10.10.1965 - Addendum No. 2 - Narrative - ARMC Emergency Dept ICU Expansion.pdf

Project No. ANE223-ANE2C-6392 Page 1 of 21

Project No. ANE223-ANE2C-6392

ADDENDUM NO. 2

TO THE REQUEST FOR PROPOSAL (RFP) FOR

10.10.1965 ARMC EMERGENCY DEPARTMENT & ICU EXPANSION FEASIBILITY STUDY

AND MASTER PLANNING

The following changes and/or additions shall be made to the RFP. All other requirements of the RFP documents shall remain the same. The proposer shall acknowledge receipt of the addendum by inserting its number and date in the RFP submittal.

1. Changes to the RFP:

Amend Section II. PROPOSAL TIMELINE to read as follows:

II. PROPOSAL TIMELINE

Amend Section VI. SCOPE OF WORK, Subsection C. Project Deliverables to read as follows:

C. Project Deliverables

For clarity and alignment with budgetary considerations, the project deliverables are organized into two categories: (1) Base Scope, which includes the planning and feasibility services required to establish programmatic needs and campus fit, and (2) Add Alternate, which includes optional implementation, delivery, and procurement framework services.

The goals of the master planning and feasibility study include the following:

Base scope deliverables

- Evaluate the adequacy of existing facilities relative to current and projected Emergency

Department demand

Release of RFP May 19, 2026

Mandatory Virtual Meeting May 27, 2026 at 2:00 p.m.

Deadline for Submission of Questions June 5, 2026 at 5:00 p.m.

Deadline for Proposals July 1, 2026 at 5:00 p.m.

Interviews of Shortlisted Proposers

Week of July 27, 2026

Date for Tentative Contract Award October 2026

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- Define functional, spatial, and operational requirements necessary to support ED and related service growth for campus transformation.

- Assess the impacts of ED growth on other clinical and ancillary departments, including outpatient clinics, intensive care services, and interventional cardiology

- Analyze campus circulation, traffic flow, parking demand, emergency access, and overall campus flow to support safe and efficient operations

- Evaluate site utilities and infrastructure capacity, including power, water, sewer, storm drainage, medical gas systems, emergency power distribution, and imaging-related shielding considerations, to identify constraints and planning-level upgrade needs

- Identify feasible expansion, reconfiguration, and phasing options that maintain uninterrupted hospital operations within an active acute-care environment

- Develop preliminary milestone schedules that include planning-level assumptions for HCAI review durations, regulatory approvals, and sequencing constraints

- Provide preliminary cost and schedule projections sufficient to support funding validation and executive decision-making

Add Alternate:

- Establish a defensible planning framework to guide future procurement and delivery.

- Evaluate and recommend an appropriate project delivery methodology for the proposed project including comparative analysis of risk allocation, schedule implications, HCAI regulatory considerations, cost control impacts, operational continuity within an active acute-care hospital environment.

- Identify required procurement sequencing under County public contracting requirements and provide clear rationale supporting the recommended delivery method.

- Develop a high-level implementation roadmap extending from completion of the feasibility phase through project closeout, including major decision milestones, environmental review assumptions planning-level HCAI review durations, procurement sequencing, design and construction phase assumptions, infrastructure upgrades, and operational phasing constraints necessary to maintain uninterrupted hospital operations.

- Evaluate and recommend an appropriate owner-side governance and delivery structure, including required program management, project management, construction management, and specialty consultant support necessary to successfully deliver the recommended project.

Amend Section VI. SCOPE OF WORK, Subsection E. Preliminary Project Delivery Schedule to read as follows:

E. Preliminary Project Delivery Schedule

- In addition to the feasibility phase schedule, Consultant shall develop a planning-level overall project delivery schedule extending through procurement, regulatory approvals, design, and construction, including planning-level HCAI review durations, procurement timelines, and critical path assumptions for executive planning and funding validation purposes.

- A phased approach has been incorporated into this RFP to align with available funding with planning priorities through a Base Scope and Add Alternate. The Base Scope provides the minimum level of planning and feasibility required to

Project No. ANE223-ANE2C-6392 Page 3 of 21 support executive decision making and capital planning. The Add Alternate includes implementation and delivery-related services and will only be exercised if feasibility is confirmed and sufficient budget is available.

Amend Section VIII. EVALUATION to read as follows:

III. EVALUATION

Proposals will be subject to an Initial Review to confirm responsiveness, by determining whether each Proposal includes the stipulated content, required certifications or licensing, etc., and is presented in the required format, in order for the Proposal to advance for evaluation. Any reasonable person reviewing for responsiveness must be able to ascertain that the Proposal meets these requirements.

The evaluation will be conducted in a two-part process. A minimum of three (3) proposers with the highest Part One evaluation scores will be shortlisted to participate in Part Two. The evaluation scores from Part One and Part Two will be added together, and the proposer with the highest overall score will be the highest ranked proposer. The County reserves the right, in its sole discretion, to shortlist more than three (3) Proposers.

A. PART ONE

Part 1 includes the following categories and may include additional specific criteria. Likewise, the listed considerations are possible considerations and may not be the only factors involved in the evaluation.

1. QUALIFICATIONS AND EXPERIENCE

Weight: 40% Considerations:

Proposer background and reputation Qualifications of the project team Experience with local approval agencies Experience with publicly bid projects Experience with similar services and entities Experienced in hospital planning pro-formas and programming, covering functional programming, space planning, feasibility and master planning for acute-care facilities, block-and-stack analysis, ROM cost estimates, and assessment of campus-wide impacts in active environments.

Direct experience with California OSHPD-1 regulated hospitals Project Lead experience with healthcare facility planning experience, including

OSHPD-1 projects Demonstrated ability to facilitate clinical and operational user engagement;

prepare functional program narratives, milestone schedules, and ROM cost estimates

2. TECHNICAL REVIEW

Weight: 30% Considerations:

Work plan

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Scheduling Quality control Adequacy of support staff and subconsultants Risk management Value-added aspects

3. REFERENCES

Weight: 10% Considerations:

Satisfactory performance of similar work Demonstrated knowledge and expertise Work product Quality of interactions Capability of assigned team members Likelihood of continued use

B. PART TWO

Part 2 includes the following categories and may include additional specific criteria. Likewise, the listed considerations are possible considerations and may not be the only factors involved in the evaluation.

INTERVIEW, PRESENTATION, OR DEMONSTRATION

Weight: 20% Considerations:

Content conveyed or demonstrated in person to the evaluation panel

General organization of the presentation or demonstration

Proposer inspired confidence in the project plan or team

The following interview format is anticipated for the shortlisted proposers:

Introductions and Project Context (10 minutes): Introductions of County staff and proposer team members, along with a brief overview of the project scope and objectives, as applicable.

Proposer Presentation (35 minutes) project, approach to the Base Scope, team organization, and relevant experience.

Question and Answer Session (15 minutes) approach, assumptions, and ability to support executive decision-making.

The County may, at its sole discretion, create a shortlist of Proposals for further evaluation;

require an oral interview, presentation, or demonstration; and utilize outside experts to assist in the evaluation process.

The County will establish an evaluation panel with responsibility for reviewing all Proposals and conducting the qualifications evaluation for Part One and Part Two. A Facilitator will manage the integrity of the qualifications evaluation process and will not be a voting member of the evaluation panel. An initial meeting will be scheduled and held with the evaluation panel members, wherein the Facilitator will distribute all relevant documents to the evaluators including the RFP, evaluation criteria, and evaluation instructions.

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After the initial meeting, evaluators will independently review and score the Proposals.

After the scores of Part One are finalized, the Facilitator will coordinate the Part Two Interviews with the shortlisted proposers and the evaluators. The evaluation panel will convene to discuss the individual scores to resolve questions and to discuss the basis for individual scores, but not for the evaluators to agree upon scoring. At the end of this discussion, each evaluator will be given an option to revise his/her scores.

Evaluators will make independent determinations for scores, including review and understanding of any additional information obtained by the group discussion. In the event a score is revised, the evaluator will document the new score and provide comments to support the revision.

If clarifying information is needed at any point, the Facilitator will contact Proposer(s) to obtain the necessary information. The Facilitator will then provide the information to the evaluation panel electronically or verbally, as appropriate.

The Facilitator will coordinate the individual scoring. Once all scorings are finalized and documented, the Facilitator will create a final qualifications evaluation scoring worksheet and rank the shortlisted proposals first, second, third, etc.

Following the qualifications evaluation and ranking of the proposals, the Facilitator will open all fee proposals from the shortlisted proposals. The ranking of the proposals will not be altered once the fee proposals have been opened. However, the fee proposals will be used during negotiations with the selected Proposer(s).

- Fee

2. Request for Information Questions and Answers:

Q1: Please confirm the time of the mandatory meeting. On page 4 it is listed as 2pm under II Proposal Timeline and 10am under the Mandatory Virtual Meeting link.

Thank you.

A1: Please see Addendum No. 1.

Q2: There are two times (10:00AM and 2:00PM) indicated in the RFP. Additionally, there are two Meeting ID's identified in the RFP. Can you clarify which time and which Meeting ID to use on 05/27/26?

A2: Please see Addendum No. 1.

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Q3: It is our assumption that participation in this feasibility and master planning effort would not preclude the successful team from pursuing future implementation or design phases. Please confirm this aligns with the County's intent.

A3: Participation in this planning and feasibility effort does not, in and of itself, preclude the successful consultant or its subconsultants from pursuing future implementation or design phases, provided that all applicable County procurement requirements and conflict of interest provisions, including those outlined in Section XI.A.43 and Attachment L of the RFP, are satisfied.

Q4: Will the attendance list be available for review?

A4: The mandatory pre-bid meeting sign-in sheets have been posted to https://pfm.sbcounty.gov/project-management/#bid-results.

Q5: Are financial statements included in the 15-page limit?

A5: Financial statements are not included in the 15-page limit.

Q6: There are no fields to fill on Attachments D and L. Please clarify if proposers should include a signature or other information on each.

A6: Signatures are not required on Attachments D and L. Proposers do not need to complete any additional fields on these forms. By initialing Attachment B, Item No. 4, the proposer acknowledges and agrees to all RFP requirements, including Attachments

Proposer agrees that all aspects of the RFP and the Proposal submitted shall be binding if the Proposal is selected and a Contract awarded

Q7: Please confirm that the 6-month contract period is for only the Base Scope.

A7: The six (6) month contract duration is provided as an initial estimate for completion of the Base Scope and Add Alternate services. Proposers shall review the scope and propose a schedule they consider appropriate to complete the work, including any adjustments to the overall duration.

Q8: Will the Fee Proposal be considered as part of the initial evaluation and shortlist selection process, or will fee proposals only be reviewed after the qualifications-based ranking has been established? What is the anticipated overall budget for this project?

A8: Fee proposals (Attachment E) are due at the same time as the rest of the proposal but shall be uploaded as a separate attachment and clearly labeled pursuant to Section VII.A.4 of the RFP. Following the qualifications evaluation and ranking of the proposals, the Facilitator will open all fee proposals from the shortlisted proposers. The ranking of the proposals will not be altered once the fee proposals have been opened. However, Project No. ANE223-ANE2C-6392 Page 7 of 21 the fee proposals will be used during negotiations with the selected Proposer(s). The anticipated overall budget is $800,000.00.

Q9: The RFP requests consultant information and identifies several disciplines within

Attachment C. To ensure consistent proposal submissions, could the County clarify the level of detail expected for proposed subconsultants at the time of proposal submission?

A9: Proposers shall include key subconsultants necessary to deliver the Base Scope as part of their submission. The level of detail provided should be sufficient to demonstrate the

Q10: The RFP states that the proposal narrative is limited to fifteen (15) pages, exclusive of the cover page, table of contents, supplementary attachments, and reports. Could the County please clarify which the proposal submission sections will be excluded from the page count? Additionally, may project descriptions, resumes, and organization charts be included within supplementary attachments without counting toward the 15-page limit?

A10: The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q11: Because the RFP is heavily focused on planning, programming, and feasibility services, yet Attachment C includes disciplines typically associated with design-phase services (Architect, Structural Engineer, Mechanical Engineer, Electrical Engineer, Civil Engineer, etc.), could the County clarify whether proposers are expected to identify a complete future design team at the time of submission, or only those consultants necessary to perform the planning, programming, master planning, infrastructure assessment, and feasibility services contemplated under this engagement?

A11: Proposers shall identify the subconsultants they intend to utilize to perform the services under this engagement. Identification of a full future design team is not required at the time of proposal submission.

Q12: What is the anticipated overall budget for this project?

A12: The anticipated overall budget is $800,000.00.

Q13: Who will serve as the evaluators? If listing the names or titles of the evaluators is not possible, could you please provide the roles they serve with the County and/or ARMC?

A13: The evaluators for this RFP shall be representatives from the Project Facilities

Management Department (PFMD) and Arrowhead Regional Medical Center (ARMC).

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Q14: The proposal format instructions do not address the use of tabs or dividers.

Please confirm whether tabs are permitted as part of the proposal submission and not included in the 15 maximum page count.

A14: Confirmed tabs are not counted toward the page limit. The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q15: On page 13 of 47, Section 5, Statement of Experience and Qualifications, Item D directs proposers to "List the qualifications as outlined in Section V." While the requirements in Sections V.A and V.B are clear, we request clarification regarding the expected deliverables for the following sections: a) Section V.C - Information About the Entity: Please clarify the deliverable to satisfy this requirement. b) Section V.D - Relevant Project Experience: Please confirm whether resumes and the organizational chart should be included as part of this section, or if they should be provided exclusively under Section 8, Project Team Organization Chart, Item C, Resumes.

A15: Refer to questions and answer no. 49 and 50 of this Addendum.

Q16: Attachment C requests license information. Please confirm whether the County is seeking license information only for the proposed key personnel assigned to this contract, or if firm-wide licensure information should also be provided.

A16: License information for the proposed key personnel assigned to the contract is required.

Firm wide licensure information is not required at the time of proposal submission.

Q17: Attachment D appears to require a signature; however, the provided form does not include a designated signature block or signature line. Please confirm whether the form is intended to be signed and, if so, whether the signature may be placed anywhere on the page.

A17: Refer to question and answer no. 6 of this Addendum.

Q18: Attachment L, appears to require a signature; however, the provided form does not include a designated signature block or signature line. Please confirm whether the form is intended to be signed and, if so, whether the signature may be placed anywhere on the page.

A18: Refer to question and answer no. 6 of this Addendum.

Q19: Given inclusion of Exhibit B (2010 Emergency Department Expansion Study) within the procurement documents, it is assumed that this document is considered a valid reference for use to reassess and build upon prior planning analyses and recommendations for application in the current campus-wide master planning and feasibility study effort. In other words, should this project be

Project No. ANE223-ANE2C-6392 Page 9 of 21 treated as an update and validation of the 2010 findings, or as an independent feasibility analysis starting from scratch? To what extent should the proposer rely on assumptions and findings from the 2010 study? Please clarify.

A19: Exhibit B is provided for reference only. Proposers shall independently assess and validate any assumptions, analyses, and findings contained in this document as part of their work under this engagement. The scope of this project should be approached as a new planning and feasibility effort, with prior studies used, as appropriate, to inform but

Q20: Section VI. Paragraph A. Project Summary. Please clarify the anticipated extent of evaluation for non-ED/non-ICU departments, support services, and campus infrastructure systems as part of the broader campus-wide planning effort. This paragraph mentions "potential expansion, relocation, or reconfiguration of other clinical service lines, including outpatient clinics, intensive care services, and interventional cardiology (cardiac catheterization laboratories), as driven by operational demand and campus-wide impacts". Impacts may touch other major components such as surgery and acute care beds. Please clarify.

A20: The requested analysis is limited to identifying and quantifying incremental volume increases in directly impacted clinical support departments resulting from projected ED growth. A comprehensive, full departmental analysis is not required.

Q21: Please confirm whether existing utility studies, campus infrastructure assessments, SPC/NPC documentation, and related existing-condition technical information will be made available to the selected team.

A21: The County will make all available existing-condition information accessible to the selected consultant upon award. This may include select utility studies, campus infrastructure documentation, SPC/NPC materials, and other technical reference all the items listed by the proposer exist in complete or current form.

Q22: Please clarify the anticipated extent of stakeholder engagement activities, including user meetings, operational workshops, and County presentation milestones anticipated during the study process.

A22: Proposers shall include in their proposal the level of stakeholder engagement, user meetings and workshops they consider necessary to successfully deliver the proposed services.

Q23: Section VII Proposal Submission, item B.10.2. Planning - Level Overall Project

Schedule; Our understanding is that the proposer is required to provide a methodology for developing the preliminary project delivery schedule required under Section V only and not the actual schedule considering this item would be

Project No. ANE223-ANE2C-6392 Page 10 of 21 a deliverable developed during master planning and feasibility study. Please confirm.

A23:

expected to describe their methodology only not to submit the actual planning-level project delivery schedule.

Q24: Section VII Proposal Submission, item B.19. Sample Report; Our assumption is that the sample report will include a few pages only due to proprietary reasons and the number of pages allowed for this RFP submission. Please confirm if this request can be limited to maximum of 2 to 3 pages.

A24: Proposers may limit the sample report to a representative excerpt; however, the submission should be of sufficient length and content to clearly demonstrate the quality The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q25: Are structural record drawings available for all campus buildings?

A25: All available existing information will be provided to the selected consultant for reference.

Q26: Are existing geotechnical reports for the campus available for review to understand geology and soil conditions?

A26: All available existing information will be provided to the selected consultant for reference.

Q27: Has the County identified any preferred expansion option preference from the

2010 study that we should focus on?

A27: The report is provided for reference only; the County has not identified a preferred expansion option, and proposers are expected to evaluate and recommend options based on current conditions, constraints, and project requirements.

Q28: Are there any structural reports, assessments, or analyses completed on the base isolation system since the 2010 ED Expansion Study? Are the base isolation system shop drawings and as-built isolator specifications available for review?

The 2010 study identified base isolation system analysis as a necessary but unfunded next step, and it would be helpful to know if an additional study has been performed or if this is something we should include as part of our scope.

A28: No structural assessment reports are currently available; all available information will be provided to the selected proposer upon award.

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Q29: Is the underground utility tunnel referenced in the 2010 study still active and in service, and is it located within the anticipated expansion footprint?

A29: The underground utility tunnel is confirmed to be active and currently in service.

Q30: What is the current Structural Performance Category (SPC) and Nonstructural

Performance Category (NPC) rating for each building on the ARMC campus? Has ARMC submitted a Seismic Compliance Plan to HCAI, and if so, what is the current compliance milestone status and timeline?

A30: Structural Performance Category (SPC) and Nonstructural Performance Category

(NPC) ratings can be obtained through the HCAI website.

Q31: Has any structural work been performed on the D&T Building basement walls or tie-back system since original construction? This was flagged in the 2010 study as a potential challenge.

A31: No structural work has been performed on the D&T Building basement walls or tie-back system since original construction.

Q32: Are there any active HCAI-approved projects currently in design or construction on campus that could affect the expansion footprint, available construction staging areas, or phasing assumptions?

A32: There are no active HCAI-approved projects currently in design or construction that would affect the expansion footprint, staging areas, or phasing assumptions.

Q33: Does the hospital have a recent TAB report of the HVAC system. If not, will the county contract with a contractor to provide the necessary information

A33: All available information will be provided to the selected proposer upon award; the cost of any air balancing (TAB) services shall be excluded from the cost of this proposal.

Q34: Is the annual preventative maintenance inspection report for the medical gas system available for the award team for review as part of the feasibility study

A34: All available information will be provided to the selected proposer upon award

Q35: The assessment report dated February 5, 2010 states that the existing central plant has available capacity for the ED addition. Has the central plant been analyzed recently for the available capacity or should this be included as part of this project to verify the capacity.

A35: Infrastructure assessment, including verification of central plant capacity, is part of this engagement.

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Q36: When will answers to these questions be provided?

A36: All responses to Request for Information (RFI) will be included in one addendum and posted in ePro by June 11, 2026.

Q37: Resumes are requested in Project Team, but also in the Statement of

Qualifications (Section V Requirements). Can we include in an appendix or is there a specific section where the full resumes should be included?

A37: The County takes no exception to including the resumes in an appendix.

Q38: Can you clarify which pages count towards the 15 page limit?

A38: The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q39: If awarded the master plan, is the team precluded from the design / implementation of the project(s)

A39: Refer to question and answer no. 3 of this Addendum.

Q40: Please clarify which section in the proposal or appendix section where the proposer should acknowledge receipt of the addendum.

A40: Please see revised Attachment B included with this Addendum.

Q41: Please confirm whether Proposers may have the option to reformat or recreate the required Attachment forms (A-L), provided all required information is included.

A41: No, proposers do not have the option to reformat and/or recreate RFP attachments. All required attachments must be completed as directed in the RFP, but proposers may also submit supplemental documents as needed.

Q42: Please confirm whether the correct solicitation number is RFP No. 10.10.1965.

Several attachment pages appear to reference RFP No. 10.10.0951

A42: Confirming the correct solicitation number is ANE223-ANE2C-6392 for Project No.

10.10.1965.

Q43: Please confirm whether Attachment K is intentionally omitted from the RFP package

A43: Confirmed.

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Q44: Please confirm whether references to Section V - Scope of Work in Attachment E should instead refer to Section VI - Scope of Work

A44: Confirmed. See revised Attachment E attached hereto.

Q45: With respect to the evaluation of related services and secondary impacts: a. We anticipate that ED and ICU volume growth would drive additional volume in diagnostic imaging, surgery, lab, pharmacy, and dietary. Please confirm that the requested analysis is limited to incremental volume increases in those departments and does not require a full departmental analysis. b. Additionally, there may be minor increases in general support departments such as storage, materials management, linen, EVS, and loading dock. Please confirm whether general support departments are excluded from the analysis.

A45: The requested analysis is limited to identifying and quantifying incremental volume increases in directly impacted clinical support departments resulting from projected ED growth. A comprehensive, full departmental analysis is not required.

General support departments are excluded from the required analysis, unless the proposer identifies a material impact that directly influences the feasibility, capacity, or operational functionality of the proposed program.

Q46: Please confirm whether resumes do not count in the total fifteen-page count and may be included as an appendix

A46: Confirmed, resumes do not count in the total page limit.

Q47: Please confirm that audited financial statements and annual reports required under Item 7, Financials, are considered "supplementary attachment and reports" and do not count toward the page limit.

A47: The cover page, table of contents, any supplementary attachments and reports are excluded from the fifteen (15) page proposal length.

Q48: Please confirm whether proposers may provide audited financial statements for

2024 and 2025 in lieu of annual reports for the past two years.

A48: Yes, the department is requesting financial statements for the years 2024 and 2025.

Q49: Please confirm whether proposers may cross-reference information provided in other proposal sections where requirements overlap, rather than duplicating the same information in multiple sections. For example, may the Project Lead qualifications, team resumes, and organization chart requirements referenced in Section V.B and Section V.D be addressed in Item 8, Project Team Organization Chart, and cross-referenced in Item 5, Statement of Experience and Qualifications?

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A49: Proposers may cross-reference information provided in other sections of the proposal where requirements overlap, provided that all required information is clearly addressed and the cross-references are specific and easy to follow. Proposers remain responsible for ensuring that each section is complete and responsive to the stated requirements.

Q50: In Section V.D, Relevant Project Experience, please clarify what is meant by the

"Entity's lead contractor and architect-of-record".

A50:

partners), proposers shall provide relevant project experience for each entity separately to clearly demonstrate the qualifications and experience of all key team members.

Q51: Please clarify scope of facility assessment as it will impact the overall cost of the engagement. Confirm items that are excluded (e.g. fire alarm, nurse call, etc.

A51: The facility assessment shall be performed at a planning level and is intended to identify major cost drivers and key infrastructure considerations associated with the proposed expansion.

Q52: The ePro bid page lists a bid opening date of 6/17/2026 at 5:00:59 PM. Could you please clarify instructions on how to submit a proposal through the ePro portal prior to that time?

A52: Instructions on how to submit a bid in ePro have been uploaded for all reference.

Q53: Could you please confirm whether project team resumes and project experience included in the response are counted towards the 15-page limit?

A53: The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q54: Are sub-consultants required to have exclusive teaming relationships with the

Prime?

A54: Exclusive teaming relationships between the Prime and sub-consultants are not required.

Q55: Will Behavioral Health Pavilion and behavioral health services be included in the master planning?

A55: No Behavioral health services are excluded from this engagement.

Q56: What level of detail is required for the functional programming - KPU / departmental metrics or a room by room program?

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A56: Functional programming shall be developed at a planning level, focusing on departmental metrics and planning assumptions sufficient to support feasibility analysis.

Q57: Is data available for current/past utilization for: A: Emergency Department - visits by acuity level / type, LOS, helipad arrivals, ambulance arrivals, etc. B: Inpatient beds - average daily census by specialty and acuity levels, LOS, etc. C:

Procedures - cases / procedures annually by specialty or service line, LOS for prep/recovery/PACU, etc. D: Outpatient clinic visits - volumes by specialty / service line, future growth strategies

A57: Development of a detailed Proforma is not part of this engagement.

Q58: Are we to assume the off-site Family Health Centers are not included in the master planning?

A58: Off-site Family Health Centers are not included in the scope of this master planning effort.

Q59: Is there a master plan completion timeframe/date as a target?

A58: A six (6)-month engagement duration is anticipated for completion of the master planning effort.

Q60: There is a base scope deliverable of "Analyze campus circulation, traffic flow, parking demand, emergency access, and overall campus flow to support safe and efficient operations." Is this scope intended to include a traffic engineer to consider broader traffic patterns and how they may interact with the surrounding public roads?

A60: The scope is limited to on-campus circulation and does not require analysis of broader off-site traffic patterns or surrounding public roadways.

Q61: Will existing as-builts, water meter data, etc be available? Or is the team responsible for conducting independent utility locate and metering as a part of this scope?

A61: Select as-built drawings and available water meter data will be provided to the selected proposer upon award.

Q62: Could the County please provide additional guidance regarding the basis for the preliminary project delivery schedule referenced in 10A, Workplan and Schedule?

Specifically, what project phases, milestones, and assumptions should Proposers use when developing the planning-level schedule?

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A62: Refer to Question and Answer No. 23 of this Addendum for guidance regarding the development of the preliminary project delivery schedule.

Q63: We understand that proposal submissions may be subject to public disclosure.

Could the County please clarify how it will handle information identified by Proposers as confidential, particularly with respect to project examples and client information included in the response?

A63: If a Proposer believes that any portion of its Proposal is exempt from public disclosure, it must indicate the specific portions believed to be confidential and not subject to disclosure on Attachment I - Public Records Act Exemptions. The Proposer also must include a brief description that sets out the reasons for exemption from disclosure.

Each stated exemption must include a citation to supporting legal authority, including statutory authority or case law, to support exemption from the Public Records Act. If there is a public records request for the proposals submitted in response to this RFP, the proposals, including all exemptions asserted by Proposers in Attachment I, will be reviewed by County Counsel. The County will use reasonable means to ensure that information that is both identified as confidential by the Proposer and confirmed as exempt from the Public Records Act upon review, is safeguarded. See RFP Section IV.J for additional information.

Q64: What level of interaction do you anticipate with local approval agencies? Please also identify which agencies.

A64: No engagement with Authorities Having Jurisdiction (AHJs) is anticipated as part of this scope.

Q65: Does ARMC (the County?) maintain a list of preferred MEP consultants and if so, would you share the list?

A65: There are no preferred MEP consultants identified at this time.

Q66: Do you anticipate the interviews being in person or virtual?

A66: Interviews are intended to be in person at either PFMD or ARMC office location.

Q67: Would the selected firm be precluded from future work?

A67: Refer to question and answer no. 3 of this Addendum.

Q68: What studies/assessments have been completed on the existing facilities?

A68: No facility assessments have been completed to date.

Q69: Will existing electrical one-line diagrams, generator load records, and/or automatic transfer switch documentation be made available to the awarded

Project No. ANE223-ANE2C-6392 Page 17 of 21 project team to support the infrastructure capacity evaluation, or will these need to be developed as a part of the project?

A69: Select existing electrical documentation, if available, will be provided to the selected proposer upon award; the cost of developing such information shall be excluded from the proposal.

Q70: Have any recent engineering master plan or facilities conditions assessments been performed on the building infrastructure systems within the last ten years?

A70: No facility assessments have been completed to date.

Q71: Does the County have the means to perform electrical load metering or will this scope need to be performed by a contracted electrician?

A71: The cost of electrical load metering, if required, shall be excluded from the cost of this proposal.

Q72: Has the Utility company identified any known constraints regarding electrical service upgrades or additional electrical demand?

A72: No known constraints have been identified by the utility company regarding electrical service upgrades or additional demand.

Q73: Can our audited financial statements be submitted as an appendix?

A73: Financial statements are supplemental attachments that can be organized as an appendix by the proposer.

Q74: Will a schedules formatted to 11 x 17 be considered 1 page or 2 pages?

A74: It will be considered as one page. The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q75: Will the team completing this work be precluded from doing the design portion?

A75: Refer to question and answer no. 3 of this Addendum.

Q76: Can we get any ED data such as visits by ESI category and imaging volumes, etc.?

A76: Development of the Proforma is excluded from this engagement.

Project No. ANE223-ANE2C-6392 Page 18 of 21

Q77: For Attachment C: A) Are you looking for a list of all proposed team members ("members") of the lead firm, or are you looking only for team members who are shareholders within the lead firm? B) Further, do you also want to see this information for each subconsultant that would be contracted under the lead design firm?

A77: Proposers shall identify the subconsultants they intend to utilize to perform the services under this engagement.

Q78: Our Articles of Incorporation are in a 58-page document. May we submit cover page and signature page or do you want the entire document?

A78: The entire document is required as stated in Attachment C and can be added as a supplemental attachment.

Q79: Do you have an entitlements package that you can share?

A79: An entitlements package is not available and is not related to the scope of this engagement.

Q80: Will providing services for the Feasibility preclude the team from proposing on and providing the design and construction services?

A80: Refer to question and answer no. 3 of this Addendum.

Q81: Does ARMC have an existing strategic plan, strategic facility plan, campus master plan, or prior feasibility study that should inform this effort? If so, will these documents be made available to the selected consultant team?

A81: There is currently no master planning or strategic facility plan available to inform this effort.

Q82: What planning horizon should be assumed for demand forecasting and master planning, and are there specific growth, service line, market expansion, or service area assumptions that should be incorporated into the planning process? If ARMC has an established primary and secondary service area definition, will that information be made available to the consultant team?

A82: Development of a pro forma is not part of this engagement; however, proposers should define appropriate planning assumptions to support their approach to feasibility and master planning.

Q83: Page 10 states "Please explain the history and business relationship, if any, between the Entity's lead contractor and the architect-of-record, as well as any prior working relationships between the Entity and other proposed team

Project No. ANE223-ANE2C-6392 Page 19 of 21 members, including specialty sub-consultants or major sub-contractors." Please clarify.

A83: Proposers are requested to identify whether the proposed team members have established working relationships or known partnerships with the proposed subconsultants, and to describe the nature of those relationships, if applicable.

Q84: Please clarify what the "Sample Report" is on page 15. Can these items be shown within other sections of the proposal?

A84: The Sample Report represents an example of the type of deliverable anticipated for this engagement. Proposers may include this material within another section of the proposal if they consider it more relevant, provided it is clearly identified.

Q85: Is there a limit on the age of projects that may be included as part of our project experience? (Ex. Completed within the last 10 years)

A85: Preference is for more recent projects, but the RFP does not include a specific limit on the age of projects that maybe included as part of the Proposers project experience.

Q86: Confirm all Attachment Forms (Attachment A- Cover Page, Attachment B-

Statement of Certification) can be located at the end of the RFP submittal. After the 15 pages.

A86: The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q87: Confirm the team will be evaluated based on experience with publicly bid projects. Clarify evaluation will be based on delivering design services and documents that are publicly bid.

A87: Experience with publicly bid projects is a consideration in the evaluation. This RFP is evaluating feasibility conceptual design.

Q88: Confirm the Financial Report per Item 7 on Page 14, is not included in the maximum 15 page count.

A88: The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q89: Will ARMC provide historical utilization data (preferably five years or more) for key departments and services, including emergency department visits, inpatient admissions, ICU utilization, surgical cases, procedural volumes, and interventional cardiology volumes?

Project No. ANE223-ANE2C-6392 Page 20 of 21

A89: Development of a proforma or detailed demand forecasting is not part of this

Q90: Does ARMC currently utilize a market intelligence or forecasting platform (e.g., Sg2, Advisory Board, Kaufman Hall, etc.) and, if so, will the selected consultant be expected to leverage those resources as part of the forecasting process?

A90: Development of a proforma or detailed demand forecasting is not part of this

Q91: Will the consultant team have direct access to key operational, clinical, and administrative stakeholders throughout the study?

A91: Yes, the selected proposer will be expected to coordinate and participate in meetings with key operational, clinical, and administrative stakeholders as part of the planning development process.

Q92: Section 5d (page 13) references section V . Section VB (page 9) request Key

Personnel Qualifications and Section 8c requests resumes, including qualifications. Can these items be consolidated to one section, under Section 8 Project Team.

A92: Yes, these items may be consolidated under one section, provided that all required information is included in the submission.

Q93: Page 14, Item 10-2 requests a Planning-Level Overall Schedule. Proposer shall describe its methodology for developing the preliminary project delivery schedule under Section V and identify key assumptions that may influence total project duration. Confirm reference to Section V, as section V does not include language around project schedule. Provide clarification as to weather a schedule is to be provided or only the methodology for developing a future schedule for the developed/defined Master Plan scope.

A93:

provide a description of their methodology for developing the planning-level project delivery schedule. Submission of an actual planning-level schedule is not required

Q94: Page 41 Alternate Proposed Cost, last line item in the table. Please clarify intent of line item "Staffing Gaps & Cost Implications". Is the intent to provide an allowance to support unanticipated scope of work?

A94: This deliverable has been removed from the RFP. Identify staffing gaps, required expertise, reporting relationships, and planning-level cost implications associated with

Project No. ANE223-ANE2C-6392 Page 21 of 21

Q95: Beyond the ROM cost estimates identified in the RFP, will the consultant team be expected to develop planning-level financial analyses, pro forma evaluations, or return-on-investment assessments associated with the recommended master planning scenarios as part of the base scope of work?

A95: No, these studies are not part of this engagement.

Q96: Will the County consider extending the 15 page-limit, or excluding resumes and forms from the 15-page limit?

A96: The 15-page limit applies only to the core proposal narrative. Resumes, forms, and other supporting documents do not count toward the limit.

Q97: Please confirm whether final submittal should be submitted via email or ePro?

A97: Proposals must be submitted electronically through the County Electronic Procurement Network (ePro).

Attachments:

ePro Upload Instructions Revised Attachment B Revised Attachment E

Moe Yousif, Interim Director Project and Facilities Management Department

MY:ll

San Bernardino County Project and Facilities Management Department 620 South E Street San Bernardino, CA 92415-0184 https://pfm.sbcounty.gov/

DATE: June 1 , 2026