REQUEST FOR BID QUESTIONNAIRE (For Services and Commodities)

Transcription

1 REQUEST FOR BID QUESTIONNAIRE (Fr Services and Cmmdities) DATE: TO: FROM:, Prcurement Services Department, Prject Manager, Phne Number 1. Prject Title: 2. Requisitin Number: Printing EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Printing POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) Pstal EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Pstal POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) Advertising EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Advertising POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) 3. Estimated Cst: $ 4. FUNDING/BUDGET SOURCE: Operating Enterprise (check all that apply) Capital Grant* Other: *If Grant funded in whle r in part, wh is the Granting Agency: Special Cnditins/Grant Requirements included in Special Cnditins. Grant expiratin date: 560_Request fr Bid - Services & Cmmdities.dc Rev: 1/21/15 Page 1 f 6

2 5. Prvide a sentence that addresses the funding surce fr this prcurement that is apprpriate fr the Recmmendatin/Staff Recmmended Mtin sectin f the Agenda Item at the time f award (per A.D. 04): 6. Delivery and/r Cntract Cmpletin Time: calendar days frm the Award Date, tice t Prceed, r Release Order Date. Describe any special delivery r cmpletin requirements: Delivery lcatin(s): 7. Previus PO/BPO Number: 8. Insurance Requirements crdinated with Risk Management: Yes, Dcumentatin frm Risk Management shuld be attached, Insurance nt required 9. Minrity Business Enterprise and Small Business Enterprise (MBE/SBE) cnsideratins crdinated with the Ecnmic Develpment Department fr pssible Small Business Set Aside: Yes, Dcumentatin frm Ecnmic Develpment Department must be attached 10. Des the prject invlve cmputer hardware, sftware r data/telephne cnnectin? Cntact the Infrmatin and Technlgy Services Department (ITS) at (813) fr mre infrmatin. Yes, Dcumentatin frm ITS shuld be attached 11. License Requirements has been crdinated with The Center fr Develpment: License Required General Cntractr Building Cntractr Electrical Painting Undergrund Utilities Mechanical Plumbing Other (Specify): 12. Pursuant t A.D. 25, all new cntracts fr direct public services shall include custmer satisfactin surveys as part f the cntractr s requirements. Did yu include requirements? Yes, Requirement(s)/Prvisin(s) included 13. Certain infrmatin is exempt frm Flrida Public Recrds Law if it pertains t security related matters. Des this bid cntain security sensitive infrmatin? Yes, Explain: 560_Request fr Bid - Services & Cmmdities.dc Rev: 1/21/15 Page 2 f 6

3 14. When the specificatins are ut f the rdinary r unique, the Requesting Department shuld have their Department Attrney review the specificatins. Have the specificatins been reviewed by the Requesting Department s Attrney? Yes, Name f Attrney:, date reviewed: 15. Are there any business decisins regarding this prcurement that may limit cmpetitin? Yes, Explain: 16. Suggested vendr list t cntact. Include business name, fax number, and address Cmpany Fax Number Address 17. Award will be based n: Invitatin t Bid (ITB) Cst Alne: Answer questin 18. Request fr Prpsal (RFP) Other factrs including cst: Answer questin ITB Special Instructins, Terms, and Cnditins: a. Bidders minimum qualificatins and experience b. Are there any ther special features (such as a Site Visit r Pre-bid Cnference [NOTE: Mandatry Site Visit and/r Mandatry Pre-Bid require a Mem f Justificatin signed by yur Directr] Special Bid Submittals, Special Exhibits, etc.)? Yes, Special Feature(s): c. Recmmended Cntract Term: d. Recmmended Renewal Perids: e. Bid Bnd Requirements: f. Additinal cntract prvisins: g. Specificatins and/r Scpe f Services (Prvide in.txt r.xml frmat. D nt use hyphen (-), ampersand (&) r less than/greater than (<, >).): Intrductin t the prject A clear statement f the intended use; essential characteristics necessary 560_Request fr Bid - Services & Cmmdities.dc Rev: 1/21/15 Page 3 f 6

4 Apprpriate type f specificatin (Brand Name, Qualified Prducts List, Design, Perfrmance, Design/Perfrmance) Backgrund infrmatin. Attach exhibits if necessary Prvide detailed specificatins and/r scpe f services that define the deliverables Deliverables with quantities (Actual r Estimated) Liquidated Damages: (Backup cmputatin shuld be attached) Yes $ per calendar day f delay Invicing r Payment requirements Cntract transitin requirements frm ne cntractr t anther Perfrmance Bnd Requirements 19. RFP Special Instructins, Terms, and Cnditins: a. Prpsers minimum qualificatins and experience: b. Are there any ther special features such as a Site Visit r Pre-Prpsal Cnference [NOTE: Mandatry Site Visit and/r Mandatry Pre-Bid require a Mem f Justificatin signed by yur Directr] Special Bid Submittals, Special Exhibits, etc.)? Yes, Special Feature(s): c. Recmmended Cntract Term: d. Recmmended Renewal Perids: e. Prpsal Bnd Requirements: f. Evaluatin Criteria: Cst 50 Pints 560_Request fr Bid - Services & Cmmdities.dc Rev: 1/21/15 Page 4 f 6

5 Qualificatins Pints Experience Pints Technical Apprach Pints g. RFP Questinnaire Prvide questins by evaluatin criteria that prpsers shuld respnd t. h. Indicate Evaluatin Cmmittee Members that d nt reprt r indirectly reprt t ne anther: Chairpersn:, Department Member:, Department Member:, Department Optinal Member:, Department Optinal Member:, Department i. Additinal cntract prvisins: j. Specificatins and/r Scpe f Services: Intrductin t the prjecta clear statement f the intended use; essential characteristics necessary Apprpriate type f specificatin (Brand Name, Qualified Prducts List, Design, Perfrmance, Design/Perfrmance) Backgrund infrmatin. Attach exhibits if necessary Prvide detailed specificatins and/r scpe f services that define the deliverables Deliverables with quantities: Actual r Estimated Liquidated Damages: Backup cmputatin shuld be attached Yes $ per calendar day f delay Invicing r Payment requirements 560_Request fr Bid - Services & Cmmdities.dc Rev: 1/21/15 Page 5 f 6

6 Cntract transitin requirements frm ne cntractr t anther Perfrmance Bnd Requirements 20. Request Fr Bid Questinnaire Attachment Checklist: Cmpleted Request Fr Bid Questinnaire Insurance Requirements MBE/SBE Review ITS Review Licensing Requirements Specificatins Suggested Vendr List Mandatry Cnference and/r Site Visits Justificatin, if applicable Liquidated Damages Cmputatin, if applicable 560_Request fr Bid - Services & Cmmdities.dc Rev: 1/21/15 Page 6 f 6

7 REQUEST FOR PROFESSIONAL SERVICES QUESTIONNAIRE UNDER F.S , CONSULTANTS COMPETITIVE NEGOTIATION ACT (CCNA) DATE: TO:, Supervisr, Prcurement Services Department THROUGH: (If Applicable) FROM:, Prject Manager, Phne : 1. This request is t initiate a prcurement fr Prfessinal Services under the subject prcedures: Prject Title: C.I.P. NO: Requisitin (RQ) number:. 2. Estimated Prject Cst: 3. Cntract Required by Date: 4. Certificatin fr this prject is required in: Architecture Engineering Landscape Architecture Surveying and Mapping 5. FUNDING/BUDGET SOURCE: Operating Enterprise (check all that apply) Capital Grant* Other: *If Grant funded in whle r in part, wh is the Granting Agency: Grant Name: Grant Expiratin Date: Special Language, Clause and/r Requirements must be attached. Grant Expiratin Date: 6. Prvide a sentence that addresses the funding surce fr this prcurement that is apprpriate fr the Recmmendatin/Staff Recmmended Mtin sectin f Agenda Item at the time f awards (per A.D. 04): Printing EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Printing POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 1 f 12

8 Pstal EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Pstal POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) Advertising EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Advertising POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) 7. There are sufficient funds in the Department t accmmdate award f the cntract. 8. This prcurement is is nt related t ne r mre f the Bard s Strategic gals. If s, which 9. Pursuant t A.D. 25, all new cntracts fr direct public services shall include custmer satisfactin surveys as part f the cntractr s requirements. Yes, Requirement/Prvisin Included, t Applicable 10. Certain infrmatin is exempt frm Flrida Public Recrds Law if it pertains t security related matters. Des this bid cntain security sensitive infrmatin? Yes 11. Number f firms t be selected t prvide the required services: Stand Alne/Single Cntract Miscellaneus Wrk Order Cntracts (Enter number f firms t receive a cntract) 12. Number f firms t be shrtlisted: (Minimum f three firms) 13. CONSULTANT INTERVIEWS (Check One) Oral Presentatins are requested Telephne discussins requested 14. Small Business Set-Aside Yes (Attach crdinatin with Ecnmic Develpment) 15. Name f User Agency (if applicable): 16. Estimated Cst f Cnstructin (if applicable): 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 2 f 12

9 17. Frm the time negtiatins are authrized, hw lng d yu expect it t take t cmplete negtiatins? Indicate number f weeks 18. The dcuments listed belw are attached t this Request and an electrnic cpy has been ed t the Sr. Prcurement Analyst: Scpe f Services, including a prpsed prject/design schedule indicating mnth/year design it t be cmplete, if applicable. (Prvide in.txt r.xml frmat) Brief Descriptin fr Legal Advertisement Evaluatin Criteria Frm Rating Guide Page Limitatins Insurance Requirements fr Prject Evaluatin Cmmittee Selectin Mem 19. Des the prject invlve cmputer hardware, sftware r data/telephne cnnectin? Cntact ITS at (813) fr mre infrmatin. Yes (Attach dcumentatin that ITS has reviewed and apprved) 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 3 f 12

10 BRIEF DESCRIPTION OF SCOPE OF SERVICES FOR LEGAL ADVERTISEMENT PURSUANT TO SECTION , FLORIDA STATUTES, HILLSBOROUGH COUNTY INVITES QUALIFIED FIRMS TO SUBMIT RESPONSES ON THE FOLLOWING PROJECT. SCOPE OF WORK: NOTE: If this request is fr miscellaneus term cntracts with ptins t renew, the initial term, dllar cap and the unilateral renewal ptin term(s) must be stated in the legal ad. 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 4 f 12

11 EVALUATION CRITERIA FORM PROJECT TITLE: THE PROJECT MANAGER (PM) SHALL ASSIGN A MAXIMUM POINT VALUE (MPV) FOR EACH EVALUATION CRITERION LISTED BELOW. THE MORE IMPORTANT THE CRITERIA, THE HIGHER THE MPV WILL BE. THE PM MUST SELECT ONE OF THE CRITERIA AS THE HIGHEST VALUED. IN THE EVENT OF A TIE, FOR THE SECOND TIEBREAKER THE FIRM RECEIVING THE HIGHEST POINTS ON THE HIGHEST VALUED CRITERIA WILL BE CONSIDERED THE HIGHER-RANKED FIRM. THE TOTAL MPV MUST EQUAL THE SUM OF 100 POINTS. EVALUATION CRITERIA MAX POINT VALUE 1. Ability f the firm and its prfessinal persnnel 2. Firm s experience with prjects f similar type and size 3. Firm s willingness and ability t meet schedule and budget requirements 4. Effect f firm s recent, current and prjected wrklad 5. Effect f prject team lcatin Ttal: (Must equal 100) The attached rating guide has been cmpleted using the MPVs listed abve. Reviewed By: Date: 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 5 f 12

12 PROFESSIONAL CONSULTANT SELECTION RATING GUIDE INSTRUCTIONS FOR COMPLETING THIS GUIDE: 1. AT THE END OF EACH EVALUATION CRITERION TITLE, INSERT THE MPV FROM THE PREVIOUS PAGE. 2. ESTABLISH A RANGE UNDER EACH CRITERION TO DISTRIBUTE THE MPV TO THE CORRESPONDING DEFINITIONS. NEGATIVE SCORES SHALL NOT BE USED. 3. EVALUATORS WILL SCORE EACH RESPONSE USING THIS RATING GUIDE. 4. THIS RATING GUIDE WILL BE INCLUDED IN THE RPS DOCUMENT FOR FIRMS TO REVIEW. EVALUATION CRITERIA NO. 1: ABILITY OF FIRM AND ITS PROFESSIONAL PERSONNEL Prject team persnnel d nt have apprpriate level f qualificatins and experience. - Prject team des nt cntain all critical disciplines. Organizatin f prject team is inapprpriate. Prime firm lacks adequate prfessinal resurces t prperly prvide services. Prpsed prject manager is nt apprpriate. Sme prject team persnnel have adequate level f qualificatins and experience. Prject team lacks minr disciplines. Organizatin f prject team is marginal. Prime firm s prfessinal resurces t prperly prvide services are marginal. Prpsed prject manager s qualificatins are marginal. Prject team persnnel have adequate level f experience. Prject team cntains all necessary disciplines. Organizatin f prject team is adequate t the prject. Prime firm has adequate prfessinal resurces t prperly prvide services. Prpsed prject manager s qualificatins are adequate. Prject team persnnel have abve average level f experience and the prject manager is uniquely qualified. Prject team cntains all necessary disciplines. Organizatin f prject team is adequate t the prject. Prime firm has superir prfessinal resurces t prperly prvide services. Prject team persnnel have exceptinal level f experience and several are uniquely qualified. Prject team cntains all necessary disciplines. Organizatin f prject team is superir. Prime firm has exceptinal prfessinal resurces t prperly prvide services. Prpsed prject manager is uniquely qualified. EVALUATION CRITERIA NO. 2: FIRM S EXPERIENCE WITH PROJECTS OF A SIMILAR SIZE AND TYPE Prime firm has marginal experience with prjects f a similar size and type. Prime firm has minr successful experience with prjects f a similar size and type. Scpe f services prvided fr representative prjects vary frm RPS Scpe. Prime firm has adequate successful, recent (within past five years) experience with prjects f a similar size and type. Scpe f services prvided fr representative prjects are similar t RPS scpe. 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 6 f 12

13 Prime firm has mre than adequate successful, recent (within past 5 years) experience with prjects f a similar size and type. Scpe f services prvided fr representative prjects are similar t RPS scpe. Prime firm has superir past and recent successful experience with prjects f a similar size and type. Scpe f services prvided fr representative prjects are similar t RPS scpe. EVALUATION CRITERIA NO. 3: FIRM S WILLINGNESS AND ABILITY TO MEET SCHEDULE AND BUDGET REQUIREMENTS Submittal des nt address either the schedule r budget. Submittal shws inadequate understanding f schedule and budget requirements. Submittal shws adequate schedule apprach and understanding f budget cntrl. Prject budget and schedule can be met r mdified t meet prject intent. Submittal shws gd understanding f and apprach t schedule and budget. Prject budget and schedule can be met. Submittal shws superir understanding f and apprach t schedule and budget with ptential imprvements fr prject delivery and cst savings. EVALUATION CRITERIA NO. 4: EFFECT OF FIRM S RECENT, CURRENT AND PROJECTED WORKLOAD Submittal shws that cnsultant des nt have sufficient available persnnel t cmplete services n schedule. Submittal shws that cnsultant s wrklad cmmitments will impact its ability t cmplete services n schedule Submittal shws that while cnsultant has adequate time and available persnnel, prir wrklad cmmitments may impact its ability t cmplete services n schedule. Submittal shws that cnsultant s prject team has adequate time and available persnnel t cmplete services n schedule. Submittal shws that cnsultant s prject team has adequate staffing available t cmplete services n schedule. Submittal indicates backup staffing capability in the event f unfreseen circumstances. 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 7 f 12

14 FOR EVALUATION CRITERIA NO.5THERE ARE TWO VERSIONS IN THIS MEMO. THE FIRST ONE LISTED BELOW IS FOR ENGINEERING CONSULTANTS AND THE SECOND ONE IS FOR ARCHITECTURE CONSULTANTS. THERE MAY BE A NEED TO CHANGE THE WORDING IN THE RATING GUIDE ON WORK ORDER BASED CONTRACTS OR FOR SURVEYING AND MAPPING PROJECTS. IF YOU ARE REQUESTING LANGUAGE DIFFERENT FROM THAT STATED IN THIS DOCUMENT, YOU MUST COORDINATE IT WITH THE SR.PROCUREMENT ANALYST. ALSO NOTE, ANY CHANGES TO THIS AREA MAY IMPACT THE PAGE LIMITATION SECTION. ENGINEERING EVALUATION CRITERIA NO. 5: EFFECT OF PROJECT TEAM LOCATION ON PROJECT Scred by Evaluatin Cmmittee Chairpersn ONLY te: Lcal is any cunty within the Tampa Bay Reginal Partnership area, i.e. Hillsbrugh, Pinellas, Pasc, Plk, Manatee, Sarasta and Hernand Cunties. n-lcal lcatin f mst f prject team, including the prime firm and Prject Manager, may adversely affect wrk quality and schedule. n-lcal lcatin f sme f prject team, althugh prime firm and prject manager may be lcal, may adversely affect wrk quality and schedule. One r tw key elements f prject teams are nn-lcal and may adversely affect wrk quality and schedule. All majr sub-cnsultants (Civil, Structural, Mechanical, Electrical, Plumbing) are lcal. Only minr elements f prject team are nn-lcal and prbably will nt affect wrk quality r schedule. All f the prject team is lcal. ARCHITECTURE EVALUATION CRITERIA NO. 5: EFFECT OF PROJECT TEAM LOCATION ON PROJECT Scred by Evaluatin Cmmittee Chairpersn ONLY te: Lcal is any cunty within the Tampa Bay Reginal Partnership area, i.e. Hillsbrugh, Pinellas, Pasc, Plk, Manatee, Sarasta and Hernand Cunties. n-lcal lcatin f mst f prject team including the prime firm, prject manager, and civil engineer may adversely affect wrk quality and schedule. n-lcal lcatin f sme f prject team, althugh prime firm, prject manager and civil engineer may be lcal, may adversely affect wrk quality and schedule. One r tw key elements f prject teams (e.g., MEP Engineer) are nn-lcal and may adversely affect wrk quality and schedule. Only minr elements f prject team are nn-lcal and prbably will nt affect wrk quality r schedule. All majr sub-cnsultants (Civil, Structural, Mechanical, Electrical, Plumbing) are lcal. All f the prject team is lcal. 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 8 f 12

15 PAGE LIMITATIONS PROJECT TITLE: INSTRUCTIONS: 1. Indicate yur chice f page limits in the spaces prvided fr each f the five (5) evaluatin criteria. 2. If yu have suggested changes t the items listed under any f the evaluatin criteria fr this prject, please advise. All changes must be crdinated with the Sr. Prcurement Analyst prir t develpment f the RPS. 3. Respnses t the evaluatin criteria shuld include, but nt necessarily be limited t, the infrmatin included with each f the criteria belw: Ability f the firm and its prfessinal persnnel Respnses limited t pages maximum, plus resumes fr key persnnel Attach resumes nly fr key persnnel f the Prject Team, detailing past experience as it relates t prjects f a similar size and type. Submit separate rganizatinal charts delineating persnnel assigned t bth cnstructin and design services, if applicable. Firm s experience with prjects f similar type and size MAXIMUM NUMBER OF PROJECTS TO BE INCLUDED: Respnses limited t ne (1) page maximum per prject List a maximum f recent prjects, preferably during the past years, t indicate prficiency in similar wrk. Firm s willingness and ability t meet schedule and budget requirements Respnse limited t pages maximum Prvide a shrt narrative utlining hw yu prpse t manage the prject in rder t meet schedule and budget requirements. Indicate the cntrls t be utilized t maintain bth schedule and budget fr this prject. Describe hw persnnel will be assigned, and tasks effectively handled, in rder t prvide the mst efficient service n the prject (during bth the design and the cnstructin phases, if applicable). 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 9 f 12

16 Effect f firm s recent, current and prjected wrklad Respnses limited t pages maximum, including a ne page graphic representatin. Describe the current wrklad and yur daily ability t handle the scpe f services. Prvide a graphic representatin f yur current cmmitment ver the next ne year perid fr key members f the prject team. Effect f prject team lcatin Respnse is limited t a page maximum. Define where elements f the wrk will be perfrmed (city/state), whether perfrmed by prime r subcnsultant firms, and wh in the Prpser's rganizatinal chart will versee perfrmance f that wrk. Specify the members f the prject team and ffice lcatin fr each. A firm shall be cnsidered lcal if it is within the Tampa Bay Reginal Partnership area, made up f Hillsbrugh, Pinellas, Pasc, Plk, Manatee, Sarasta and Hernand Cunties. 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 10 f 12

17 M E M O R A N D U M DATE: TO: Michael J. McNabb, Risk Management FROM: SUBJECT: INSURANCE REQUIREMENTS FOR PROFESSIONAL CONSULTANT SELECTION Please prvide the insurance requirements and limits f liability fr: PROJECT: Attached is a brief Scpe f Wrk fr the prject (ttal sheets). A. Wrker s Cmpensatin and Emplyer s Liability Insurance: Emplyer s Liability: $ Limit Each Accident $ Limit Disease Aggregate $ Limit Disease Each Emplyee B. Cmmercial General Liability Insurance*: General Aggregate $ Prducts - Cmpleted Operatins Aggregate $ Persnal and Advertising Injury $ Each Occurrence $ Fire damage (Any One Fire) $ Specific Cntract Aggregate Limits $ C. Business Autmbile Liability Insurance*: Bdily Injury & Prperty Damage Liability: $ Cmbined Single Limit Each Accident D. Prfessinal Liability Insurance Each claim and aggregate $ E. Aircraft Liability Insurance* $ F. Pllutin Liability Insurance $ *General Liability, Aut Liability, Garage Keepers, and Aircraft Insurance must include Hillsbrugh Cunty, a plitical subdivisin f the State f Flrida as an Additinal Insured. Risk Management: BY: Signature Title Date 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 11 f 12

18 MEMORANDUM DATE: TO: Supervisr, Prcurement Services Department FROM:, Directr, Department SUBJECT: Prject Title: Evaluatin Cmmittee Selectin fr Cnsultant s Cmpetitive Negtiatin Act (CCNA) In accrdance with the prcurement manual prcedures established fr the CCNA Prfessinal Cnsultant Selectin prcess, the representatives listed belw will cmprise the Evaluatin Cmmittee fr the subject prject. cmmittee member listed is a direct r indirect reprt t any ther cmmittee member. The Cunty Attrney and Prcurement Services Department representatives serve in an advisry capacity t the cmmittee. EVALUATION COMMITTEE: 1. Prject Manager (CHAIR): Phne: 2. Member: Phne: 3. Member: Phne: 4. Member: Phne: 5. Member: Phne: SCORING METHOD TO BE USED: Cnsensus (Recmmended scring methd) Individual (Prvide explanatin why the cnsensus scring methd shuld nt be used) NOTE 1: NOTE 2: The Cmmittee may be extended t up t five (5) members. At the discretin f the Prcurement Services Department, the Cmmittee may be expanded t include a representative f a lcal Prfessinal Assciatin t serve in an advisry capacity nly. Cmmittee members shall refrain frm discussing the respnses with ther cmmittee members and are prhibited frm discussing any matters related t this prject with respndents r anyne except authrized advisrs until negtiatins with the tp-ranked firm(s) have been authrized. Additinally, evaluatins shall be based n nly the infrmatin prvided in the cnsultant s written respnse, presentatins, and reference checks. cc: Evaluatin Cmmittee Members 559_Request fr Bid - Prfessinal Services (CCNA).dc Rev: 1/21/15 Page 12 f 12

19 CONSTRUCTION SERVICES QUESTIONNAIRE DATE: TO: Jhn Bensn, Prcurement Operatins Crdinatr, Prcurement Services Department THROUGH: (If Applicable) FROM:, Prject Manager, Phne : Please prepare cntract dcuments fr the fllwing prject accrding t the infrmatin given belw: 1. Requisitin Number (RQ) Prject Title: Scpe f Wrk (fr use in Advertisement: C.I.P.. Estimated Base Cst fr the Prject: 2. Slicitatin Event: Invitatin t Bid Request fr Prpsal, Cntract Manager at Risk Request fr Prpsal, Design/Build Indicate Evaluatin Cmmittee Members (fr RFPs nly): 1. Chairpersn:, Phne 2. Member:, Phne 3. Member:, Phne 4. Member:, Phne 5. Member:, Phne 3. Cntract Cmpletin Time: calendar days frm the tice t Prceed, r by 4. Retainage: a. Standard (Recmmended): 10%, then 5% after 50% Cmpletin. b. Other: %, then after 50% Cmpletin c. ne 561_Request fr Bid - Cnstructin.dc Rev: 9/4/2015 Page 1 f 5

20 5. Liquidated Damages (Memrandum f cmputatin must be attached): a. If interim milestnes: See attached schedule b. See Special Cnditins c. Maximum LD's shall nt exceed: per calendar day f delay d. If n interim milestnes: per calendar day f delay 6. Term (WORCS) Cntract: Yes If Yes, Cntract shall be in effect fr Number f Renewals: Number f Years fr Each Renewal: Cst Escalatin? Describe: Year(s) Specify the amunt the award will be capped if ther than the ttal calculated bid amunt: If requesting award be made t mre than ne cntractr, include justificatin fr needing multiple awards and hw wrk rders will be assigned t the cntractrs. (i.e., rtatinal, 2 nd awardee wuld be fr emergencies nly, etc.) 7. Allwance(s) d. Permits e. n-priced Items (NPI) f. Other: g. Other: 8. Design Firm #1: Address: Design Cntact Persn: Phne Fax Design Firm #2: Address: Design Cntact Persn: Phne Fax 12. Prjects under $500,000 must have been submitted t SBE Cmmittee prir t submitting Request fr Bids. Prjects $500,000 and greater must have been submitted t MBE Cmmittee prir t submitting Request fr Bids. Has this prject been reviewed by the apprpriate cmmittee, and is a cpy f the results attached? Yes 561_Request fr Bid - Cnstructin.dc Rev: 9/4/2015 Page 2 f 5

21 13. FUNDING/BUDGET SOURCE: Operating Enterprise (check all that apply) Capital Grant* Other: *If Grant funded in whle r in part, wh is the Granting Agency: Special Cnditins/grant requirements included in Special Cnditins. Name f Grant: Grant Expiratin Date: 14. Prvide a sentence that addresses the funding surce fr this prcurement that is apprpriate fr the Recmmendatin/Staff Recmmended mtin sectin f the Agenda Item at the time f award (per A.D. 04): Advertising EBS Oracle Funding Surce Fund (5) Center (6) Accunt (6) Subaccunt (4) Activity (4) Advertising POETA Funding Surce: Prject (9) Organizatin Expenditure Type Task (4) Award (8) 15. Pursuant t A.D. 25, all new cntracts fr direct public services shall include custmer satisfactin surveys as part f the cntractr s requirements. Yes, Requirement/Prvisin Included, t Applicable 16. Certain infrmatin is exempt frm Flrida Public Recrds Law if it pertains t security related matters. Des this bid cntain security sensitive infrmatin? Yes 17. Prpsed Equals be reviewed: After Bid Clsing (Recmmended) Prir t Bid Clsing 18. Is the Trench Safety Act applicable? Yes 561_Request fr Bid - Cnstructin.dc Rev: 9/4/2015 Page 3 f 5

22 19. Des this prject require the Cntractr t the requirements f the Jessica Lundsfrd Act? Yes 20. D the Special Cnditins indicate all Hillsbrugh Cunty permits that must be btained by the Cntractr, and the cst fr each (as required by State statute)? Yes ne required 21. If the prject is estimated under $200,000, are Perfrmance/Payment Bnds recmmended? Yes 22. Insurance requirements (crdinated with Risk Management): Yes (cpy attached r frwarded with specificatins) Insurance Required 23. Des the prject invlve cmputer hardware, sftware r data/telephne cnnectin? (Cntact ITS at (813) fr mre infrmatin) Yes (Attach dcumentatin that the Infrmatin Technlgy Services Department has reviewed and apprved) 24. Are Alternates included? (If yes, prvide cst estimate fr each alternate and hw the selectin f alternates will be made) Yes indicate the Special Cnditins r Divisin 1-16 page where they are addressed: 25. Is a Mandatry Site Visit, Mandatry Pre-bid Cnference required? Yes Attach Mem f Justificatin, signed by Directr. 26. Will the Cntractr perfrm any wrk n CSX (railrad) right-f-way? Yes 561_Request fr Bid - Cnstructin.dc Rev: 9/4/2015 Page 4 f 5

23 27. License Requirements, (crdinated with The Center fr Develpment): General Cntractr Building Cntractr Electrical Painting Undergrund Utilities Mechanical Plumbing Other (Specify) License Required Indicate the Special Cnditins page where licensing is addressed: 28. ATTACHMENTS CHECKLIST: e. Attach files t the Oracle requisitin. f. single file can be mre than 30MB in size. Liquidated Damages Justificatin Memrandum Mandatry Pre Bid/Site Visit Justificatin Memrandum Special Cnditins (Prvide in Wrd frmat) Divisin 1-16 Sectins fr use in bid (as applicable) (Prvide in Wrd frmat) RFQ Line Item Template fr Cnstructin (Prvide in Excel frmat) Insurance Requirements, apprved by Risk Management MBE r SBE Cmmittee review results Memrandum REQUIRED. (t required, if LAP) Technical Specificatins Plan Sheets/Drawings (.pdf frmat) 29. SPECIAL INSTRUCTIONS: 561_Request fr Bid - Cnstructin.dc Rev: 9/4/2015 Page 5 f 5