HomeMy WebLinkAboutCC RES 17-58RESOLUTION NO. 17-58
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF TUSTIN,
CALIFORNIA APPROVING PLANS AND SPECIFICATIONS FOR THE
TUSTIN EMERGENCY OPERATION CENTER AND CORPORATE YARD
PROJECT CIP No. 10067 CONSTRUCTION PROJECT AND
AUTHORIZING ADVERTISEMENT FOR BIDS
WHEREAS, it is the intention of the City Council of the City of Tustin, California
to contract for the Tustin Emergency Operations Center and Corporate Yard Project CIP
No. 10067 Construction Project; and
WHEREAS, the City Engineer has presented plans and specifications for the
construction of said work; and
WHEREAS, on December 19, 2017, the City of Tustin pre -qualified five general
contractors as eligible to bid this project;
WHEREAS, this project has been determined to be categorically exempt pursuant
to Section 15301 (Class 1), 15302 (Class 2), 15303 (Class 3) and 15332 (Class32) of the
California Environmental Quality Act (CEQA); and
NOW, THEREFORE, BE IT RESOLVED that the plans and specifications
presented by the City Engineer are hereby approved as the plans and specifications for:
Tustin Emergency Operations Center and Corporate Yard Project CIP No. 10067
BE IT FURTHER RESOLVED that the City Clerk is hereby authorized and
directed to advertise as required by law for the receipt of sealed bids or proposals for
the performance of the work specified in the aforesaid plans and specifications;
PASSED AND ADOPTED at a regular meeting of theCity Council of the City of
Tustin held on the 19th day of December 2017. \ a
ELWYN
Mayor
ATTEST:
ERICA N. RABE,
City Clerk
Resolution No. 17-58
Page 1 of 2
STATE OF CALIFORNIA )
COUNTY OF ORANGE ) SS
CITY OF TUSTIN )
I, Erica N. Rabe, City Clerk and ex -officio Clerk of the City Council of the City of Tustin,
California, do hereby certify that the whole number of the members of the City Council is
five; that the above and foregoing Resolution No. 17-58 was duly and regularly passed
and adopted at a regular meeting of the City Council held on the 19th day of December
2017 by the following vote:
COUNCILMEMBER AYES:
COUNCILMEMBER NOES:
COUNCILMEMBER ABSTAINED:
COUNCILMEMBER ABSENT:
3"VV -
ERI A N. RAB ,
City Clerk
Murray,Gomez,Bernstein,Puckett,Clark (5)
Resolution No. 17-58
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GENERAL CONTRACTOR
PRE -QUALIFICATION QUESTIONNAIRE
FOR
EMERGENCY OPERATIONS CENTER & CORPORATE YARD PROJECT
CIP #10067
City of Tustin
Public Works Dept.
300 Centennial Way
Tustin, Ca. 92780
Deadline for Submissions: 2:00 PM, THURSDAY, NOVEMBER 16TH, 2017
TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
The City of Tustin seeks to pre -qualify General Contractors for the construction of RC
Sports Park ("Project"), and now invites sealed pre -qualification submittals from General
Contracting Class "B" Contractors.
Notice is hereby given that the City of Tustin has determined that general contractor
bidders on this Project must be pre -qualified prior to submitting a bid on this Project.
The pre -qualification evaluation is solely for the purpose of determining which General
Building Contractors are deemed qualified for the successful performance of the
construction of the Project.
Only Class "B" Contractors that have been determined to be qualified under this
process will be allowed to bid on the Project.
It is mandatory that all Contractors who intend to submit a bid, fully complete the pre -
qualification questionnaire, provide all requested materials, and be approved by the City
of Tustin to be on the final qualified bidders list.
FILING OF SUBMITTALS:
All submittals must be filed in a sealed package with the City of Tustin, Public Works
Division, 300 Centennial Way, Tustin, California 91780, on or before 2:00 pm,
Thursday, November 16th, 2017, for the purpose of pre -qualification for this Project.
Pre -Qualification, Questionnaires may be obtained at:
Jon Hughes, Program Manager
Griffin Structures
Jhughes@griffinstructures.com
It is the sole responsibility of the Contractor to see that the Pre -Qualification Submittal is
received before the stated deadline.
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
PROJECT DESIGN TEAM
OWNER
CITY OF TUSTIN
300 Centennial Way
Tustin, California
92780
Jason Churchill: (714) 573-3355
Jchurchill(a-)_tustinca.org
PROGRAM MANAGER
GRIFFIN STRUCTURES
2 Technology Dr.
Irvine, Ca. 92618
Jon Hughes (949) 444-1615
JhughesCaD-griffinstructures.com
ARCHITECT OF RECORD
LPA Inc.
5161 California Ave. suite 100
Irvine, Ca. 92617
Tracey Powl (949) 701-4055
Tpowl[a)Ipainc.com
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
TABLE OF CONTENTS
Project Description and Submittal Instructions..- . ................. _ .......... ... 5
Statement of Understanding .............................................................. ... 9
Questionnaire
Part 1: Essential Requirements for Qualification .............................11
Part II: Questionnaire
Section A: Current Organization and Structure .................... .. 13
Section B: History of Business and Performance ..................16
Section C: Compliance with Regulatory Requirements .......... 20
Part III: Similar Project Experience Questionnaire ........................ .. 23
Part IV: Organizational Resources ...........................................29
Questionnaire Scoring ........................ ...................................... 30
Attachments
Attachment A: Project Rendering... .............................................. A-1
Attachment B: Standard Contract ................................................. B-1
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
PROJECT DESCRIPTION
Located 1472 Service Road, Tustin Ca. 92780, the City of Tustin's New Emergency
Operations Center (EOC) and Corporate Yard will be placed at the existing Field
Services Maintenance Facility. This project includes, but is not limited to; the demolition
of the existing Administration Building and portable offices and site elements, and the
construction of a new (2) story, 17,284 SF building which will house a new EOC,
Telemetry Center, Field Services Administration, City Wellness Center, Field Services
Locker Rooms, and supporting infrastructure, The Project also includes site work
including but not limited to the construction of a new parking canopy, material bins, site
utilities, landscaping, off site infrastructure and both soft and hardscape.
The project will involve careful coordination to maintain all operations to the existing
Vehicle Maintenance Bay and Fueling Station. Because the facility intended for
demotion provides all power and communications to the remaining site buildings, this
project will require very specific phasing to insure all buildings intended to remain are
supplied with the necessary infrastructure before the Administration Building is
demolished. This involves the construction and placement of a new SCE transformer,
and construction and placement of a new exterior meter panel. All services to the
Vehicle Maintenance Bay and Fueling Station must remain uninterrupted throughout the
entire duration of the project.
This project also includes extensive, highly technical audio visual and
telecommunications installations. This includes installations for 911 Dispatch Facilities,
Emergency Operations, Radio Communications, Telemetry Center (Data Center),
integration with City Fiber Network, and other elements.
The Engineer's estimate for this project is $10,0.00,000
PROJECT SCHEDULE
The current tentative Project Schedule is as follows:
Pre -Qualification of Contractors: ....................October, 2017 — December, 2017
Project Bidding: ....................January, 2018 — February, 2018
Award Project: ......... . .................... ............ March, 2018
Start Construction: ............................... ......April, 2017
PRE -QUALIFICATION SCHEDULE
Notice Inviting RFQ for Pre -Qualification Submittals: ........................... 10112/17
Final Date for Submission of Bidder Questions: ................................. A 1/02/17
Final Date for Responses to Bidder Questions....................................11/09/17
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Submissions Due: ............................................................................. 11/16/17
Selection Notification......................................................................11/30/17
GENERAL
The City is seeking qualified Class "B" General Contractors with construction
experience of at least five (5) projects demonstrating comparable experience. Please
see Part III Similar Project Experience for a definition of "comparable experience."
Each prospective Contractor must successfully complete the pre -qualification
questionnaire, provide all requested materials in the required form, and be approved by
the City of Tustin to be on the final qualified bidders list. The City of Tustin will not
accept submission of incomplete or late documentation. Incomplete documentation will
result in the rejection of the prospective Contractor.
Answers to all questions contained in the attached questionnaire, information about
current bonding capacity, notarized statement from surety, and the most recent
reviewed or audited financial statements, with accompanying notes and supplemental
information, are required.
City of Tustin reserves the right to unilaterally adjust, increase, limit, suspend, or rescind
the pre -qualification rating based on subsequently learned information. Contractors
whose rating changes significantly after pre -qualification to disqualify them will be
notified, and given an opportunity for a hearing consistent with the hearing procedures
described below to appeal a pre -qualification rating.
PRE -QUALIFICATION GUIDELINES
Each prospective Contractor must successfully complete the pre -qualification process
outlined in this document. No other pre -qualification process completed for the City of
Tustin will meet these requirements.
Prospective Contractors must submit "Statements of Qualifications" (SOQ) by
completing the Pre -Qualification Submittal Questionnaire package. The City will not
accept information or documents from other parties. Submission of incomplete and/or
unclear Pre -Qualification Submittal Questionnaire or required materials will result in
rejection of the prospective contractor.
Any questions or requests for information must be submitted in writing to:
Jon Hughes
Program Manager
Griffin Structures, Inc.
Email: Jhughes(a�griffinstructures.com
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
PREPARATION OF PRE -QUALIFICATION SUBMITTALS
The submittal information should be presented in a binder and separated by section
dividers. Oversize drawings (larger than 11"x17"), if provided, should be folded and
inserted into plastic carriers. Five (5) hard copies and one (1) electronic copy in *.PDF
format of the Pre -Qualification Submittal shall be delivered to the City of Tustin. The
completed Pre -Qualification Submittal should not exceed 50 pages. The City of Tustin
reserves the right to waive minor irregularities and omissions in the information
contained in the pre -qualification application submitted.
EVALUATION AND ANALYSIS
Pre -qualification of prospective contractors will be determined from the information
submitted in each Pre -Qualification Questionnaire Submittal. The City of Tustin
reserves the right to verify from other available sources the information provided by the
Contractor and to rely upon such information gathered during the verification process.
The City of Tustin's decision will be based on objective evaluation criteria. Further
consideration of a prospective contractor's qualifications will be made only if the
prospective contractor meets all of the following minimum requirements:
1. Submission of a properly completed and signed Declaration
2. Possession of the valid California Contractors "B" License in good standing
3. Meet bonding capacity requirements
4. Meet insurance requirements
5. Demonstration of General Contractor's Comparable Experience
6. Project Manager/Field Superintendent Comparable Experience
7. No completion of work by surety in the last 10 years
8. Department of Industrial Relations history
9. Meet financial requirements
The Pre -Qualification Questionnaire Submittal Analysis Form that will be used to verify
minimum qualifications is included. The City of Tustin will screen each responding
prospective Contractor's statement for minimum qualifications and develop a list of Pre -
Qualified Contractors.
City of Tustin reserves the right to reject any or all responses to pre -qualification
questionnaires and any or all subsequent. bids for construction projects, and to waive
any irregularities in any response to the pre -qualification application.
While it is the intent of the pre -qualification questionnaire and required documents to
assist the City in determining bidder responsibility prior to bid and to aid the City in
selecting the lowest responsible bidder, neither the fact of pre -qualification, nor any pre -
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
qualification rating, will preclude the City of Tustin from a post -bid consideration and
determination of whether a bidder has the quality, fitness, capacity and experience to
satisfactorily perform the proposed work.
All financial and proprietary information provided by prospective contractors will be kept
confidential to the extent permitted by law. However, by submitting the pre -qualification
packet, the Contractor agrees that the contents of the submittal may be disclosed to
third parties for the purpose of verification, investigation of substantial allegations, or in
any appeal hearing. Also, the names of prospective contractors applying for pre -
qualification status will be subject to disclosure.
APPEALS PROCEDURE
Any contractor who the City determines to not pass the pre -qualification process shall
have the right to request review of the determination. The contractor shall request
review by delivering to the Director of the City's Department of Public Services a written
notice requesting a review. The contractor shall deliver such written notice to the
Director within five (5) business days of being notified that the Contractor has been
determined not to be qualified and the basis for the determination. The Contractor
waives its right to challenge the City's decision if it fails to deliver the notice within the
five (5) business days.
The Director or their designee shall conductea determination hearing no later than ten
(10) business days following receipt of the contractor's written notice. The hearing
conducted by the Director shall be informal but will be an evidentiary hearing. At the
hearing, the Contractor will be given the opportunity to present information and present
reasons in opposition to the determination. The Director shall consider all evidence,
information and arguments submitted by the contractor relevant to the City's
determination, the City's response to such. evidence, information and arguments, and
any other information the Director deems relevant. Promptly following the hearing, the
Director shall issue a written decision whether the contractor is qualified or not qualified.
Following the hearing, the contractor may further appeal to the City Manager of the City
of Tustin a decision by the Director that the Contractor is not qualified. The Contractor
must request a hearing before the City Manager by delivering to the City Clerk, with a
copy to the Director, a written notice of appeal. The contractor must deliver the written
notice of appeal within five (5) business days of the date of the Director's notice that the
contractor is not qualified. The contractor waives its right to challenge the Director's
decision if it fails to deliver the notice within the five (5) business days.
The City Manager shall hold a de novo hearing within ten (10) days of Contractor's
written notice of appeal. The City Manager shall uphold or reverse the Director's
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
qualification rafting, will preclude the City of Tustin from a post -bid consideration and
determination of whether a bidder has the quality, .fitness, capacity and experience to
satisfactorily perform the proposed work.
All financial and proprietary information provided by prospective contractors will be kept
confidential to the extent permitted by law. However, by submitting the pre -qualification
packet, the Contractor agrees that the contents of the submittal may be disclosed to
third parties for the purpose of verification, investigation of substantial allegations, or in
any appeal hearing. Also, the names of prospective contractors applying for pre -
qualification status will be subject to disclosure.
APPEALS PROCEDURE
Any contractor who the City determines to not pass the pre -qualification process shall
have the right to request review of the determination. The contractor shall request
review by delivering to the Director of the City's Department of Public Services a written
notice requesting a review. The contractor shall deliver such written notice to the
Director within five (5) business days of being notified that the Contractor has been
determined not to be qualified and the basis for the determination. The Contractor
waives its right to challenge the City's decision if it fails to deliver the notice within the
five (5) business days.
The Director or their designee shall conduct•a determination hearing no later than ten
(10) business days following receipt of the contractor's written notice. The hearing
conducted by the Director shall be informal but will be an evidentiary hearing. At the
hearing, the Contractor will be given the opportunity to present information and present
reasons in opposition to the determination. The Director shall consider all evidence,
information and arguments submitted by the contractor relevant to the City's
determination, the City's response to such..evidence, information and arguments, and
any other information the Director deems relevant. Promptly following the hearing, the
Director shall issue a written decision whether the contractor is qualified or not qualified.
Following the hearing, the contractor may further appeal to the City Manager of the City
of Tustin a decision by the Director that the Contractor is not qualified. The Contractor
must request a hearing before the City Manager by delivering to the City Clerk, with a
copy to the Director, a written notice of appeal. The contractor must deliver the written
notice of appeal within five (5) business days of the date of the Director's notice that the
contractor is not qualified. The contractor waives its right to challenge the Director's
decision if it fails to deliver the notice within the five (5) business days.
The City Manager shall hold a de novo hearing within ten (10) days of Contractor's
written notice of appeal. The City Manager shall uphold or reverse the Director's
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
decision based on the entire record, including the information and evidence presented
to the Director and any additional information and evidence received by the City
Manager at the hearing.
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
decision based on the entire record, including the information and evidence presented
to the Director and any additional information and evidence received by the City
Manager at the hearing.
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
I
STATEMENT OF UNDERSTANDING
The undersigned certifies that the statements and information contained in this submittal
are complete and accurate and that the submittal contains no false or deliberately
misleading information. The undersigned hereby agrees and declares that receipt of this
submittal by the City of Tustin does not constitute either a direct or implied guarantee to
the Contractor that pre -qualification is or will be granted and also agrees to the
procedures and conditions of the pre -qualification requirements described in the Pre -
Qualification Document.
(1) Legal Name of Applicant (Contractor)
(2) Address of Applicant (Contractor)
(3) Phone Number
Email
Fax
(4) Applicant is a ( ) Corporation ( ) Partnership ( ) Sole Proprietorship ( ) Joint Venture
(5) If Contractor is a Corporation, name the State of Incorporation
(6) Total number of years the Contractor has been contracting
(7) Total number of years the Contractor has been in construction
(8) Banking institution authorized to provide corroboration of applicant's financial
stability:
Name:
Address:
Contact:
(9) Execution:
Telepho
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1
TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
The undersigned is a legally authorized representative of the Contractor. The legal
name of the Contractor is
State of California
Contractor's License Number: Type:
Expiration:
being first duly sworn, says that all statements
and information contained in this Submittal are complete and accurate and that this
Submittal contains no false or deliberately misleading information.
Contractor
Printed Name Signature
Title
Subscribed and sworn to before me this
,20
Notary Public in and for the State of
Residing at
Expiration Date:
END OF FORM
day of
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS Ir
PART I: ESSENTIAL REQUIREMENTS FOR QUALIFICATION
IMPORTANT NOTE:
Contractor may be immediately disqualified if the answer to any of questions 1
through 7 is "no."
Contractor will be immediately disqualified if the answer to any of questions 8
through 12 is "yes." . If the answer to question 10 is "yes," and if debarment
would be the sole reason for denial of pre -qualification, any pre -qualification
issued will exclude the debarment period.
1. Contractor possesses a valid and current California Class "B" General Contractor's
License in good standing for this project for which it intends to submit a bid.
❑ Yes ❑ No
2. Contractor has (or can provide proof that they can obtain within ten (10) business
days prior to award) an insurance policy(ies) consistent with Attachment B "City of
Tustin — Standard Contract".
❑ Yes ❑ No
3. Contractor has current workers' compensation insurance policy as required by the
Labor Code or is legally self-insured pursuant to Labor Code section 3700 et. seq.
❑ Yes ❑ No
4. Have you attached your latest copy of a reviewed or audited financial statement with
accompanying notes and supplemental information?
❑ Yes ❑ No
NOTE. A financial statement that is not either reviewed or audited by a Certified
Public Accountant (CPA) is not acceptable. A letter verifying availability of a line of
credit may also be attached; however, it will be considered as supplemental
information only, and is not a substitute for the required financial statement.
5. Have you attached a notarized statement from an admitted surety insurer (approved
by the California Department of Insurance and authorized to issue bonds in the State
of California), which states that your current bonding capacity is at least $40,000,000
for this project, and $80,000,000 aggregate, should you be selected?'
Yes ❑ No
NOTE: Notarized statement must be from Surety Company, not an agent or broker.
' An additional notarized statement from the surety may be requested by the City of Tustin at the time of
submission of a bid, if this pre -qualification package is submitted more than 60 days prior to submission of the
bid.
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TUSTIN EMERGENCY OPERATIONS CENTER
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
6. Contractor has completed at least five (5) comparable projects in the last ten (10)
years? See Part III: Similar Project Experience Questionnaire for criteria.
❑ Yes ❑ No
7. Contractor has (or can provide proof that they can obtain within ten (10) business
days prior to award) insurance policy with a policy limits consistent with the sample
contract insurance requirements in Attachment B.
❑ Yes ❑ No
8. Has your contractor's license been revoked at any time in the last ten (10) years?
❑ Yes ❑ No
If yes, please explain why:
9. Has a surety firm completed, or is in the process of completing, a contract on your
behalf, or has paid for completion because your firm was default terminated by the
project owner within the last ten (1.0) years?
❑ Yes ❑ No
10. At the time of submitting this pre -qualification form, is your firm ineligible to bid on or
be awarded any local, state or federal public works contracts, or perform as a
subcontractor on any such public works contract, - pursuant to either Labor Code
section 1777.1 or Labor Code section 1777.7 or any other local, state or federal law
or regulation?
❑ Yes ❑ No
If the answer is "Yes," state the beginning and ending dates of the period of
debarment:
Starting
Ending
11. At any time during the last ten (10) years, has your firm or any of its owners or
officers been convicted of a crime involving the awarding of a contract of a
government construction project, or the bidding or performance of a government
contract?
❑ Yes ❑ No
12. In the last ten (10) years has your firm been denied an award of a public works
contract based on a finding by a public agency that your company was not a
responsible bidder?
❑ Yes ❑ No
lf* "yes," explain on a separate signed page. Identify the year of the event, the
owner, the project and the basis for the finding by the public agency.
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TUSTIN EMERGENCY OPERATIONS CENTER
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
PART II: QUESTIONNAIRE
Section A. Current Organization and Structure of the Business
For Firms That Are Corporations:
la. Date incorporated:
1 b. Under the laws of what state:
1c. Provide all the following information for each person who is either (a) an officer of
the corporation (president, vice president, secretary, treasurer), or (b) the owner of
at least ten percent (10%) of the corporation's stock.
Name Position Years
with Co.
%
Ownership
Social
Security# .
1 d. Identify every construction firm that any person listed above has been associated
with (as owner, general partner, limited partner or officer) at any time during the last
five years.
NOTE. For this question, "owner" and "partner" refer to ownership of ten percent
(70°10) or more of the business, or ten percent (10%) or more of its stock, if the
business is a corporation.
Dates of Person's
Person's Name Construction Firm Participation with Firm
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TUSTIN EMERGENCY OPERATIONS CENTER
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Section B. History of the Business and Performance
1. Has there been any change in ownership of the firm at any time during the last ten
(10) years?
NOTE. A corporation whose shares are publicly traded is not required to
answer this question.
❑ Yes ❑ No
If "yes," explain on a separate signed page.
2. Is the firm a subsidiary, parent, holding company, or affiliate of another construction
firm?
NOTE: Include descriptive and background information about other firms if
one firm owns fifty percent (50%) or more of another, or if an owner, partner,
or officer of your firm holds a similar position in another firm.
❑ Yes ❑ No
If "yes," explain on a separate signed page.
3. Are any corporate officers, partners or owners connected to any other construction
firms?
NOTE. Include descriptive and background information about other firms if an
owner, partner, or officer of your firm holds a similar position in another firm.
❑ Yes ❑ No
If "yes," explain on a separate signed page.
4. State your firm's gross revenue for each of the last three (3) years:
2013 2014 2015
5. How many years has your organization been in business in California as a
contractor under your present business name and license number? Years
6. Was your firm in bankruptcy at any time during the last ten (10) years?
❑ Yes ❑ No
If "yes," please attach a copy of the bankruptcy petition, showing the case number
and the date on which the petition was filed, and a copy of the Bankruptcy Court's
discharge order, or any other document that ended the case, if no discharge order
was issued.
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TUSTIN EMERGENCY OPERATIONS CENTER
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Licenses
7. List all
8. If any of your firm's license(s) are held in the name of a corporation or partnership,
list below the names of the qualifying individual(s) listed on the California
Contractors State License Board (CSLB) records who meet(s) the experience and
examination requirements for each license.
9. Has your firm changed names or license number in the past ten (10) years?
❑ Yes ❑ No
If "yes," explain on a separate signed page, including the reason for the change.
10. Has any owner, partner, or (for corporations) officer of your firm operated a
construction firm under any other name in the last ten (10) years?
❑ Yes. ❑ No
If "yes," explain on a separate signed page, including the reason for the change.
11. Has any CSLB license held by your firm or its Responsible Managing Employee
(RME) or Responsible Managing Officer (RMO) been suspended within the last ten
(10) years?
Yes ❑ No
If "yes," please explain on a separate signed sheet.
Disputes
12. At any time in the last ten (10) years has your firm been assessed and paid
liquidated damages after completion of a project under a construction contract with
either a public or private owner?
❑ Yes ❑ No
If yes, explain on a separate signed page, identifying all such projects by owner,
owner's address, the date of completion of the project, amount of liquidated
damages assessed and all other information necessaryto fully explain the L
assessment of liquidated damages.
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
13. In the last ten (10) years has your firm, or any firm with which any of your company's
owners, officers or partners was associated, been debarred, disqualified, removed or
otherwise prevented from bidding on, or completing, any government agency or
public works project for any reason?
NOTE: "Associated with" refers to another construction firm in which an
owner, partner or officer of your firm held a similar position, and which Is
listed. in response to question 1c or 1d on this form.
❑ Yes ❑ No
If "yes," explain on a separate signed page. State whether the firm involved was the
firm applying for pre -qualification here or another firm. Identify by name of the
company, the name of the person within your firm who was associated with that
company, the year of the event, the owner of the project, the project and the basis
for the action.
NOTE: The following two (2) questions refer only to disputes between your
firm and the owner of a project. You need not include information about
disputes between your firm and a supplier, another contractor, or
subcontractor. You need not include information about "pass-through"
disputes in which the actual dispute is .between a sub -contractor and a project
owner. Also, you may omit reference to all disputes about amounts of less
than $10,000.
14. In. the past ten (10) years has any claim against your firm concerning your firm's
work on a construction project been filed in court or arbitration?
❑ Yes ❑ No
If "yes," on separate signed sheets of paper 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 in which the case was filed and a brief description of
the status of the claim (pending or, if resolved, a brief description of the resolution).
15. In the past ten (10) years has your firm made any claim 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 separate signed sheets of paper 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 in which the
case was filed and a brief description of the status of the claim (pending, or if
resolved, a brief description of the resolution).
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
16. At any time during the past ten (10) years, has any surety company made any
payments on your firm's behalf as a result of a default, to satisfy any claims made
against a performance or payment bond issued on your firm's behalf, in connection
with a construction project, either public or private?
❑ Yes ❑ No
If "yes," explain on a separate signed page the amount of each such claim, the name
and telephone number of the claimant, the date of the claim, the grounds for the
claim, the present status of the claim, the date of resolution of such claim if resolved,
the method by which such was resolved if resolved, the nature of the resolution and
the amount, if any, at which the claim was resolved.
17. In the last ten (10) years has any insurance carrier, for any form of insurance,
refused to renew the insurance policy for your firm?
❑ Yes ❑ No
If "yes," explain on a separate signed page. Name the insurance carrier, the form of
insurance and the year of the refusal.
Criminal Matters and Related Civil Suits
18. Has your firm or any of its owners, officers or partners ever been found liable in a
civil suit or found guilty in a criminal action for making any false claim or material
misrepresentation to any public agency or entity?
❑ Yes ❑ No
If "yes," explain on a separate signed page, including identifying who was involved,
the name of the public agency, the date of the investigation and the grounds for the
finding.
19. Has your firm or any of its owners, officers or partners ever been convicted of a
crime involving any federal, state, or local law related to construction?
❑ Yes ❑ No
If "yes," explain on a separate signed page, including identifying who was involved,
the name of the public agency, the date of the conviction and the grounds for the
conviction.
20. Has your firm or any of its owners, officers or partners ever been convicted of a
federal or state crime of fraud, theft, or any other act of dishonesty?
❑ Yes ❑ No
If "yes," identify on a separate signed page the person or persons convicted, the
court (the county if a state court, the district or location of the federal court), the year
and the criminal conduct. F
is
1
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Bonding
21. Bonding capacity:
Provide documentation from your surety identifying the following:
Name of bonding company/surety:
Name of surety agent, address and telephone number:
22. If your firm was required to pay a premium of more than one percent (1%) for a
performance and payment bond on any project(s) on which your firm worked at any
time during the last five (5) years, state the percentage that your firm was required to
pay. You may provide an explanation for a percentage rate higher than one percent
(1 %), if you wish to do so.
23. List all. other sureties (name and full address) that have written bonds for your firm
during the last five (5) years, including the dates during which each wrote the bonds:
24. During the last ten (10) years, has your firm ever been denied bond coverage by a
surety company, or has there ever been a period of time when your firm had no
surety bond in place during a public construction project when one was required?
❑ Yes ❑ No
If yes, provide details on a separate signed sheet indicating the date when your firm
was denied coverage and the name of the company or companies which denied
coverage; and the period during which you had no surety bond in place.
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Section C. Compliance with Regulatory Requirements
25. Has CAL OSHA cited and assessed penalties against your firm for any "serious,"
"willful" or "repeat" violations of its safety or health regulations in the past ten (10)
years?
NOTE: If you have filed an appeal of a citation, and the Occupational Safety
and Health Appeals Board has not yet ruled on your appeal, you need not
include information about it.
❑ Yes ❑ No
If "yes," attach a separate signed page describing the citations, including information
about the dates of the citations, the nature of the violation, the project on which the
citation(s) was or were issued, the amount of penalty paid, if any. If the citation was
appealed to the Occupational Safety and Health Appeals Board and a decision has
been issued, state the case number and the date of the decision.
26. Has the Federal Occupational Safety and Health Administration cited and assessed
penalties against your firm in the past ten (10) years?
NOTE: If you have filed an appeal of a citation and the Appeals Board has not
yet ruled on your appeal, or if there is a court appeal pending, you need not
include information about the citation.
❑ Yes ❑ No
If "yes," attach a separate signed page describing each citation.
27. Has the EPA or any Air Quality Management District or any Regional Water Quality
Control Board cited and assessed penalties against either your firm or the owner of
a project on which your firm was the contractor, in the past ten (10) years?
NOTE: If you have filed an appeal of a citation and the Appeals Board has not
yet ruled on your appeal, or if there is a court appeal pending, you need not
include information about the citation.
Yes ❑ No
If "yes," attach a separate signed page describing each citation.
28. How often do you require documented safety meetings to be held for construction
employees and field supervisors during the course of a project?
29. List your firm's Experience Modification Rate (EMR) (California 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.
Current year:
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Previous year:
Year prior to previous year:
If your EMR for any of these three years is or was 1.00 or higher you may, if you
wish, attach a letter of explanation.
30. Within the last ten (10) years has there ever been a period when your firm 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 signed page. If "No," please provide a statement by your
current workers' compensation insurance carrier that verifies periods of workers'
compensation insurance coverage for the last five years. (If your firm has been in the
construction 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 the construction
business.)
Prevailing Wage Compliance Record
31. Has there been any occasion during the last ten (10) years in which your firm was
required to pay either back wages or penalties for your own firm's failure to comply
with the State's prevailing wage laws?
NOTE: This question refers only to your own firm's violation of prevailing wage laws,
not to violations of the prevailing wage laws by a subcontractor.
❑ Yes ❑ No
If "yes", attach a separate signed page or pages, describing the nature of each
violation, identifying the name of the project, the 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 you were required to
pay.
32. During the last ten (10) years, has there been any occasion in which your own firm
has been penalized or required to pay back wages for failure to comply with the
Federal Davis -Bacon prevailing wage requirements?
❑ Yes ❑ No
If "yes," attach a separate signed page or pages describing the nature of the
violation, identifying the name of the project, the date of its completion, the public
agency for which it was constructed; the number of employees who were initially
underpaid, the amount of back wages you were required to pay along with the
amount of any penalty paid.
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
PART III SIMILAR PROJECT EXPERIENCE QUESTIONNAIRE
Part III is a verification of the answer provided in Part I Essential Requirements, Question 6.
Respondents whose experience is not verifiable according to the following criteria shall be
disqualified as failing to meet the Essential Requirements.
Contractor shall provide information about its five (5) most recent comparable projects, all
of which must have been successfully completed within the last ten (7) years. All 5 projects
must meet the minimum criteria:
1. Minimum project value of $10,000,000
2. Public Safety, Public Service Facility, and/or Critical Infrastructure (EOC, Fire
Station, Police Station, Emergency Dispatch Facility, Critical Infrastructure,
Corporate Yard, Utility Facility, City Hall, Public Administration Building, Data
Centers)
3. Site Improvements including wet and dry utilities, site landscape, parking, and site
concrete.
4. Of the (5) projects listed, (1) of the projects must be LEED SILVER or higher.
5. Of the (5) projects listed, (2) must demonstrate the installation of extensive audio
visual and telecommunications infrastructure.
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
General Contractor Experience Requirements: Reference 1
Project Name:
Location:
Owner:
Owner Representative, address, email and phone number:
Architect or Engineer, address, email and phone number:
Description of Project, Scope of Work Performed:
Percentage of Base Contract subcontracted:
Total Value of Construction breakdown with initial contract award/final contract
M "11
Original Scheduled Completion Date:
Initial Contract time in days: Time Extensions granted in Days:
Days Liquidated damages assessed:
Actual Date of Completion:
LEED (Yes / No):
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
General Contractor Experience Requirements: Reference 2
Project Name:
Location:
Owner:
Owner Representative, address, email and phone number:
Architect or Engineer, address, email and phone number:
Description of Project, Scope of Work Performed:
Percentage of Base Contract subcontracted:
Total Value of Construction breakdown with initial contract award/final contract
sum:
Original Scheduled Completion Date:
Initial Contract time in days: Time Extensions granted in Days:
Days Liquidated damages assessed:
Actual Date of Completion:
LEED (Yes / No):
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
General Contractor Experience Requirements: Reference 3
Project Name:
Location:
Owner:
Owner Representative, address, email and phone number:
Architect or Engineer, address, email and phone number:
Description of Project, Scope of Work Performed:
Percentage of Base Contract subcontracted: _
Total Value of Construction breakdown with initial contract award/final contract
sum:
Original Scheduled Completion Date:
Initial Contract time in days: Time Extensions granted in Days:
Days Liquidated damages assessed:
Actual Date of Completion:
LEED (Yes / No):
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General Contractor Experience Requirements: Reference 4
Project Name:
Location:
Owner:
Owner Representative, address, email and phone number:
Architect or Engineer, address, email and phone number:
Description of Project, Scope of Work Performed:
Percentage of Base Contract subcontracted:
Total Value of Construction breakdown with initial contract award/final contract
sum:
Original Scheduled Completion Date:
Initial Contract time in days: Time Extensions granted in Days:
Days Liquidated damages assessed:
Actual Date of Completion:
LEED (Yes / No):
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
General Contractor Experience Requirements: Reference 5
Project Name:
Location:
Owner:
Owner Representative, address, email and phone number:
Architect or Engineer, address, email and phone number:
Description of Project, Scope of Work Performed:
Percentage of Base Contract subcontracted:
Total Value of Construction breakdown with initial contract award/final contract
Original Scheduled Completion Date:
Initial Contract time in days: Time Extensions granted in Days:
Days Liquidated damages assessed:
Actual Date of Completion:
LEED (Yes / No):
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
PART IV ORGANIZATIONAL RESOURCES
Staff Roster/Functions
1. Contractor shall furnish an organization chart that includes all supervisory positions
anticipated to be assigned to the Project. Indicate therein which ones are full time
on site and which are part time.
List key members of your staff whom you consider candidates to be assigned to
work as a full-time team member resident on this Project and complete all requested
information as shown below.
Key, full-time candidate team .members must include, without limitation:
1. Project Manager and 2. Superintendent. Use separate sheets of paper that
contain all of the following information:
Name:
Job Title:
Number of Years with Firm:
Proposed Function on the Project:
Number of Years in Current Position:
Number of Projects (in job function) Completed:
Number of Years in Construction Industry:
Minimum of two (2) projects, in a supervisory role, of similar type and scale as
described in Section III: Similar Project Experience Questionnaire. On separate
sheet provide project description, value, dates of construction, references and
reference contact information for each project.
I, the undersigned, certify and declare that I have read all the foregoing
answers to this pre -qualification questionnaire and know their contents. The matters
stated in the questionnaire answers are true of my own knowledge and belief, except
as to those matters stated on information and belief, and as to those matters I
believe them to be true. I declare under penalty of perjury under the laws of the
State of California, that the foregoing is correct.
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TUSTIN EMERGENCY OPERATIONS CENTER
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Signature Date
Print Name
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
L,
A LIST OF THE SCORABLE QUESTIONS AND THE SCORING INSTRUCTIONS
The scorable questions are in two sections as follows:
Part II — Section B History of the business and organizational performance;
Part II — Section C Compliance with occupational safety and health laws, workers'
compensation and other labor legislation;
Note: This section includes only those questions that are "scorable" from the Part II
Questionnaire. The following question numbers, correspond to those used in the Part II.
The Scores Needed for Pre -Qualification
To pre -qualify, a contractor would be required. to qualify under Part I, then have a passing
grade within each of the two large categories in Part 11 referred to above.
Section B, "History of the business and organizational performance,"
The prospective contractor is required to meet a passing score of 51 on this
portion of the questionnaire (of -a maximum score of 68 on this portion of the
questionnaire).
Section C, "Compliance with occupational safety and health laws, workers' compensation and
other labor legislation"
The prospective contractor is required to meet a passing score of 27 on this
portion of the questionnaire (of a maximum score of 38 points on this portion of the
questionnaire).
Questions about History of the Business and Organizational Performance
Section B
(14 questions)
5. Howmany years has your organization been in business in California as a contractor
under your present business name and license number? Years
3 years or more = 2 points
4 years = 3 points
5 years = 4 points
6 years or more = 5 points
TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
6. Was your firm in bankruptcy at any time during the last ten (10) years?
❑ Yes ❑ No
"No" = 3 points "Yes" = 0 points
11. Has any CSLB license held by your firm or its Responsible Managing Employee ("RME")
or Responsible Managing Officer ("RMO") been suspended ,within the last ten (10)
years?
❑ Yes ❑ No
"No" = 5 points "Yes" = 0 points
12. At any time in the last ten (10) years has your firm been assessed and paid liquidated
damages after completion of a project under a construction contract with either a public
or private owner?
❑ Yes ❑ No
No projects with liquidated damages of more than $10,000, or one (1) project with
liquidated damages = 5 points
Two (2) projects with liquidated damages of more than $10,000 = 3 points
Any other answer. 0 points -
13. In the last ten (10) years has your firm, or any firm with which any of your company's
owners, officers or partners was associated, been debarred, disqualified, removed or
otherwise prevented from bidding on, or completing, any government agency or public
works project for any reason?
NOTE: "Associated with" refers to another construction firm in which an owner,
partner or officer of your firm held a similar position, and which is listed in
response to question 1c or 1d on this form.
❑ Yes ❑ No
"No" = 5 points "Yes" = 0 points
NOTE: The following two questions refer only to disputes between your firm and
the owner of a project. You need not include information about disputes between
your firm and a supplier, another contractor, or subcontractor. You need not
include information about "pass-through" disputes in which the actual dispute is
between a sub -contractor and a project owner. Also, you may omit reference to
all disputes about amounts of less than $10,000.
14. In the past ten (10) years has any claim a ainst your firm concerning your firm's work
on a construction project been filed in .court or arbitration?
❑ Yes ❑ No
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
/f the firm's average gross revenue for the last three (3) years was less than
$50 million, scoring is as follows:
5 points for either "No" or "Yes" indicating 1 such instance
3 points for "Yes" indicating 2 such instances
0 points for "Yes" if more than 2 such instances
If your firm's average gross revenue for the last three years was more than $50
million, scoring is as follows:
5 points for either "No" or "Yes" indicating 1, 2, or 3 such instances
3 points for "Yes" indicating either 4 or 5 such instances
0 points for "Yes" if more than 5 such instances
15. In the past ten (10) years has your firm made any claim 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 your firm's average gross revenue for the last three (3) years was less than $50
million scoring is as follows:
5 points for either "No" or "Yes" indicating 1 such instance
3 points for "Yes" indicating 2 such instances
0 points for "Yes" if more than 2 such instances
If your firm's average gross revenue for the last three years was more than $50
million scoring is as follows:
5 points for either "No" or "Yes" indicating 1, 2, or 3 such instances
3 points for "Yes" indicating either 4 or 5 such instances
0 points for "Yes" if more than 5 such instances
16. At any time during the. past ten (10) years, has any surety company made any payments
on your firm's behalf as a. result of a default, to satisfy any claims made against a
performance or payment bond issued on your firm's behalf, in connection with a
construction project, either public or private?
❑ Yes ❑ No
5 points for either "No" or "Yes" indicating 1 such claim
3 points for "Yes" indicating no more than 2 such claims
Subtract 5 points for "Yes" if more than 2 such claims
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TUSTIN EMERGENCY OPERATIONS CENTER
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
17. In the last ten (10) years has any insurance carrier, for any form of insurance, refused to
renew the insurance policy for your firm?
❑ Yes ❑ No
5 points for either "No" or "Yes" indicating 1 such instance
3 points for "Yes" indicating 2 such instances
0 points for "Yes" or if more than 2 such instances
18. Has your firm or any of its owners, officers or partners ever been found liable in a civil
suit or found guilty in a criminal action for making any false claim or material
misrepresentation to any public agency or entity? .
❑ Yes ❑ No
"No" = 5 points "Yes" =subtract 5 points
19. Has your firm or any of its ,owners, officers or partners ever been convicted of a crime
involving any federal, state, or local law related to construction?
❑ Yes .❑ No
"No" = 5 points "Yes" = subtract 5 points
20. Has your firm or any of its owners, officers or partners ever been convicted of a federal
or state crime of fraud, theft, or any other act of dishonesty?
❑ Yes ❑ No
"No" = 5 points "Yes" = subtract 5 points
22. If your firm was required to pay a premium of more than one per cent for a performance
and payment bond on any project(s) on which your firm worked at any time during the
last five (5) years, state the percentage that your firm was required to pay. You may
provide an explanation for a percentage rate higher than one per cent, if you wish to do
SO.
5 points if the rate is no more than one per cent
3 points if the rate was no higher than 1.10 per cent
0 points for any other answer
24. During the last ten (10) years, has your firm ever been denied bond coverage by a
surety company, or has there ever been a period of time when your firm had no surety
bond in place during a public construction project when one was required?
❑ Yes ❑ No
"No" = 5 points "Yes" = 0 points
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
Questions about compliance with safety, workers compensation,
prevailing wage and apprenticeship laws.
Section C
(8 questions)
25. Has CAL OSHA cited and assessed penalties against your firm for any "serious," "willful"
or "repeat" violations of its safety or health regulations in the past ten (10) years?
NOTE: If you have filed an appeal of a citation, and the Occupational Safety and
Health Appeals Board has not yet ruled on your appeal, you need. not include
information about it.
❑ Yes ❑ No
If the firm's average gross revenue for the last three years was less than $50
million, scoring is as follows -
5 points for either "No" or "Yes" indicating 1 such instance
3 points for "Yes" indicating 2 such instances
0 points for "Yes" if more than 2 such instances
If the firm's average gross revenue for the last three years was more than $50
million, scoring'is as follows:
5 points for either "No" or "Yes" indicating 1, 2, or 3 such instances
3 points for "Yes" indicating either 4 or 5 such instances
0 points for "Yes" if more than 5 such instances
26. Has the Federal Occupational Safety and Health Administration cited and assessed
penalties against your firm in the past ten (10) years?
NOTE: If you have filed an appeal of a citation and the Appeals Board has not yet
ruled on your appeal, or if there is a court appeal pending, you need not include
information about the citation.
❑ Yes ❑ No
If the firm's average gross revenue for the last three years was less than $50
million, scoring is as follows:
5 points for either "No" or "Yes" indicating 1 such instance
3 points for "Yes" indicating 2 such instances
0 points for "Yes" or if more than 2 such instances
If the firm's average gross revenue for the last three years was more than $50
million, scoring is as follows.
5 points for either "No" or "Yes" indicating 1, 2, or 3 such instances
3 points for "Yes" indicating either 4 or 5 such instances
0 points for "Yes" if more than 5 such instances
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
27. Has the EPA or any Air Quality Management District or any Regional Water Quality
Control Board cited and assessed penalties against either your firm or the owner of a
project on which your firm was the contractor, in the past ten (10) years?
NOTE: If you have filed an appeal of a citation and the Appeals Board has not yet
ruled on your appeal, or if there is a court appeal pending,. you need not include
information about the citation.
❑ Yes ❑ No
if the firm's average gross revenue for the last three years was less than $50
million, scoring is as follows;
5 points for either "No" or "Yes" indicating 1 such instance
3 points for "Yes" indicating 2 such instances
0 points for "Yes" or if more than 2 such instances
If the firm's average gross revenue for the last three years was more than $50
million, scoring is as follows:
5 points for either "No" or "Yes" indicating 1, 2, or 3 such instances
3 points for "Yes" indicating either 4 or 5 such instances
0 points for "Yes" if more than 5 such instances
28. How often do you require documented safety meetings to. be held for construction
employees and field supervisors during the course of a project?
3 points for an answer of once each :week or more often
0 points for any other answer
29. List your firm's Experience Modification Rate (EMR) (California 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.
Current year: _
Previous year:
Year prior to previous year:
NOTE: An Experience Modification Rate is issued to your firm annually by your
workers' compensation insurance carrier.
5 points for three-year average EMR of .95 or less
3 points for three-year average of EMR of more than .95 but no more than 1.00
0 points for any other EMR
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
30. Within the last ten (10) years has there ever been a period when your firm had
employees but was without workers' compensation insurance or state -approved self-
insurance?
❑ Yes ❑ No
5 points for either "No" or "Yes" indicating 1 such instance
0 points for any other answer
31. Has there been any occasion during the last ten (10) years in which your firm was
required to pay either back wages or penalties for your own firm's failure to comply with
the State's prevailing wage laws?
Yes ❑ No
If your firm's average gross revenue for the last three years was less than $50
million, scoring is as follows:
5 points for either "No," or "Yes" indicating either 1 or 2 such instance
3 points for "Yes" indicating 3 such instances
0 points for "Yes" and more than 3 such instances
If your firm's average gross revenue for the last three years was more than $50
million, scoring is as follows:
5 points for either "No" or "Yes" indicating no more than 4 such instances
3 points for "Yes" indicating either 5 or 6 such instances
0 points for "Yes" and more than 6 such instances
32. During the last ten (10) years, has there been any occasion in which your own firm has
been penalized or required to pay back wages for failure to comply with the Federal
Davis -Bacon prevailing wage requirements?
❑ Yes ❑ No
If your firm's average gross revenue for the last three years was less than $50
million, scoring is as follows:
5 points for either "No," or "Yes" indicating either 1 or 2 such instance
3 points for "Yes" indicating 3 such instances
0 points for "Yes" and more than 3 such instances
If your firm's average gross revenue for the last three years was more than $50
million, scoring is as follows:
5 points for either "No" or "Yes" indicating no more than 4 such instances
3 points for "Yes" indicating either 5 or 6 such instances
0 points for "Yes" and more than 6 such instances
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REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
ATTACHMENT A
PROJECT RENDERINGS
Page 39
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TUSTIN EMERGENCY OPERATIONS CENTER
& CORPORATE YARD PROJECT, CIP No. 10067
REQUEST FOR PRE -QUALIFICATION OF GENERAL CONTRACTORS
ATTACHMENT B
Copy of Standard Contract
Page 11
SECTION D
SAMPLE CONTRACT
SECTION D
CONTRACT
FOR
EMERGENCY OPERATIONS CENTER & CORPORATE YARD
CIP No. 10067
This agreement, made and concluded, in triplicate, this day of ,
between the City of Tustin, California, hereinafter called City, and
hereinafter called Contractor.
ARTICLE I
20 ,
Witnesseth, that for and in consideration of the payments and agreements hereinafter
mentioned, to be made and performed by the City, and under the conditions expressed in the
two bonds, bearing date with these presents and hereunto annexed, the Contractor agreed with
City, at his own proper cost and expense, to do all the work and furnish all the materials
necessary to construct and complete in good workmanlike and substantial manner and to the
satisfaction of the City, in accordance with the plans and specifications, as may be amended
from time to time as of the date of this Agreement, entitled:
EMERGENCY OPERATIONS CENTER & CITY YARD
CIP No. 10067
which said plans and specifications are hereby specifically referred to and by such references
made a part hereof. Said plans and specifications are on file in the office of the City Engineer of
the City of Tustin, California.
ARTICLE II
Contractor agrees to receive and accept the following prices as full compensation for furnishing
all materials and for doing all the work contemplated and embraced in the Agreement; and also
for all loss or damage arising out of the nature of the work aforesaid, or from the action of the
elements, or from any unforeseen difficulties or obstructions which may arise or be encountered
in the prosecution of the work until its acceptance by the City, and for all risks of every
description connected with the work; also for all expenses incurred by or in consequence of the
suspension or discontinuance of work and for well and faithfully completing the work, and the
whole thereof, in the manner and according to the plans and specifications, and the
requirements of the Engineer under them.
D-1
CONTRACT
FOR
EMERGENCY OPERATIONS CENTER & CITY YARD
CIP No. 10067
CITY OF TUSTIN
ITEM
NO.
CONTRACT ITEM
DESCRIPTION
ESTIMATED
QUANTITY
UNIT
TYPE
UNIT
PRICE
TOTAL
PRICE
$
$
$
$
$
GRAND TOTAL CONTRACT PRICE
D-2
I
i
i
ARTICLE III
City hereby promises and agrees with Contractor to employ and does hereby employ Contractor
to provide the materials and to do the work according to the terms and conditions herein
contained and referred to, for the prices aforesaid, and hereby contracts to pay the same at the
time, in the manner and upon the conditions above set forth; and the said parties for
themselves, their heirs, executors, administrators, successors and assigns do hereby agree to
the full performance of the covenants herein contained.
ARTICLE IV
It is further expressly agreed by and between the parties hereto that should there be any conflict
between the terms of this instrument and the bid or proposal of Contractor, then this instrument
shall control and nothing herein shall be considered as an acceptance of the said terms of said
proposal conflicting herewith.
ARTICLE V
1. The CITY OF TUSTIN has obtained from the Director of Industrial Relations the general
prevailing rate of per diem wages and the general prevailing rate for legal holiday and overtime
work in the locality in which the work is to be performed for each craft or type of work needed to
execute this contract and maintains copies thereof in the office of the City Engineer.
The Contractor agrees that not less than said prevailing rates shall be paid to workers employed
on this public works contract as required by Labor Code Sections 1771 and 1774 of the State of
California.
Prevailing Wages Notice Requirements
• No contractor or subcontractor shall be listed on a bid proposal for a public works project
unless registered with the Department of Industrial Relations pursuant to Labor Code
Section 1725.5.
• No contractor or subcontractor shall be awarded a contract for public work on a public
works project unless registered with the Department of Industrial Relations pursuant to
Labor Code Section 1725.5
This project is subject to compliance monitoring and enforcement by the Department of
Industrial Relations.
(For federally funded Davis -Bacon projects, add the following)
This is a ,Davis -Bacon project and the Federal Regulations will be enforced. Any contract
entered into pursuant to this notice will incorporate the provisions of the Federal Labor
Standards, which are on file at the office of the City Engineer, 300 Centennial Way, Tustin, CA
92780. Attention is directed to the Federal minimum wage rate requirements in the Special
Provisions. If there is a difference between the minimum wage rates determined by the Director
of the California Department of Industrial Relations for similar classifications of labor, the
Contractor and subcontractor shall pay not less than the higher wage rate. The City will not
accept lower State wage rates not specifically included in the Federal minimum wage
determinations. This includes "helper" (or other classifications based on hours of experience) or
any other classification not appearing in the Federal wage determinations. Where Federal wage
determinations do not contain the State wage rate determination otherwise available for use by
D-3
the Contractor and subcontractors, the Contractor and subcontractors shall pay not less than
the Federal minimum wage rate which most closely approximates the duties of the employees in
question.
F
2. The Contractor shall, as a penalty to the CITY OF TUSTIN, forfeit Two Hundred Dollars
($200.00) for each calendar day or portion thereof for. each worker paid (either by Contractor or
any subcontractor of Contractor) less than the prevailing rate as prescribed in the preceding
paragraph for the work provided for in this contract, all in accordance with Sections 1774 and
1775 of the Labor Code of the State of California.
3. Section 1773.1 of the Labor Code of the State of California, regarding the payment of
travel and subsistence payments, is applicable to this contract.
4. Section 1777.5 of the Labor Code of the State of California, regarding the employment of
apprentices, is applicable to this contract if the prime contract involves Thirty Thousand Dollars
($30,000.00) or more, or twenty (20) working days or more and under such circumstances,
Contractor shall be fully responsible to ensure compliance with all the provisions of Labor Code
§1777.5 for all apprentice -able occupations on the project. A Contractor or subcontractor who
violates Section 1777.5 shall forfeit to the City of Tustin, as a civil penalty, the sum of One
Hundred Dollars ($100.00) for each calendar day of noncompliance. Notwithstanding Section
1727 of the Labor Code, upon receipt of a determination that a civil penalty has been imposed,
the City of Tustin shall withhold the amount of the civil penalty from contract progress payments
then due or to become due. Any funds withheld by the City of Tustin pursuant to this section
shall be deposited in the General Fund of the City of Tustin.
5. The Contractor shall not employ, or allow work to be performed by, a subcontractor who
is ineligible to perform work on the project pursuant to Section 1777.1 or 1777.7 of the Labor
Code pertaining to debarment by the Labor Commissioner for violations of the Prevailing Wage
Laws.
6. In performance of this contract, not more than eight (8) hours shall constitute a day's
work. The Contractor shall fully conform to Article. 3, Chapter 1, Part 7, Division 2 (Sections
1810 et seq.) of the Labor Code of the State of California. Pursuant to the provisions of Section
1813 of the Labor Code of the State of California, the Contractor shall, as a penalty to the City
of Tustin, forfeit twenty-five Dollars ($25.00) for each worker employed in the execution of the
contract by the Contractor or by any subcontractor for each calendar day during which such
worker is required or permitted to work more than eight (8) hours in any one calendar day and
forty (40) hours in any one calendar week in violation of the provisions of Article 3 of Chapter 1
of Part 7 of Division 2 of the. Labor Code of the State of California.. Contractor shall keep an
accurate record showing the name and actual hours worked each calendar day and each
calendar week by each worker employed by Contractor in connection with the public work.
7. Contractor agrees to keep accurate payroll records showing the name, address, social
security number, work classification, straight time and overtime hours worked each day and .
week and the actual per diem wages paid to each journeyman, apprentice or worker employed
by him in connection with the public work, and agrees to insist that each of his subcontractors
do the same. Contractor further agrees that his payroll records and those of his subcontractors
shall be available to the employee or his representative, the Division of Labor Standards
Enforcement, and the Division of Apprenticeship Standards, and shall comply with all of the.
provisions of Labor Code Section 1776, et sem, in general.
8. Contractor is also aware of the provisions of Section 3700 of the Labor Code which
requires every employer to be insured against liability for Worker's Compensation or undertake r
self-insurance in accordance with the provisions of that code and will comply with such
provisions before commencing the performance of the work of this contract. 6=
D-4
ARTICLE VI
In connection with the performance of this contract, the City shall have the authority to enter the
worksite at any time for the purpose of identifying the existence of conditions, either actual or
threatened, that may present a danger or hazard to any and all employees. The Contractor
agrees that the City, in its sole authority and discretion, may order the immediate abatement of
any and all conditions that may present an actual or threatened danger or hazard to any andall
employees at the worksite.
The Contractor acknowledges the provisions of Section 6400 of the Labor Code, which requires
that employers shall furnish employment and a place of employment that is safe and healthful
for all employees working therein. In the event the City identifies the existence of any condition
that presents an actual or threatened danger or hazard to any or all employees at the worksite
the City is hereby authorized to order the immediate abatement of that actual or threatened
condition pursuant to this section.
The City may also, at its sole authority and discretion, issue an immediate stop work order to the
Contractor to ensure that no employee working at the worksite is exposed -to a dangerous or
hazardous condition. Any stop work order issued by the City to the Contractor in accordance
with the provisions of this section shall not give rise to any claim or cause of action for delay
damages by the Contractor or the Contractor's agents or subcontractors against the City.
ARTICLE VII
The Contractor shall indemnify and save harmless the City of Tustin and all officers and
employees thereof from all claims, suits, or actions of every name, kind and description, brought
for, or on account of, injuries to or death of any person including, but not limited to, workers and
the public, or damage to property resulting from the construction of the work or by or in
consequence of any negligence regarding the work, use of improper materials or equipment in
construction of the work, neglect or refusal of Contractor to faithfully perform the work and all of
Contractor's obligations under the contract, or by or on account of any act or omission by the
Contractor or his agents or a subcontractor or his agents or a third party during the progress of
the work or at any time before its completion and final acceptance, or which might arise in
connection with the agreed upon work or is caused by or happening in connection with the
progress of said work, or on account of any passive or active negligent act or omission by the
City of Tustin, its officers, employees and agents, save and except claims arising through the
sole and exclusive negligence or sole and exclusive'willful misconduct of the City of Tustin.
The defense and indemnification by Contractor shall include all costs and expenditures
including attorney's fees incurred' by the City of Tustin or its employees, officers or agents with
respect to such claim or suit and Contractor will, if requested by City of Tustin, defend any
litigation arising out of such claims at the sole cost and expense of Contractor.
In addition to any remedy authorized by law; so much of the money due the Contractor under
and by virtue of the contract as shall be considered necessary in the sole discretion of the City
of Tustin may be retained by the City until disposition has been made of such claims for
damages as aforesaid.
ARTICLE VIII
The Contractor shall take out and maintain during the life of the contract, commercial general
liability, automobile liability and worker's compensation insurance.
Contractor will procure, at no additional cost to the City, a Builder's Risk and Installation
Construction coverage" insurance policy for the work of this contract. Coverage must name the
ORM
R
i
City as insured and shall include all perils coverage and a face value equal to the contracted
amount for such work. Such policy, to be obtained after acceptance of bid, must be approved
by the City Attorney and on file prior to the execution of the Contract by the City.
The amount of the commercial general liability and automobile insurance shall not be less than
the following;
• Single limit coverage applying to bodily and personal injury liability and property
damage: $2,000,000.
Primary General Liability and Automobile Liability policy shall have,single limit coverage not less
than $ 2,000,000. The minimum insurance requirements cannot be satisfied through
Umbrella/Excess insurance policies.
The following insurer endorsements are required if not part of the policy:
1. The City of Tustin, its elective and appointive boards, officers, agents and employees
named as additional insured in the policy as to the work being performed under the
contract;
2. The coverage is primary and no other insurance carried by the City of Tustin will be
called upon to contribute to a loss under this coverage;
3. The policy covers blanket contractual liability;
4. The policy limits or liability are provided on an occurrence basis;
5. The policy covers broad form property damage liability;
6. The policy covers personal injury as well as bodily injury liability;
7. The policy covers explosion, collapse, and underground hazards;
8. The policy covers products and completed operations;
9, The policy covers use of non -owned automobiles; and
10. The coverage shall not be cancelled or terminated unless thirty (30) days' written
notice is first given to the City of Tustin.
11. Insurers shall be authorized to do business in the State by the Department of
Insurance and shall meet the following qualifications:
A.M. Best's Rating of Grade A and Class VII (seven) (if an Admitted Insurer),
and Grade A- or better and Class X (ten) or better (if offered by a Surplus Line
Broker) is acceptable. Workers' compensation insurance rated Grade B- or
better and Class VII (seven) or better, or offered by the State Compensation
Fund, is acceptable.
12. The worker's compensation and employer's liability insurance policies shall contain a
waiver of subrogation in favor of the City.
Contractor shall provide to the City within ten (10) working days after the date of notice of award
of the contract evidence of the aforementioned insurance with insurer endorsements, which
must meet the requirements of this Article. An Acord Certificate will be accepted solely as
evidence of the name of the insurers and the amounts of insurance. Failure to comply with
M
these requirements will result in annulment of the award, forfeiture of the proposal guarantee,
and the City will pursue award to the next qualified responsive bidder. Contractor is advised that
insurance requirements are non-negotiable and City will not consider waiving insurance
requirements. There are no exceptions.
ARTICLE IX
Upon receipt of a claim or -summons and complaint by the City Clerk relating to this Contract,
the City Clerk shall provide written notice within five (5) working days to the contractor of the
claim or summons and complaint. For purposes of this section, notice to the contractor may be
via facsimile, messenger or by first class mail and addressed to:
[Insert name & address of contractor]
Nothing herein obligates the City to provide notice of a claim or summons and complaint that
does not clearly identify the contract or contractor.
D-7
In Witness Whereof, the parties have hereunto set their hands and seals the year and
date first above written.
THE CITY OF TUSTIN
BY:
(SEAL) Mayor of the City of Tustin
ATTEST:
City Clerk of the City of Tustin
CONTRACT AND BOND APPROVED AS TO FORM:
Date
City Attorney
APPROVED AS TO CONTENT:
Date
City Engineer
CONTRACTOR
Firm Name:
(SEAL) By:
Title:
Note: Attach proper acknowledgment for signatures of authorized person(s) (use copies of
blank form provided in Section C).
M:
Bond No.
Amount
Premium
CITY OF TUSTIN
PUBLIC CONTRACT
FAITHFUL PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS: That , as
and hereinafter referred to collectively as "Principal", and a corporation
organized and existing under the laws of the State of and duly authorized
to transact surety business in the State of California, as, and hereinafter referred to as, "Surety",
are held and firmly bound unto the City of Tustin hereinafter referred to as the "City", in the sum
Of $ for payment of which Principal and surety bind themselves, their heirs,
administrators, successors and assigns, jointly and severally as follows:
THE CONDITION OF THE ABOVE OBLIGATION IS THAT:
WHEREAS, Principal has entered into a contract dated , 20�, with
City to do and perform the following, generally described work, which is more particularly
described in said contract for the construction of: .
EMERGENCY OPERATIONS CENTER & CITY YARD
CIP No. 10067
WHEREAS, all of such improvements are to be constructed and installed in accordance
with the plans and specifications described, referred to and incorporated in said contract; and
WHEREAS, Principal shall commence and complete the construction and installation of
such improvements as provided in said contract; and
NOW, THEREFORE, if Principal shall faithfully perform all agreements contained in the
aforesaid contract, then this obligation shall be null and void.
PROVIDED, HOWEVER, if Principal shall not faithfully perform all agreements contained
in the hereinabove described contract and all obligations, then this obligation shall remain in full
force and effect.
PROVIDED FURTHER HOWEVER, that Surety hereby stipulates and agrees that no
change, extension of time, alteration or modification of the contract documents or of the work to
be performed thereunder shall in any way affect its obligation on this bond and it does hereby
waive notice of any such change, extension of time, alteration or modification of the contract
documents or of the work to be performed thereunder; and
PROVIDED FURTHER, that in case suit is brought upon this bond by the City or any
other person who may bring an action on this bond, a reasonable attorney's flee, to be fixed by
the Court, shall be paid by Principal and Surety.
10
IN WITNESS WHEREOF, Principal and Surety have caused these presents to be duly
signed and sealed this day of
SURETY:
(Name)
BY:
(SEAL) Attorney -in -Fact
BY:
Address of Surety:
APPROVED AS TO FORM:
City Attorney
(SEAL)
APPROVED AS TO CONTENT:
Date
City Engineer
PRINCIPAL:
BY:
(Name)
TITLE:
Address of Principal:
Note: Attach proper acknowledgment for both Surety & Principal (use copies of blank form
provided.in Section C).
D-10
Amount
Premium
CITY OF TUSTIN
PUBLIC CONTRACT
LABOR AND MATERIALS PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS: That ,
as and hereinafter referred to collectively as "Principal", and
a corporation organized and existing under the laws of the State of and
duly authorized to transact surety business in the State of California, as and hereinafter referred
to as, "Surety", are held and firmly bound unto the City of Tustin hereinafter referred to as the
"City", in the sum of $ for payment of which Principal and surety bind
themselves, their heirs, administrators, successors and assigns, jointly and severally as follows:
THE CONDITION OF THE ABOVE OBLIGATION IS THAT:
WHEREAS, Principal has entered into a contract dated , 20 with
the City to do and perform the following, generally described work, which is more particularly
described in said contract for the construction of:
EMERGENCY OPERATIONS CENTER & CITY YARD
CIP No. 10067
WHEREAS, Principal shall commence and complete the construction and installation of
such improvements provided in said contract; and
NOW THEREFORE, if Principal shall pay the Contractor, his subcontractor, and all
persons renting equipment.or furnishing labor or materials to them for such improvements, for
the full cost of such improvements and submit amounts due under the State Unemployment
Insurance Act with respect to such labor, then this obligation shall be null and void.
PROVIDED, HOWEVER, if Principal shall not pay the subcontractor and all persons
renting equipment or furnishing labor or materials to them for such improvements for the full
cost of such improvements, or if Principal fails to submit amounts due under the State
Unemployment Insurance Act with respect to such labor, then Surety will pay for the same in an
amount not exceeding the sum set forth above, which amount shall inure to the benefit of all
persons named in Civil Code Section 3181.
PROVIDED FURTHER, HOWEVER, that Surety stipulates and agrees that no change,
extension of time, alteration or modification of the contract documents or of the work to be
performed thereunder shall in any way affect its obligation on this bond and it does hereby
waive notice of any such change, extension of time, alteration or modification of the contract
documents or of the work to be performed thereunder; and
PROVIDED FURTHER, that in case suit is brought upon this bond by the City or any
other person named in Civil Code Section 3181 who may bring an action on this bond, a
reasonable attorney's fee, to be fixed by the Court, shall be paid by Principal and Surety.
D-11
IN WITNESS WHEREOF, Principal and Surety have caused these presents to be duly
signed and sealed' day of , 20_.
SURETY:
(Name)
BY:
(SEAL)
Attorney -in -Fact
BY:
APPROVED AS TO FORM:
City Attorney
(SEAL)
APPROVED AS TO CONTENT:
Date
City Engineer
Address of Surety:
PRINCIPAL:
BY:
(Name)
TITLE:
Address of Principal:
Note: Attach proper acknowledgments for both Surety & Principal (use copies of blank form
provided in Section C).
D-12
COMPENSATION INSURANCE CERTIFICATE
Pursuant to Section 1861 of the State Labor Code, each Contractor to whom a public works
contract has been awarded shall sign the following certificate and shall submit same to the City
prior to performing any work on the contract:
I am aware of the provisions of Section 3700 of the Labor Code which reads as follows:
"Every employer except the State shall secure the payment of compensation in one or more of
the following ways:
(a) By being insured against liability to pay compensation in one or more insurers duly
authorized to write compensation insurance in this State.
(b) By securing from the Director of Industrial Relations a certificate of consent to self -insure,
which may be given upon furnishing proof satisfactory to the Director of Industrial Relations of
ability to self -insure and to pay any compensation that may become due to his employee."
CONTRACTOR:
SIGNED:
NAME:
TITLE:
COMPENSATION INSURANCE CERTIFICATE
TO BE SUBMITTED WITH CONTRACT
D-13
CONTRACTOR LICENSING STATEMENT TO BE PROVIDED BY SUCCESSFUL BIDDER
PRIOR TO AWARD OF CONTRACT
i
The undersigned Contractor or Corporate Officer, declares under penalty of perjury that the
attached copy of the Contractor's pocket licenses or certificate.of licensure is current and valid,
and is in a classification as required by the project specifications and appropriate to the work to
be undertaken for this project.
PROJECT: EMERGENCY OPERATIONS CENTER & CITY YARD
CIP No. 10067
CONTRACTOR:
SIGNED:
NAME:
TITLE:
Note: Attach proper acknowledgments for both Surety & Principal (use copies of blank form
provided in Section C).
D-14
TUST I N
IiUnmmci OUR FUTURE
HONORING OUR PAST
Project:
Project Number:
To (Contractor):
CITY OF TUSTIN
PUBLIC WORKS DEPARTMENT
CONTRACT CHANGE ORDER
Change Order Number:
You are hereby directed to make the herein changes from the plans and specifications or do the following
described work not included in the plans and specifications on this contract.
NOTE: THIS CHANGE ORDER IS NOT EFFECTIVE UNTIL APPROVED BY THE CITY ENGINEER.
Unless otherwise stated, rates for rental of equipment cover only such time as equipment is actually
used and no allowance will be made for idle time.
Change requested by:
CHANGE IN CONTRACT ITEMS
The following changes are hereby made to the contract:
INCREASE(DECREASE)
ITEM NO. DESCRIPTION UNIT PRICE QUANTITY AMOUNT
TOTAL
ADDITIONAL WORK (NON CONTRACT ITEM)
DESCRIPTION UNIT PRICE QUANTITY AMOUNT
TOTAL
GRAND TOTAL NET CHANGE
Payment for elimination/additions of bid items will be reflected on the progress payments.
D-15
CHANGE TO CONTRACT PRICE
The contractor shall be paid a sum of for all work included in this change order. This
sum constitutes full compensation, including mark-ups and extended overhead.' The compensation
(time and cost) set forth in this Change Order comprises the total compensation due the Contractor, the
Subcontractors and all suppliers, for the work or change defined in this Change Order, including all
impact on any unchanged work. By signing this Change Order, the Contractor acknowledges and agrees,
on behalf of himself, all Subcontractors and all suppliers, that the stipulated compensation includes
payment for all work contained in this Change Order, plus all payment for the interruption of schedules,
extended overhead costs, delay, and all impact, ripple effect or cumulative impact on all other work
under this Contract. The signing of this Change Order shall indicate that the Change Order constitutes
full mutual accord and satisfaction for the change, and that the time and/or cost under the Change
Order constitutes the total equitable adjustment owed the Contractor, all Subcontractors, and all
suppliers, as a result of this change. The Contractor, on behalf of himself, all Subcontractors and all
suppliers, agrees to waive all rights, without exception or reservation of any kind whatsoever, to file any
further claim or request for equitable adjustment of any type, for any reasonably foreseeable cause that
shall arise out of or as a result of this Change Order or the impact of this Change Order on the remainder
of the work under this Contract.
TOTAL COST THIS CHANGE ORDER: DECREASE INCREASE
By reason of this order the contract time completion will be adjusted as follows: working days.
SUMMARY OF CONTRACT CHANGE ORDERS
COST OF PRECEDING CHANGE ORDERS: DECREASE INCREASE
TOTAL COST OF CHANGE ORDERS TO DATE DECREASE INCREASE
We the undersigned contractor have given careful consideration to the change proposed and hereby agree, if this proposal is
approved, that we will provide all equipment, furnish all materials, except as may otherwise be noted above, and perform all
services necessary for the work above specified, and will accept as full payment therefore the prices shown above.
Accepted Date Contractor
By Title
Approval recommended by Date
Construction Manager/Contract Administrator
Approved by Date
City Engineer
D-16
~ PLEASE PRINT CITY OF TUSTII i PERMIT NO,:
DEPT
ENGINEERING DIVISION PUBLIC WORKS
ENGINEEPUBLIC RIGHT-OF-WAY ENCROACHMENT DRAWING No.:
9f10 CenwrmlaiWay AND CONSTRUCTION PERMIT CITY BUSINESS
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INSPECTION FEE$
'IMPORTANT
ceso IPriON or wwonx;
m"—Ty SCMEOULE
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Call 4714) 573-3150 - Engineering
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Division 40 hours prior to start of
work for inspection. No
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Construction will be allowed on
Saturdays,'Suridays, Holld3ys.or
alternate Fridays City'Isctosed, unless
oihetwise authorized. Read
Standard Provisions and Conditions
on reverse side andtor attached.
Southern California Edison must be
notitied prior to workers and/or
equipment operating within 6 test,
and cranas or hoisting devices
A #
m $
within 10 feet of overhead electric
lines. Station 461W421iofthe
Government 'Code requires a
Digaled Identlflcallon Number be
issued before a °Permit to 2xcavatw
will bevatld. For your DlpAlert 10.
t
number call Underground service
Alert toll free at 'i-500-422-4133
0$_.$
two working days before you dig,
CASH PERMIT
5f #
INSPECTION
#
TQYAk,fir;°:.. , :7, .7
DEPOSIT$ t FEE #
* FEES#
_
$
FINAL
CAORDEPOSITTOORFEFt1NDEDTO: ❑APPLICANS
c�1
.L_pCGNTAAdlCfi
INSPECTION;
DATE,,
AMOUNT OF CASH DEPOSIT RELEASEC: s
REt,EASED BY;
PLI.ASEREAD CAREFULLY: t agree. to cOmplywlth.ilee ptOYi010115 andcorA100110 set (Orth on the back sndferattolts0lo this applW01.10n and all CITY ordinstmoo,
rc Wulions, slar*rds and speeiODanona currently In fame, and to pity for om"I and proper replacemantotany item lottalled undetthin permit which does not
comply with th0 above. 1 arae to payfat any additional rapiaotmentsin exc.eas of the amdunts shown above which may bT vut or damaosd as a rssuk cf anywork
CComplished under this POWL
APPLICANT: DATE',
Paver NApE slsxAruaa
APPROVED BY: ISSUED By. _ DA*t&',
WHITE -PERMANENT RECORD GREEN-INSPECT16N • CANARY -FINANCE PINK -APPLICANT • GOLDENROD-wATERDivlstoN
STANDARD PROVISIONS AND CONDITIONS
PERMIT. This permit is not valid unless signed by the City Engineer or his authorized representative, and contains a
City validation stamp.
This permit or an exact copy must be kept at the site of the work.
This permit is void if work is not completed within 6 months of the validation date, unless otherwise noted. An extension
may be granted, if such extension is applied for no later than 72 hours before permit expires.
The City reserves the right to revoke this permit at anytime for non-compliance with its provisions and conditions.
INSPECTION. Inspections are required prior to beginning work, after completion of work, and at all other times as may
be deemed necessary by the City Engineer or as specified in any applicable standards.
Inspections will be performed and construction permitted between the hours of 7:30 a.m. and 5:00 p.m. Mondays through
Fridays, except City observed Holidays and alternating off Fridays.
STANDARDS. Applicant agrees to perform the work authorized by this permit in a safe and workmanlike manner
subject to the approval of the City Engineer or his authorized representative. Work shall be done in conformance with all
City ordinances, resolutions, standards and specifications in force and the latest edition of the Standard Specifications for
Public Works Construction, "The Green Book", unless otherwise specified. The applicant shall also comply with all
pertinent codes, orders, regulations and laws of local, state, and federal governments, agencies and utilities.
PUBLIC CONVENIENCE AND SAFETY. Barricades must be kept and maintained on all trenches, excavations and
obstructions. Warning lights must be maintained at night. Arrow boards shall be required on all arterial lane closures, and
as required elsewhere. All traffic control warning and safety devices shall conform to the requirements set forth in the
current Manual of Traffic Controls for Construction and Maintenance Work Zones issued by the State of California
Department of Transportation (Caltrans),
The applicant shall. be responsible for placing and maintaining in a safe and neat manner temporary bituminous surfacing
in all areas where existing pavement has been removed. Permanent paving shall be placed in a timely manner as directed
by the City Engineer.
Street closure(s) will not be permitted except upon specific approval of the City Engineer.
Access to fire hydrants shall be maintained at all times.
Construction materials, debris or equipment shall not be stored within the public right-of-way unless authorized by the
City Engineer.
RESPONSIBILITY FOR DAMAGE AND LOSS. Applicant shall indemnify and save harmless the City of Tustin, its
Officers and Agents from all suits or actions for any injuries or damages received or sustained by any person or persons by
or from the applicant, his servants or agents and from any loss, damage, liability, cost or expense, including, but not
limited to reasonable attorney fees that may arise during or be caused in any way by or in the construction of the work or
by or inconsequence of any negligence in guarding the same, or, for improper methods or materials used in the
construction. The applicant shall indemnify and be liable for all costs or expenses, including, but not limited to reasonable
attorney fees that may be incurred in enforcing this clause again the applicant.
LICENSES. Contractor must hold a valid State Contractors License for the class of work they will perform and must
hold a valid CITY OF TUSTIN Business License.
GUARANTEES AND RESPONSIBILITIES. The work done shall be guaranteed for a period of one year. Failure of
City Inspectors to detect flaws in the work shall not relieve the applicant of the responsibility to construct all work per City
Standards,
ADDITIONAL FEES. The applicant shall be responsible and may be charged additional fees for reinspection and/or
any miscellaneous inspections not expressly mentioned in the foregoing schedule.
Fees for a permit issued after work has started shall include a $100.00 penalty fee.
The City shall reserve the right to correct any deficiencies and all costs shall be borne by the applicant.
Failure to install barricades which are subsequently placed by the City to protect the public shall be billed to the applicant
at a charge of $5.00 per barricade per day, $2.50 per warning light per day, plus all applicable City crew call -out costs.
CASH DEPOSITS. Excess deposits will be refunded only after final inspection and approval.
LABOR NON-DISCRIMINATION AND DISABILITIES ACT. In compliance with Federal Regulations, the City of
Tustin does not discriminate on the basis of race, color, national origin, age or disability.
All public facilities must be constructed to the standards contained within the Americans with Disabilities Act.
USA/UTILITY MARKINGS. All USA/Utility markings shall be removed when work is completed.
D-18
ATTACHMENT 3
List of Contractors Not Determined Qualified
For
Construction of Tustin Emergency Operation Center and
Corporate Yard Project
• TOBO Construction, Inc.