Circle) 2013 Less than $500,000 $500,000-$1mil $1 - $4.9mil $5 - $10 Over $10 mil 2014 Less than $500,000 $500,000-$1mil $1 - $4.9mil $5 - $10 Over $10 mil 2015 Less than $500,000 $500,000-$1mil $1 - $4.9mil $5 - $10 Over $10 mil 2

3 COMPANY INFORMATION 1. Does Your Company presently have a business plan? If yes: What is the length of your forecasted business plan? 3 Years 5 Years 10 Years 2. Has your business plan been updated within the past 2 years? 3. Is the business plan used in the management and operations of the business? 4. Does your company have an experienced Estimator? If yes, please indicate the contact name: 5. Does your company maintain active DBE certification with NYSDOT? If yes, please list the certification(s) issued. 6. Please list your business organizational affiliations. 7. How long have you been certified as a DBE with NYSDOT? 8. During the past twelve (12) months, has your firm done the following: a) Participated on a NYSDOT project as a prime or subcontractor? Prime Sub NA 3

4 b) Submitted a quote to work as a prime or subcontractor on a NYSDOT project? NA c) Been solicited by a prime contractor to work on a NYSDOT project? NA 9. What percentage of your revenue comes from government contracts versus private contracts? 0-25% 26%-50% 51%-75% 76%-100% 10. Have you completed/ performed on any private work contracts in the past twelve months? 11. Do you work primarily as a prime or subcontractor? Prime Contractor Subcontractor 12. Have you ever been debarred, suspended, or removed from a federally-funded or NYS funded project? (detail) INSURANCE & BONDING 1. Do you currently have a Commercial General Liability policy in force? 2. If so, what are the limits of liability? $100,000/ $200,000 $300,000/ $600,000 $500,000/ $1 Million $2 Million+ Other (please list) 3. Do you currently have a Worker s Compensation Policy? 4

5 4. Do you understand the NYSDOT electronic bidding procedures? 5. How often are you required to provide bonding for projects? Frequently Very Seldom Occasionally Never 6. Has your company ever been bonded by a Surety Company? If yes, please list Surety Company and date issued below: Name of Surety Date Bond Issued What was/is the amount of bonding? Up to $500,000 >$500,000-$1 Mil >$1 - $5 Mil Higher (amount) If not bonded, does it negatively affect your company s ability to compete for contracts? Yes 7. Do you have a Professional Liability Policy? (amount) FINANCIAL STATEMENTS 1. Do you know how to read a financial statement (e.g. balance sheet; income statement; cash flow statement)? 2. What method of accounting does your company use? Cash Accrual Other (list) 5

6 3. Does your accounting system comply with Federal Acquisition Regulations (specifically FAR 31)? I do know 4. Does your firm utilize a computerized accounting system? (name of system) 5. Who prepares your company s financial statements? CPA (outside) Bookkeeper (outside) In-House Accountant or CPA Other: 6. What levels of financial statements does your company use: Internally Prepared Compiled Other Reviewed Audited 7. What types of financial information do you review on a regular basis? Please indicate below: Balance Sheet Cash Flow Statement Trial Balance Income Statement General Ledger Accounts Receivable Aging Report 8. How frequently are financial statements generated? Please indicate below: Monthly Annually Quarterly Other: 9. Do any financial or lending institutions require that you submit periodic financial information to them? Yes (State purpose) 10. Do you have an internally generated Indirect Cost Rate Schedule? 11. If Yes, does it comply with FAR 31 and the AASHTO Guide? Yes Unsure 6

7 12. Have you ever completed an ICQ (Internal Control Questionnaire) for any NYSDOT project? Yes (Date) 1. How are your business tax returns prepared? BUSINESS TAX RETURNS Outside CPA/Tax Accountant Other Service Repaired In-House 2. Do you understand new/existing business tax laws pertaining to the structure of your company? MANAGEMENT / OPERATIONS 1. Is there a formal written succession plan in place? 2. Does your company have an organizational chart showing key business segments, employees and their titles? 3. Who manages operations? 4. Does your company have a Human Resources Manager or a person that serves in that capacity? 5. Do you have a business loan of credit? If yes, what is the amount? Yes ($) 6. Does your company have current licenses for all the disciplines of work your company performs? N/A 7

8 7. Do you have written policies and procedures for: Accounting Timekeeping Payroll Bidding/Estimating MARKETING 1. Does your company have a website? If yes, please identify the website: 2. What means of marketing do you currently use? Website Mailing Networking Other 3. Do you currently have a firm profile and marketing material detailing service offerings? 4. What marketing materials do you currently utilize (ex: business cards, brochures, etc.)? 5. Does your company have an up-to-date capability statement? Yes (Please attach) 6. When is the last time you updated your firm s marketing materials? Date: TECHNOLOGY 1. What type of software, if any, does your company utilize for the following? A. Accounting/Financial Management B. Project Management C. Bidding/Estimating D. Timekeeping E. E-Commerce 8

9 F. Payroll 2. How would describe your computer skills? Advanced Intermediate Beginner ne 3. Do you need assistance with navigating the NYSDOT website? 4. Are there any other resources that you believe would benefit your company that you currently do not have access to? (if yes please list below) SAFETY 1. Is there a safety program implemented in the company s standard operating procedures that clearly define each employee(s) role(s) and responsibilities? Yes NA 2. Is there a Fleet Safety Program for vehicles/equipment and drivers/operators that logs driver(s) license record check, training, and inspections? Yes NA 3. Have your employees received training to label hazmat with the Globally Harmonized System (GHS)? Yes NA 4. Does your company have the capability to develop, update, and implement, Job Site Hazard Analysis (JSHA) on each job site? Yes NA 5. Has your company had the following safety training? Please check all that apply. Occupational Safety and Health Administration (OSHA) Flagger Certification Hazardous Communication Work Zone Safety Other 9

10 CONSTRUCTION MANAGEMENT 1. Number of General Contractors you performed work for during the previous accounting cycle: 2. Have you successfully been awarded a Transportation related Construction Contract within the last 9 months? 3. If Yes, list the contract(s) and amount awarded: Contract Name Amount Awarded 4. List the largest non-transportation related contract(s) your company has seen through to completion over the last 12 months: 5. List 5 Contractors with whom you have worked within the past 3 years: Name Address Phone 6. Could the above-mentioned names be used as references? Yes 7. What is your method of ensuring deliverables are satisfied according to the contract terms? a) Who maintains the schedule to ensure deliverables are submitted to your clients? 10

11 8. Are you subject to Davis-Bacon requirements? If yes, do you have a person in-house who monitors compliance? Yes I don t know 9. Do you lease or own the key equipment needed to perform in your business? Lease Own 10. How often do you process payroll? Weekly Bi-weekly/Semi-monthly Monthly TRAINING 1. Do you have any interest in participating in any NYSDOT sponsored one-on-one technical assistance programs? 2. What specifically can NYSDOT do to help your company compete for business? 3. Have you encountered any impediments or issues while doing business with NYSDOT? 4. Have you encountered any barriers or issues when doing business with NYSDOT Prime contractors? Please explain. 11

12 5. If bidding and/or working on federally-funded highway construction projects, do you think your DBE status gives you an advantage, disadvantage, or has no impact? Please explain. 6. Are you able to mentor other DBEs in helping them bid successfully and perform better on federally-funded highway projects/contracts? If yes, what types of technical assistance would you be willing and able to provide? 7. Are you interested in expanding your business and bidding on highway contracts as a prime or sub-contractor? If so, what types of training and/or technical assistance do you feel would be beneficial in reaching that goal? 8. In what ways do you keep up with NYSDOT s current contracting opportunities? Word of mouth NYSDOT s procurement website Local Organizations Other 9. On a scale of 1-10 (1 not comfortable at all, 10- an expert), how comfortable are you reading and understanding contracts? 12

13 THANK YOU FOR YOUR RESPONSES!! Please return this questionnaire, along with any supplementary materials to: MH Miles Company, CPA, PC Attn: Susan Matthews 1945 Mason Mill Road, Suite 200 Decatur, GA Telephone: 1(866) Fax: (404) Comments 13