REQUEST FOR ANNUAL PRE-QUALIFICATION OF PUBLIC WORKS CONTRACTORS

STANISLAUS COUNTY OFFICE OF EDUCATION 1100 H STREET MODESTO, CA 95354 REQUEST FOR ANNUAL PRE-QUALIFICATION OF PUBLIC WORKS CONTRACTORS Requested for Pre-Qualification Issued: December 8, 2017 Responses Due: January 16, 2018

STANISLAUS COUNTY OFFICE OF EDUCATION NOTICE OF AND INSTRUCTIONS FOR ANNUAL PRE-QUALIFICATION OF PUBLIC WORKS CONTRACTORS The Stanislaus County Office of Education has determined that all licensed contractors who intend to submit bids on Stanislaus County Office of Education Public Works projects must fully complete the required pre-qualification process. Only bids from pre-qualified contractors will be accepted on County Office projects and all entities making a bid as a joint venture must be pre-qualified. NOTICE OF PRE-QUALIFICATION WINDOW The Stanislaus County Office of Education will accept pre-qualification applications from 8:00 a.m. until 2 p.m. on January 16, 2018. The required Statement of Experience form and Financial Statement are private and confidential, are not public records and will not be released by the County Office of Education absent a legal requirement to do so. The information provided in the attached Statement of Experience and Financial Statement, and any other documents or information provided by the pre-qualification applicant will be used by the County Office, along with other sources of information available to the County Office to pre-qualify applicants and to determine the size and scope of projects that each successful pre-qualification applicant is qualified to bid. Enclosed with this Notice and Instruction are the following documents: 1. Stanislaus County Office of Education required Statement of Experience form; 2. Stanislaus County Office of Education required Pre-Qualification Financial Summary; 3. Stanislaus County Office of Education Pre-Qualification Selection Criteria Evaluation (This form is provided for information only so that applicants understand the evaluation criteria for informational purposes only.) The answers to questions set forth in the Statement of Experience will be used to determine whether or not an applicant is rated as superior, adequate or inadequate in each of the selection criteria areas. All applicants receiving a superior or adequate determination in all categories will be passed on to the presentation/oral interview process, if one is implemented, or otherwise determine to be pre-qualified if the County Office waives the presentation/oral interview process. The answers given to all questions will be considered for each of the published criteria s/factors where the answers are relevant to the material. For example, answers to question 12 regarding defaults on public works, question 13 regarding bankruptcy, question 15 regarding debarment, and question 28 regarding in surety payments on behalf of applicants on other projects because of defaults to effect ratings, published criteria/factors to 5, 9, 10, 11, and 12. Answers demonstrating prior defaults, bankruptcies, debarments in surety payments because 1

of default will, barring extenuating circumstances, result in inadequate ratings in relevant categories resulting in a not qualified determination based on County Office s published criteria/factors. This pre-qualification process is used to preliminarily determine contractor responsibility. Pre-qualification does not eliminate or otherwise preclude County offices consideration of whether or not a pre-qualified contractor has the demonstrated responsibility, capacity and experience to complete any specific project responsibly based on the size, scope, or unique requirements of any given project. Upon notice that an applicant is not pre-qualified to submit bids on Stanislaus County Office of Education Public Works projects for reasons other than the applicant s failure to timely submit required information, the applicant may appeal the decision by delivering a written request for a hearing not later than five (5) business days after receipt of the notice denying prequalification. Failure to timely request a hearing constitutes a waiver of any right to appeal a non-qualification decision, administratively or through any other legal proceeding. The pre-qualification approval is valid for not less than one (1) calendar year, and prequalified contractors will be notified of their pre-qualification status annually. Place two copies of your completed application in an envelope, mark it as prequalification application and confidential, and mark it to the attention of Carina McDonald, Stanislaus County Office of Education 1100 H St., Modesto, CA 95354. 2

1. Name of Firm: STANISLAUS COUNTY OFFICE OF EDUCATION REQUIRED STATEMENT OF EXPERIENCE (If additional space is required for your response, please use the attached continuation page) 2. Address of Firm: Telephone Number: 3. How many years has your organization been in business as a Contractor under its present name? years Under what other names has your organization operated? 4. Type of Organization: o Corporation o Partnership o Individual o Joint Venture o Other 5. If a corporation, answer the following: a. Date of Incorporation: b. State of Incorporation: c. President s name: d. Vice President s name(s): e. Treasurer s name: f. List of shareholders and their respective ownership interest: 1

Name Ownership Interest 6. If an individual or partnership, answer the following: a. Date organized: b. Name and address of all Partners: Name Title General/Limited Partner 7. If other than a corporation or partnership, describe the organization and named principals (i.e., subsidiary, joint venture, etc.): a. List all joint venture agreements the organization has engaged in during the past 3 years, and the projects completed (and their location) under such agreements. 8. List the state (and categories) where your organization is legally qualified to do business. Indicate registration or license numbers if applicable. List states in which a partnership or trade name is filed. State Category License/Registration No. 2

9. Specify type and percent of work performed with your own workforce. 10. Have you ever failed to complete any work awarded to you? If so, note when, where and why and provide the name and business address of the project Owner. 11. Within the past five years, has any officer or partner of your organization ever been an officer or partner of another organization that failed to complete a construction contract? If so, attach a separate sheet of explanation? o Attached 12. Within the past ten years, has the Contractor, officers or principals of the organization been defaulted on a any public works project? If so, when, the project name, the project owner and under what circumstances. 13. Has the Contractor, officer or principals of the organization filed for, or been adjudged bankrupt, either voluntary or involuntary bankruptcy, within the past 10 years? If so, give the case number and the date on which the petition was filed, and attach a copy of the Bankruptcy Court s discharge order, or of any other document that ended the case, if no discharge order was issued. 14. Has the Contractor, officer or principals of the organization ever had a license suspended? If so, give the date, place, under what name and under what circumstances. 3

15. Has the Contractor, officer or principals of the organization ever been debarred, disqualified, removed or otherwise prevented from bidding on, or completing, any government agency or public works project for any reason? 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. 16. In the last five 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? If so, identify the year of the event, the owner, the project and the basis for the finding by the public agency. 17. At any time in the last five 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? If so, identify all such projects by owner, owner s address, and the date of completion of the project, amount of liquidated damages assessed and all other information necessary to fully explain the assessment of liquidated damages. 18. Has the Contractor, officer or principals of the organization been indicted for or convicted of any felony within the past 10 years? If so, give for each case (1) date (2) charge (3) place (4) court and (5) action taken. Attach any explanation you want to provide. o Attached 19. On a separate sheet (form attached), list all non-public works construction projects your organization has in progress giving the name and location of the project, owner, architect, contract amount, percent complete and scheduled completion date. o Attached 20. On a separate sheet (form attached), list all public works projects your organization has completed in the past ten years, giving the name of the project, location, owner, architect, contract amount, percent complete and completion date. o Attached 4

21. On a separate sheet (form attached), list all public works projects your organization has in progress giving the name of the project, location, owner, architect, contract amount, percent complete and completion date. o Attached 22. On a separate sheet, list the construction experience of key individuals in your organization. Key personnel shall include principal(s), or officer(s) having overall project responsibility, as well as on-site project manager(s), superintendent(s), project controls engineer(s), schedule manager(s), and all others involved in the management of the project. o Attached 23. Give the name and address of all bonding companies and agents with whom Contractor has done business during the last 5 years. Bonding Co. Address Agent Amount of Bonding 24. 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 three 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. 25. During the last five 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 works construction project when one was required? If so, provide details indicating the date when your firm was denied coverage and the name of the company or companies which denied coverage, the reason for denial of coverage and the period during which you had no surety bond in place. 26. Has the Contractor, officers or principals of the organization been involved in litigation or other claims regarding any project in the past ten years? If so, please state the following: 5

Plaintiff Defendant Amount Court Disposition 27. Are there now pending or in the preceding ten years have there been any actions against you (the organization) or have you had to pay back wages, either because of a settlement or judgment with the California State Department of Labor Standards Enforcement for failure to pay prevailing wages? If none, so state. Name of Project Date Filed Disposition Explain 28. At any time during the past five 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? If so, state 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. 29. In the last five years has any insurance carrier, for any form of insurance refused to renew the insurance policy for your firm? If so, state the name of the insurance carrier, the form of insurance and the year of the refusal and the reason for refusal. 30. Please list the Financial Institution where line(s) of credit have been established: Name Contact Pers. Phone Amount 6

Attachment for Item 19 PROJECT NAME NAME OF OWNER AND ARCHITECT WITH CONTACT AND PHONE # ADDRESS OF OWNER AND ARCHITECT CONTRACT AMOUNT % COMPL. SCHED. COMPL. DATE 7

Attachment for Item 20 PROJECT NAME NAME OF OWNER AND ARCHITECT WITH CONTACT AND PHONE # ADDRESS OF OWNER AND ARCHITECT CONTRACT AMOUNT % COMPL. SCHED. COMPL. DATE 8

Attachment for Item 21 PROJECT NAME NAME OF OWNER AND ARCHITECT WITH CONTACT AND PHONE # ADDRESS OF OWNER AND ARCHITECT CONTRACT AMOUNT % COMPL. SCHED. COMPL. DATE 9

SUPPLEMENTAL/CONTINUATION FOR STATEMENT OF EXPERIENCE (Duplicate If You Need Additional Pages) Question # 10

CERTIFICATION FOR STATEMENT OF EXPERIENCE (Name), declares under penalty of perjury: That(s) he/she as (title), is the party making the statement of experience and that such statement is true and correct. Sign on appropriate line below and notarize: Signature of: Applicant, if the Applicant is an individual; Partner, if the Applicant is a partnership; Officer, if the Applicant is a Corporation. State of California County of ) On before me, (insert name and title of the officer) personally appeared, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) 11

STANISLAUS COUNTY OFFICE OF EDUCATION REQUIRED PRE-QUALIFICATION FINANCIAL SUMMARY General Information: 1. Name Of Firm: 2. Date Of Last Unaudited Financial Statement: 3. Date Of Last Audited Financial Statement: Financial Information: Cash & Marketable Securities.$ Inventory.. $ Total Current Assets $ Total Intangible Assets.$ Total Assets..$ Total Short Term Debt..$ Total Current Liabilities $ Total Long Term Debt... $ Total Liabilities.$ Total Shareholders Equity..$ Total Preferred Stock... $ Retained Earnings $ General & Administrative Expenses. $ Operating Profit / Loss......$ Earnings Before Interest & Taxes $ Total Interest Expenses.$ Net Income / Loss.$ 1

Rental Expense.$ Depreciation And Amortization $ Extraordinary Items $ 2

CERTIFICATION FOR FINANCIAL SUMMARY (Name), declares under penalty of perjury: That(s) he/she as (title), is the party making the financial summary and that such summary is true and correct. Sign on appropriate line below and notarize: Signature of: Applicant, if the Applicant is an individual; Partner, if the Applicant is a partnership; Officer, if the Applicant is a Corporation. State of California County of ) On before me, (insert name and title of the officer) personally appeared, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. 3

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature (Seal) 4

STANISLAUS COUNTY OFFICE OF EDUCATION Pre-Qualification Selection Criteria Evaluation Contractor: Date: Published Criteria/Factors Superior Adequate Inadequate Pass Notes 1 Experience, expertise, and knowledge of Public Works construction process. 2 Ability to meet established budgets and timelines. 3 Location of the firm s office relative to SCOE. 4 Ability to provide exemplary construction services, including the identification and profile of key personnel assigned to the Project(s). 5 Ability to coordinate offsite and on-site issues with SCOE and any other design professionals and consultants retained by SCOE, jurisdictional agencies, including the Local Public Works Department, Building and Safety Department and others (as applicable). 6 Knowledge of jurisdictional agencies, including utilities (as applicable). 1

7 Ability and willingness to work with local vendors, suppliers, and contractors. 8 Training and experience of key personnel in Public Works construction. 9 Staff capacity, depth, and current workload. 10 Nature and quality of the firm s completed work, particularly like environments to this project. 11 Stability, reliability and continuity of the firm and its members. Summary Comments: Name: Title: Name: Title: 2