00 41 20 Qualifications Statement (CRW).pdf

00 41 20 Qualifications Statement (CRW)

SECTION 00 41 20

QUALIFICATION STATEMENT

CAPITAL REGION WATER

2027 SEWER SYSTEM IMPROVEMENTS PROJECT

Name and address of Contractor-Bidder: ____________________

Submitted To: Capital Region Water

For consideration with regard to: 2027 SEWER SYSTEM IMPROVEMENTS PROJECT

1. Companies bidding on this Project must submit this Statement of Bidder’s Qualification with

Bid.

2. Only Companies which are determined to be responsible contractors under Laws and

Regulations, and the Contract Documents will be designated as qualified bidders at the time awards are made on the prime contracts offered on the Project.

3. The Instructions to Bidders and other Bidding Documents govern the Owner’s consideration of this completed statement of Bidder’s qualification.

4. Bidder shall answer all questions on this form, supplying the requested documents using the spaces indicated (with additional pages if necessary) and attaching documents as required.

I. Capability

1. State your Company’s name and the address of your Company’s principal place of business

(main office or headquarters).

2. State the categories of work for which your Company desires to be considered on the above

Project.

3. State your Company’s form of organization (sole proprietorship, partnership, corporation, limited liability company, etc.).

4. If your Company is a corporation, state:

A. Date of incorporation.

B. Place of incorporation.

C. Names and titles of all officers.

Use additional pages if necessary.

D. Provide the names of all your Company’s subsidiaries, or parent organizations, and all affiliated organizations, giving the relationship of each to your Company.

5. If your Company is a limited liability company, state.

A. Date of filing of the certificate of organization.

B. State where filed.

C. Names and titles of all officers, members and managers.

D. Provide the names of all your Company’s subsidiaries, or parent organizations, and all affiliated organizations, giving the relationship of each to your Company.

6. If your Company is a partnership (including a joint venture), state.

A. Date of formation.

B. Under which state's laws the partnership was formed.

C. Whether partnership is general or limited.

D. Names and home addresses of all partners (indicate any limited partners).

E. Names of all organizations controlled by your Company or any of its partners.

7. If your Company is a sole proprietorship, or some form of organization other than a corporation, an LLC, or partnership, attach the operating agreement or other documentation governing the activities of the organization, and state:

A. The type of organization and the date established.

B. Names and home addresses of each of the principals.

C. Names of all organizations controlled by your Company or any of its principals.

8. Regarding ownership and control.

A. List all organizations and individuals who have a financial interest greater than 5% in your

Company.

B. Identify any other organization or individual who controls or substantially influences the bidding or operation of your Company.

9. Provide the numbers, categories, and locations of all employees and officers.

10. Is your Company currently registered to do business in Pennsylvania?

If not, do you have a pending application for registration?

11. Does your Company hold all necessary licenses to perform the work for which you desire to be considered for this Project? If so, identify those licenses.

If not, identify all pending applications for those licenses.

Specify your Mercantile License Number for each municipality in which Work shall be performed:

12. Identify all your Company’s offices located in Dauphin, Cumberland, Perry and Lebanon

Counties.

13. Identify all your Company’s offices located elsewhere in the Commonwealth of Pennsylvania.

14. How many years has your Company been in business as a Contractor or Subcontractor under your present business name?

15. List the years of experience your Company has in the construction of the type required for your contract.

A. as a prime contractor; and

B. as a subcontractor.

16. State.

A. The percentage of work normally completed using your own employees.

B. The percentage of work your Company intends to complete itself on this Project.

C. The nature of the work your Company will perform itself on this Project and the trades you will employ.

D. The equipment that you own or lease that is available for work on the Project.

Owned Equipment:

Leased Equipment:

E. The nature of the work which your Company would expect to subcontract on this Project.

F. The names and addresses of your Company’s major suppliers for this Project.

G. A list of all collective bargaining agreements to which you are bound.

17. List the three principal officers, administrators, managers and superintendents who will be assigned to the Project—identification of qualifications, with specific attention to years in present position, years with your Company, years of construction experience, and magnitude and type of work.

18. Identify any work your Company has performed for the Owner for each, identify the location of project, nature of contract (prime, sub, etc.), contract amount, kind of work, and nature of project.

19. List other similar projects that your Company has performed in Pennsylvania (up to a maximum of seven of the most recent projects)—for each, identify the name and address of owner, location of project, nature of contract (prime, sub, etc.), contract amount, kind of work, and nature of project. You may refer to projects previously identified.

20. List all of the other projects that involve the same type of construction that your company has completed, up to a maximum of seven of the most recent projects—and for each, identify the name and address of owner, location of project, nature of contract (prime, sub, etc.), contract amount, kind of work, and nature of project. You may refer to projects previously identified.

21. List the name of the Project, the Owner, the Architect or Engineer, the total contract value, the date of completion, and the percentage of work completed with your own forces of the major construction projects which your Company currently has under construction, under contract and awarded. You may refer to projects previously identified.

22. List the name of the Project, the Owner, the Architect, the Engineer, the total contract value, the date of completion, and the percentage of work completed with your own forces of the major construction projects which your Company has completed in the last two (2) years.

You may refer to projects previously identified.

23. List all unpaid obligations to local, state, or federal taxing authorities, including but not limited to income, withholding and unemployment taxes.

24. List any projects awarded but which your Company failed to complete or on which your

Company was declared to be in default—identify dates, name and address of owner, name and location of project and kind of work, and the reasons the project was not completed.

25. List any projects for which your Company received change orders, settlements or awards exceeding ten percent (10%) of the original value of the contract in the last five (5) years.

II. Financial Integrity

1. Upon Owner’s request, your company shall provide a complete copy of its most recent financial statement, with an explanation of whether it is a certified statement or a compilation, and including but not limited to the following items:

A. Current assets (cash, joint venture accounts, accounts receivable, notes receivable, accrued interest on notes, deposits, materials and prepaid expenses), net fixed assets and other assets;

B. Current liabilities (accounts payable, notes payable, accrued interest on notes, provision for income taxes, advances received from owners, accrued salaries, accrued payroll taxes), other liabilities, and capital (capital stock, authorized and outstanding shares, par values, earned surplus);

C. Date of preparation, name and address of preparer;

D. Identification and relationship to your Company of the organization whose financial statement is provided, if such organization is not the identical organization provided on page 1; and

E. A statement as to whether the organization whose statement is provided will serve as your

Company’s guarantor under any contract for construction under this Project.

Financial information identified as such and enclosed in a separate sealed envelope will be treated as confidential.

If your company is an LLC with a corporate parent, or other subsidiary, and if your company intends to rely on the financial resources of the parent or other subsidiary, the Company must submit financial information for that entity as well at the same time.

The Company agrees to provide the financial statement: ☐ Yes ☐ No.

A negative response shall be conclusively treated as nonresponsive and shall disqualify the Bidder.

2. Provide your Company’s net working capital (current assets over current liabilities) and date of determination.

3. Provide identification of all existing credit lines, with the name, address, and telephone number of the credit source, the total amounts of the lines, amounts drawn down, and amounts remaining.

4. List the names of your Company’s secured creditors, and the property subject to their security interests.

5. List the names and addresses of your Company’s three largest unsecured creditors.

6. Provide the name, address, and telephone number of your Company’s surety for the payment and performance bonds, total bonding capacity, and available bonding capacity.

7. Has your Company, within the last three (3) years, been in a reorganization under Chapter 11 of the United States Bankruptcy Code, or in any other manner seeking an arrangement or debt adjustment with its creditors? If so, explain.

8. Identify any parent, subsidiary, or other company affiliated with your Company which has declared bankruptcy, or been placed into bankruptcy, in the last ten (10) years.

9. Have any of your officers or principal operating personnel been employed or associated with a company that has been in bankruptcy or ceased to operate at any time in the last ten (10) years?

If so, state the person’s name, title, and the name of the company involved.

10. Identify all cancellations, terminations, or rescissions of contracts of insurance or suretyship involving your Company within the last five (5) years.

III. Conduct

1. List all felony convictions, all bidding-related offenses, and all misdemeanor convictions involving moral turpitude of your Company, its affiliates, its owners holding more than a five percent

(5.0%) interest, its officers, and its administrators, managers, and superintendents that may be assigned to the project.

2. List all debarments, suspensions, and denials of pre-qualification of your Company, its affiliates, and its owners holding more than five percent (5.0%) interest, for any federal, state, local or other governmental contracting, including but not limited to Prevailing Wage and Davis Bacon debarments, etc.

3. Identify all construction-related disputes of any kind including lawsuits, arbitrations, mechanics’ lien proceedings, and other claims in the last ten (10) years, which claims were either brought by or against your Company.

4. Identify all proceedings of a governmental, administrative or enforcement nature of whatever kind, including minority/women business enterprise program, environmental, wage and hour, prevailing wage, employment discrimination, or other kind of proceeding involving your Company which are currently active or were resolved in the last five (5) years.

5. List all unpaid obligations to local, state, or federal taxing authorities, including but not limited to income, withholding and unemployment taxes.

(Name of Bidder)

By: _________________________

Title

Date: _________________

END OF SECTION

CAPITAL REGION WATER