06 - 7555-15 Subconsultant Staffing List-Architecture and Engineering3.docx
DOCX document 336 KB Posted
- Solicitation number
- 2120656
- Issued by
- Jefferson County, New York
About this file
Form 7555-15 is a Subconsultant Staffing List for Architecture and Engineering Consultants required by the State University of New York (SUNY) system. The form is used to document all proposed prime consultant firms and subconsultants participating in design and construction administration services. Respondents must identify their firm, list all subconsultants with their Federal ID numbers, and provide licenses for professionals in disciplines including architecture, civil engineering, landscape architecture, structural engineering, plumbing/fire protection, HVAC, electrical, cost estimating, and asbestos/hazmat. The form requires completion with estimated work scope percentages for each firm or subconsultant, designation of Partner in Charge and Key Staff members, and confirmation of whether New York State businesses will be used in contract performance.
The form enforces compliance with New York State's Minority and Women Owned Business Enterprise (MWBE) and Service Disabled Veteran Owned Business Enterprise (SDVOB) programs as established in Article 15-A and Article 17-B of the Executive Law. Respondents must identify certified MBE or WBE subconsultants and SDVOB subconsultants on separate pages, document prior contract relationships with these firms, and provide justification for estimated participation percentages. For the Blake Building project at SUNY Geneseo, the procurement requires compliance with 15 percent MBE goals, 15 percent WBE goals, and 6 percent SDVOB goals. An updated Subconsultant Staffing List with dollar values must be submitted at the cost proposal stage if the firm is selected, and any changes to an approved list require review and approval by SUNY's Project Coordinator.
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Other files
| File | Type | Posted |
|---|---|---|
| 20- Form 7555-18 Bidders Certifications2.docx | DOCX document | |
| 02 - Design Team Summary Table3.xlsx | XLSX spreadsheet | |
| 17 - OSC Form A2.doc | DOC document | |
| 18 - Form 7557-108 EEO Staffing Plan2.docx | DOCX document | |
| 07 - 7557-104 MWBE EEO2.doc | DOC document | |
| 19 - Form 7557-110 Workforce Utilization Report2.xlsx | XLSX spreadsheet | |
| 061122 - Request for Qualifications-Blake Hall Renovation.pdf | ||
| 16 - OSC Form B2.doc | DOC document |
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Text version
Form 7555-15
Subconsultant Staffing List – Architecture and Engineering Consultant Name: Campus:
List your firm’s name for self-performed work. List all Subconsultants. Complete page two for MBE or WBE Subconsultants.
SUNY Project No.: Project Title: Date:
GOALS: % MBE % WBE (As specified in the Project Advertisement)
Consultant / Subconsultant / Design Area Name and Address
| Federal ID No. |
| MBE or WBE |
| SDVOB |
Y or N NYS Business Y or N Contract Value Percentage % Contract Dollar Value $ Include ONLY IF this form is being submitted as part of a COST PROPOSAL
| Partner in Charge and/or Key Staff |
| Phase or date service begins |
Architecture
License #
Civil Engineering
License #
Landscape Architecture
License #
Structural
License #
Plumbing / Fire Protection
License #
HVAC
License #
Electrical
License #
Cost Estimating
License #
Asbestos / Hazmat
License #
Other (Please Specify)
License #
Will New York State Businesses be used in the performance of this contract? ______ ______ Yes No
Minority and Women Owned Business Enterprises
Firm Name
MBE or WBE Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
MBE or WBE Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
MBE or WBE Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
MBE or WBE Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
MBE or WBE Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Certification: I hereby certify that the information provided on this form is true, accurate and complete. I understand that the information provided is to be used to comply with the reporting requirements of Article 15-A of the Executive Law.
Signature (Officer of the Company): __________________________________________________ Date:_____________________ Name: ________________________________________________________________________ Title:_________________________________________________________________________
For internal use only.
MWBE Program Coordinator Approval: ________________________________________________ Date:_____________________
Service Disabled Veteran Owned Business Enterprises
Firm Name
Type
SDVOB
Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
Type
SDVOB
Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
Type
SDVOB
Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
Type
SDVOB
Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Firm Name
Type
SDVOB
Discipline Has your firm held contracts with this firm in the past? Y or N
Brief summary of services to be provided with justification of estimated participation:
Certification: I hereby certify that the information provided on this form is true, accurate and complete. I understand that the information provided is to be used to comply with the reporting requirements of Article 17-B of the Executive Law.
Signature (Officer of the Company): __________________________________________________ Date:_____________________ Name: ________________________________________________________________________ Title:_________________________________________________________________________
For internal use only.
Program Coordinator Approval: ________________________________________________ Date:_____________________
Instructions for completing form 7555-15:
1. Fill in all requested information including your firm name, SUNY Project No., Project Title, Campus, date and the Minority and Women Owned Business Enterprise goals as specified in the Project Advertisement.
2. In the Consultant/Subconsultant fields, enter both your firm as prime and any proposed subconsultant firms. Firms located out of New York State should have the appropriate approvals in place to practice in NYS. If a firm, including your firm provides service in multiple disciplines, list them for each area of expertise. Discipline areas may be modified as appropriate. Add additional pages if necessary.
3. Enter the Federal ID number for your firm and any subconsultant firms.
4. Enter “M” or “W” if your firm or any proposed subconsultant firms are certified by NY State as a Minority or Woman-Owned Business Enterprise. Identify if a firm is a Service Disabled Veteran Owned Business Enterprise.
5. With the submittal of qualifications: Enter the estimated percentage of the work scope for your firm and any identified subconsultants. Do not enter dollar values. Do not enter “TBD”. The sum of the individual percentages should add up to 100%.
6. Enter the name of the Partner in Charge and/or Key Staff member from your firm and subconsultants firms. Also include the individual’s license number if providing professional services.
7. Complete page 2 with the name of each certified MBE or WBE subconsultant identified on page 1 of the Subconsultant staffing list, note whether the firm is an MBE or WBE and their discipline. Provide a brief summary of the services to be provided by the certified MBE or WBE with justification to support the estimated participation.
8. Complete page 3 with the name of each certified Service Disabled Veteran Owned Business Enterprise subconsultant identified on page 1 of the Subconsultant staffing list. Provide a brief summary of the services to be provided by the certified MBE or WBE with justification to support the estimated participation.
9. The certification must be signed and dated by an individual from your firm who is authorized to sign on behalf of your company.
10. Retain a copy for your files and as a reference for proposing any future changes. Any proposed changes to an approved Subconsultant Staffing list must be reviewed with the Project Coordinator and approved by SUNY.
11. If your firm is selected, at the time the cost proposal is submitted an updated Subconsultant Staffing List with Dollar Values is required.
| Page 1 of 4 | SUNY Procedure 7555; Form 7555-15 |
| January 2017 |
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