GWINNETT COUNTY DEPARTMENT OF WATER RESOURCES

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AIA Document A305 - Electronic Format CONTRACTOR S QUALIFICATION STATEMENT

Transcription:

July 23, 2012 NOTICE OF PRE-QUALIFICATION OF CONTRACTORS FOR THE PRESTRESSED CONCRETE CYLINDER PIPE (PCCP) PRESSURIZED WATER MAINS 48 AND LARGER AND APPURTENANCES Gwinnett County is soliciting applications from Contractors for pre-qualification to furnish labor, materials and equipment for the Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances at various locations throughout Gwinnett County. Special Conditions: The Gwinnett County Department of Water Resources shall comply with O.C.G.A 36-91-20 as amended for mandatory pre-qualification of prospective bidders. Therefore, interested applicants should obtain a Pre-Qualification Application for the Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances from the Gwinnett County Purchasing Office, 75 Langley Drive, Lawrenceville, Georgia 30046 (Telephone No. 770-822-8734). Applications will be evaluated based on established criteria listed in the application. All qualified and disqualified applicants will be notified in writing. Contractors will be considered pre-qualified upon issuance of the notification of pre-qualification. Pre-qualified Contractors will remain pre-qualified until the County determines otherwise; or a period of five (5) years passes and the Pre-Qualified contractor has not done any work directly for the Gwinnett County Department of Water Resources. One (1) original of the application must be completed and date stamped into the Gwinnett County Purchasing Office. Although the Purchasing Division will take effort to notify prequalified Contractors of bids that are based on the established criteria of the application, it is the Contractor s ultimate responsibility to ensure that they remain abreast of Gwinnett County s solicitations. Depending on the scope and complexity of work to be performed, individual projects may require a project-specific prequalification, independent of the standard pre-qualification process. The review and approval process will require a minimum of three weeks from the date of application, as well as receipt of any supplemental information requests, is received into the Gwinnett County Purchasing Office. Contractors under consideration for pre-qualification may not submit bids for projects that have advertised prior to the contractor s notification of pre-qualification. Questions regarding pre-qualification applications should be submitted in writing to Shelley McWhorter, Purchasing Associate III, fax 770-822-8728/8731 or e- mail Shelley.McWhorter@gwinnettcounty.com. Applicant shall not attach information in lieu of completion of the application document. All information requested by the County shall be provided within the application document; however, additional pages may be attached if more space is required or as otherwise instructed within the application document. All additional pages should be clearly labeled with the applicant s name, section, name item number and page number. Applicant s qualification will be determined based upon the information presented. All questions must be answered in full, without exception. Failure to do so may result in the applicant being deemed nonresponsive and therefore may not be considered for qualification. GWINNETT COUNTY DEPARTMENT OF WATER RESOURCES

PAGE: PQ 2 Date of Application: TO BID CONSTRUCTION PROJECT Project Name: Pre-Qualification of Contractors for the Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances Type of Project: Description: Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances Qualify Contractors to furnish labor, materials and equipment for the Repair and/or Replacement of Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances at various locations in Gwinnett County Owner Name: Gwinnett County Applicant Name: Note: Gwinnett County reserves the right to approve of all personnel provided by the Contractor including but not limited to Project Managers, Project Superintendents and subcontractors for any portion of work resulting from this pre-qualification process. GWINNETT COUNTY DEPARTMENT OF WATER RESOURCES USE ONLY Approved: Initials: Not Approved: Date: PQ2

PAGE: PQ 3 I. INSTRUCTIONS A. Applicant SHALL NOT attach information in lieu of completion of the application document. All information requested by the County SHALL be provided within the application document, however, additional pages may be attached if more space is required or as otherwise instructed within the application document. All additional pages SHOULD be clearly labeled with the applicant s name, section, name item number and page number. B. Applicant s qualification WILL be determined based upon the information presented. All questions must be answered in full, without exception. Failure to do so may result in the applicant being deemed nonresponsive and therefore may not be considered for qualification. C. Only complete and accurate information shall be provided by the Applicant. The Applicant hereby warrants that, to the best of its knowledge and belief, the responses contained herein are true, accurate, and complete. The applicant SHALL complete the applicant certification on page PQ15. The Applicant also acknowledges that the Owner is relying on the truth and accuracy of the responses contained herein. If it is later discovered that any material information given in response to a question was provided by the Applicant, knowing it was false, it shall constitute grounds for immediate disqualification and termination or rescission by the owner of any subsequent agreement between the Owner and the Applicant. The Owner shall also have and retain any other remedies provided by law. D. If there are any questions concerning the completion of this form, the Applicant is encouraged to contact the Owner s representative, Shelley McWhorter, Purchasing Associate III, at Gwinnett County Purchasing Division, telephone 770-822-8734 or fax 770-822-8728/8731. E. The original completed form must be date stamped into the Gwinnett County Purchasing Office. The envelope should be clearly marked with the title of the pre-qualification. PQ3

PAGE: PQ 4 II. MINIMUM PRE-QUALIFICATION CRITERIA IMPORTANT MINIMUM PREQUALIFICATION CRITERIA A. Bonding Company must be licensed to do business in Georgia, licensed to do business by the Georgia Secretary of State, authorized to do business in Georgia by the Georgia Insurance Department; listed in the Department of the Treasury s Publication of Companies Holding Certificates of Authority as Acceptable Surety on Federal Bonds and as Acceptable Reinsuring Companies and have A.M. BEST Rating of A-, FSC VI or higher. Applicant must list name of Bond or Surety Company providing bond not just the name of Bonding Agent. B. Regarding Section V Company Experience Similar Projects -The satisfactory completion of at least four (4) pressurized water main projects consisting of 48 or larger Prestressed Concrete Cylinder Pipe (PCCP) and appurtenances, 100 linear feet or more, within the past ten (10) years. Three (3) of these projects must have been constructed within the right-of-way and/or at a road intersection, and required traffic diversion/maintenance; with one (1) of these projects laid in the roadway with complete road width restoration. Three (3) of these projects must have successfully completed connections between PCCP and DIP (Ductile Iron Pipe). Two (2) of these projects must include the relocation and/or adjustment of customer water meters. One (1) of the projects shall have had rock excavation. Additionally, two (2) of these projects will have been a project in which the applicant constructed a pressurized water main replacement system in an established neighborhood and involved the restoration of landscaped yards. Two (2) of these projects will have involved the coordination and work in conjunction with other utilities. One (1) of the projects must have been performed directly for a utility or other government entity. Further, the applicant must have been the licensed utility contractor for all of the four (4) projects listed in this application. C. At least 50 percent of the work will be performed by personnel directly employed by the applicant. D. Corporations (including principal/corporate officers), Partners and/or Individuals interested in being considered for prequalification with Gwinnett County shall not be currently under indictment for criminal misconduct involving any local, state or federal government entity. PQ4

PAGE: PQ 5 III. GENERAL BACKGROUND A. Current name and address of Applicant: 1. Applicant Name: Mailing Address: City: State and Zip: Business Address City: State and Zip: Telephone and Fax: E-mail: 2. Applicant is: Corporation Partnership Individual (Complete appropriate Affidavit on pages PQ12, PQ13 or PQ14 of this Application) 3. Applicant is: Licensed to conduct utility business in the State of Georgia? Yes No If Yes, Provide State of Georgia Utility Applicants License Number: B. Principals/Officers/Individuals authorized to sign contracts: Name and Title: Name and Title: Name and Title: Name and Title: Name and Title: C. What percentage of the work will the Applicant perform with its own employees: % D. Is applicant currently under indictment for criminal misconduct involving any local, state or federal government entity? Has applicant ever been indicted involving any local, state or federal government entity? If so, what was the disposition of the charges? PQ5

PAGE: PQ 6 IV. BONDING A. Bonding Capacities: 1. What is the Applicant s current total bonding capacity with a contract surety company? $ Maximum 2. What is the Applicant s current single contract bonding capacity with a contract surety company? $ Single B. Please identify the Applicant s surety company and the current line of bonding credit that company has extended to the Applicant. 1. Bond Surety Company (Bid) Name: Mailing Address: City: State and Zip: Telephone and Fax: E-mail: Bonding Credit: 2. Bond Surety Company (Payment and Performance) Name: Mailing Address: City: State and Zip: Telephone and Fax: E-mail: Bonding Credit: C. Please give the name, address, and telephone number of your current surety agent or underwriting contact: Name: Mailing Address: City: State and Zip: Telephone and Fax: E-mail: PQ6

PAGE: PQ 7 V. COMPANY EXPERIENCE SIMILAR PROJECTS Beginning on the following pages, list projects as noted below: Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances. PQ 8 through PQ 11 B. Regarding Section V Company Experience Similar Projects -The satisfactory completion of at least four (4) pressurized water main projects consisting of 48 or larger Prestressed Concrete Cylinder Pipe (PCCP) and appurtenances, 100 linear feet or more, within the past ten (10) years. Three (3) of these projects must have been constructed within the right-of-way and/or at a road intersection, and required traffic diversion/maintenance; with one (1) of these projects laid in the roadway with complete road width restoration. Three (3) of these projects must have successfully completed connections between PCCP and DIP (Ductile Iron Pipe). Two (2) of these projects must include the relocation and/or adjustment of customer water meters. One (1) of the projects shall have had rock excavation. Additionally, two (2) of these projects will have been a project in which the applicant constructed a pressurized water main replacement system in an established neighborhood and involved the restoration of landscaped yards. Two (2) of these projects will have involved the coordination and work in conjunction with other utilities. One (1) of the projects must have been performed directly for a utility or other government entity. Further, the applicant must have been the licensed utility contractor for all of the four (4) projects listed in this application Further, list projects for which the applicant was the licensed utility contractor most closely resembling the work proposed under the description on PQ1 for the specific application you are qualifying for. Describe projects in terms of degree of difficulty, problems encountered, etc., or any pertinent information that might be useful in the evaluation of your request for prequalification. PQ7

PAGE: PQ 8 A. Project No. 1 - Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances Project Name: Location: Utility Owner (utility that actually takes over the pipeline): Address: Contact Person Telephone: Contact Person E-mail Address: Project Engineer: Address: Contact Person Telephone: Contact Person E-mail Address: Contract Dates: Date of Notice to Proceed: Description of Pressurized Water Mains and / or Sewer Force Mains: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Date of Final Completion: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Was this a pressurized water main project that was constructed within the right-of-way and/or at a road intersection, requiring traffic diversion/ maintenance? Did this project require laying pipeline in the roadway with full roadway width restoration? Did this project require the successful completion of connection between PCCP and DIP? Did this project include the relocation and/or adjustment of customer water meters? Did this project include rock excavation? Was this a pressurized water main that was constructed in an established neighborhood and included the restoration of landscaped yards? Did this project include the coordination and work in conjunction with other utilities? Were you the licensed utility contractor on this project? Comments: PQ8

PAGE: PQ 9 B. Project No. 2 - Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances Project Name: Location: Utility Owner (utility that actually takes over the pipeline): Address: Contact Person Telephone: Contact Person E-mail Address: Project Engineer: Address: Contact Person Telephone: Contact Person E-mail Address: Contract Dates: Date of Notice to Proceed: Description of Pressurized Water Mains and / or Sewer Force Mains: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Date of Final Completion: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Was this a pressurized water main project that was constructed within the right-of-way and/or at a road intersection, requiring traffic diversion/ maintenance? Did this project require laying pipeline in the roadway with full roadway width restoration? Did this project require the successful completion of connection between PCCP and DIP? Did this project include the relocation and/or adjustment of customer water meters? Did this project include rock excavation? Was this a pressurized water main that was constructed in an established neighborhood and included the restoration of landscaped yards? Did this project include the coordination and work in conjunction with other utilities? Were you the licensed utility contractor on this project? Comments: PQ9

PAGE: PQ 10 C. Project No. 3 - Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances Project Name: Location: Utility Owner (utility that actually takes over the pipeline): Address: Contact Person Telephone: Contact Person E-mail Address: Project Engineer: Address: Contact Person Telephone: Contact Person E-mail Address: Contract Dates: Date of Notice to Proceed: Description of Pressurized Water Mains and / or Sewer Force Mains: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Date of Final Completion: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Was this a pressurized water main project that was constructed within the right-of-way and/or at a road intersection, requiring traffic diversion/ maintenance? Did this project require laying pipeline in the roadway with full roadway width restoration? Did this project require the successful completion of connection between PCCP and DIP? Did this project include the relocation and/or adjustment of customer water meters? Did this project include rock excavation? Was this a pressurized water main that was constructed in an established neighborhood and included the restoration of landscaped yards? Did this project include the coordination and work in conjunction with other utilities? Were you the licensed utility contractor on this project? Comments: PQ10

PAGE: PQ 11 D. Project No. 4 - Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances Project Name: Location: Utility Owner (utility that actually takes over the pipeline): Address: Contact Person Telephone: Contact Person E-mail Address: Project Engineer: Address: Contact Person Telephone: Contact Person E-mail Address: Contract Dates: Date of Notice to Proceed: Description of Pressurized Water Mains and / or Sewer Force Mains: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Date of Final Completion: Pipe Size: Pipe Material: Pipe Contents: Pipe Length: Was this a pressurized water main project that was constructed within the right-of-way and/or at a road intersection, requiring traffic diversion/ maintenance? Did this project require laying pipeline in the roadway with full roadway width restoration? Did this project require the successful completion of connection between PCCP and DIP? Did this project include the relocation and/or adjustment of customer water meters? Did this project include rock excavation? Was this a pressurized water main that was constructed in an established neighborhood and included the restoration of landscaped yards? Did this project include the coordination and work in conjunction with other utilities? Were you the licensed utility contractor on this project? Comments: PQ11

PAGE: PQ 12 AFFIDAVIT FOR CORPORATION STATE OF ) SS. County of ) Name ), being duly sworn, deposes and says: that he/she is of, Title Company the corporation submitting the attached Application for Prequalification, that he/she has read the same, that he/she has personal knowledge of the facts and statements made therein and that he/she certifies that the facts and statements made therein are true and correct. Sworn to before me this day of 201. Officer must sign here Sworn to and subscribed before me this day of 201. My Commission Expires: Notary Public Seal PQ12

PAGE: PQ 13 AFFIDAVIT FOR PARTNERSHIP STATE OF ) SS. County of ) Name ), being duly sworn, deposes and says: that he/she is of, Title Company the partnership submitting the attached Application for Prequalification, that he/she has read the same and that the same is true and correct. Sworn to before me this day of 201. General Partner must sign here Sworn to and subscribed before me this day of 201. My Commission Expires: Notary Public Seal PQ13

PAGE: PQ 14 AFFIDAVIT FOR INDIVIDUAL STATE OF ) SS. County of ) Name ), being duly sworn, deposes and says: that he/she is of, Title Applicant the applicant submitting the attached Application for Prequalification, that he/she has read the same and that the same is true and correct. Sworn to before me this day of 201. Applicant must sign here Sworn to and subscribed before me this day of 201. My Commission Expires: Notary Public Seal PQ14

PAGE: PQ 15 APPLICANT CERTIFICATION I certify to the Owner that the information and responses provided on this Application for Prequalification are true, accurate and complete. The Owner, or its designated representative, may contact any entity or reference listed in this Application. Each entity or reference may make any information concerning the Applicant available to the Owner or its designated representative. Sworn to before me this day of 201. APPLICANT: By: Title: Sworn to and subscribed before me this day of 201. My Commission Expires: Notary Public Seal PQ15

PAGE: PQ 16 FOR GWINNETT COUNTY DEPARTMENT OF WATER RESOURCES USE ONLY Prestressed Concrete Cylinder Pipe (PCCP) Pressurized Water Mains 48 and Larger and Appurtenances #1 Project Name: Telephone: E-mail: Date Contacted: Comments: #2 Project Name: Telephone: E-mail: Date Contacted: Comments: #3 Project Name: Telephone: E-mail: Date Contacted: Comments: #4 Project Name: Telephone: E-mail: Date Contacted: Comments: End of Application PQ16