159564-RFP_CP-02 03 34 Site Work.pdf

UNCLASSIFIED

Notice For Federal Business Opportunities - Subcontracts Page 1 of 1 Rev. 03, Dated November 09, 2011 159564-RFP, CP -02, CP-03, & CP-34

Notice for Federal Business Opportunities General Information:

Document Type: Sources Sought

Solicitation Number: 159564

Title: CP-02 Temporary Site Utilities, CP-03 Site Preparation, & CP-34 Nuclear Facility Excavation and Storm Pond

Response Date: 20-December-2011

Classification Code: 56

NAICS: 238910

Small Business Set Aside: No

Recovery Act Project: No

Contracting Office Address:

Acquisition Services Management - CMRR Project Los Alamos National Laboratory (DOE Contractor) PO Box 1663 MS D442 Los Alamos, NM 87545.

Point(s) of Contact:

Primary: Name: Brian J Bowers

E-Mail: bjbowers@lanl.gov

Secondary: Name: Robert Ping E-Mail: rwping@lanl.gov

Description:

BACKGROUND:

The Chemistry and Metallurgy Research Replacement (CMRR) Project is issuing Requests for Expressions of Interest and Prequalification Data (REO) for potential construction/service subcontracts for the planned CMRR Nuclear Facility at the Los Alamos National Laboratory. A bidders list will be developed for each type of construction/service subcontract to be procured.

This request does not represent any confirmation by LANS of inclusion on the final bidders list, notification of subcontract award or authorization to commence any work related to this request.

INSTRUCTIONS:

All interested, capable, and responsible sources that wish to respond to this sources sought are required to download the supplementary document(s) included on the posting website.

The supplements include a summary scope of work and several questionnaire(s) that must be completed in their entirety and returned electronically to the identified Point(s) of Contact by the Requested Response Date. The questionnaires are designed to evaluate general subcontractor capabilities (technical and financial), safety experience, and quality experience.

Once the sources sought requirement has closed, the CMRR Project will Pre-Qualify offerors based on accurate and complete submission of the questionnaire(s).

mailto:bjbowers@lanl.gov� mailto:rwping@lanl.gov�

Request for Expression of Interest, Subcontract Page 1 of 4 Rev. 04, Dated November 16, 2011 159564-RFP, CP-02, CP-03, & CP-34 moo+

Request for Expression of Interest

159564 – RFP

CP-02 Temporary Site Utilities, CP-03 Site Preparation, & CP-34 Nuclear Facility Excavation and Storm Pond

For The Chemistry & Metallurgy Research Replacement (CMRR) Project

Los Alamos National Laboratory (LANL) is seeking Expressions of Interest and Prequalification Data from qualified firms for the services described below.

GENERAL NOTES:

The Chemistry and Metallurgy Research Replacement (CMRR) Project is issuing Requests for Expressions of Interest and Prequalification Data (REO) for potential construction/service subcontracts for the planned CMRR Nuclear Facility at the Los Alamos National Laboratory. A bidders list will be developed for each type of construction/service subcontract to be procured.

This request does not represent any confirmation by LANS of inclusion on the final bidders list, notification of subcontract award or authorization to commence any work related to this request.

SCOPE OF WORK:

The SUBCONTRACTOR shall furnish qualified personnel, equipment, tools, supplies, transportation, temporary offices, technical supervision, professional expertise and materials to safely perform all Work necessary for provision of complete Construction Package (CP) CP-02, CP-03, and CP 34. Safe completion of all work required, individually and cumulatively, by these three CPs will comprise the Work of this Subcontract. The work includes:

CP-02 – Temporary Utilities Subcontract Package

The temporary utilities subcontract package includes furnishing all labor, materials, tools, and equipment to provide temporary utilities to laydown yards and the NF site, as follows:

• Provide construction survey control for all facilities listed below;

• Install new 15 kV duct bank and underground cable from existing manhole MH46-173 to first high voltage power pole on south side of Pajarito Road at TA-46;

• Install duct bank and cable under Pajarito road to serve the batch plant, TA-46 laydown yards and warehouse; provide transformers and terminate;

• Furnish and install all temporary electrical power distribution systems for the TA-46 laydown/fabrication yards, TA-63 batch plant and warehouse, and temporary power grid at the NF site;

• Furnish and install a temporary water supply for the areas listed above;

• Furnish and install temporary sanitary sewer installations for the TA-46 laydown/fabrication yards, and TA-63 batch plant and warehouse;

Request for Expression of Interest, Subcontract Page 2 of 4

• Furnish and install fire suppression systems at the TA-46 laydown/fabrications yards, and TA-63 batch plant and warehouse;

• Tie into the CP-39 subcontractor temporary construction electrical feed to the NF and install main temporary NF power board and temporary construction power distribution system; and

• Raise covers of existing manholes and access vaults within TA-46 and TA-63 graded areas to match new surface grades.

• Furnish and install materials for utility tie-in’s by LANL.

CP-03 – Site Preparation Subcontract Package

The site preparation subcontract package includes furnishing all labor, materials, tools, and equipment to clear and grub, grade, compact, and provide aggregate surface material for the TA-46 laydown yards and TA-63 batch plan site, including the following:

• Provide construction survey control for all facilities listed below;

• Install silt fence and environmental protection measures at laydown yards;

• Clear and grub existing vegetation from laydown/fabrication areas;

• Develop area at TA-54 to receive clear and grub material from this construction package as well as clear and grub material from CP-37, CP-04, and CP-36 subcontractors. Install BMPs based upon approved SWPPPs and other environmental protection measures in the spoils area as they maintain the spoils site during the life of their contract;

• Excavate, grade, and compact fill and aggregate surfacing materials at laydown yards and ramps;

• Accept backfill material from CP-34 subcontractor and process as needed to obtain compactable backfill material;

• Install asphalt roads and area aggregate paving in laydown yards;

• Develop construction trailer pads, parking lots, and sidewalks;

• Install fencing and gates for laydown yards;

• Install drainage improvements and BMP ponds;

• Install signage;

• Install acceleration and deceleration lanes on Pajarito Road for access into TA-46; and

• Construct new truck/warehouse access intersection from Pajarito Road into TA-46, and “slip” access into TA-63.

CP-34 – NF Site Excavation and Storm Pond

The Site Excavation and Storm Pond subcontract package includes furnishing all labor, materials, tools, and equipment to perform excavate the NF site and install the NF storm pond, as follows:

• Provide personnel and surveying equipment and perform construction surveying services to lay out NF excavation and ramps, and layout new storm pond adjacent to TA-50;

• Clear, grub, and excavate new storm pond, install new overflow weirs and concrete structures;

• Fine grade and seed area around new storm pond as required;

• Install underground piping and manhole structures from NF site to the new storm pond;

• Install temporary dewatering pump lift station and tie into storm pond underground drain piping;

• Install guardrail systems along the west RLUOB access road;

• Remove existing fence and structures on the south side of the NF excavation site;

• Excavate west earth wall to the south PIDAS fence as shown on drawings;

• Install rock anchors and shotcrete at the existing north and west earth faces of the NF excavation area adjacent to the PIDAS fences as required;

Request for Expression of Interest, Subcontract Page 3 of 4

• Excavate NF site to the top of basemat foundation elevation while installing rock anchor and shotcrete retaining wall system;

• Perform “neat line” cut for basemat foundation 6" outside the perimeter of the building. Excavate to 6" below the bottom elevation of the basemat. Install shotcrete as required on walls of excavation;

• Install 6-in.-thick concrete mud mat for the basemat;

• Supply excavated materials as backfill to the CP-03 Site Preparation subcontractor at TA-46 and

TA-63 as well as to the TA-48/-55 site development subcontractor;

• Develop area at TA-54 to receive excavated material from this construction package;

• Provide compaction and earth moving equipment at TA-54 to consolidate excavation spoils for excavated material that will be used for backfill around the NF building as part of CP-05;

• Install Best Management Practices (BMPs) based upon approved Storm Water Pollution

Prevention Plans and other environmental protection measures in the spoils area as they maintain the spoils site during the life of their contract;

• Deliver and stockpile all excess materials to at TA-54. Install 8" compacted gravel road base around perimeter of NF basemat excavation. Install ground deflection monitoring devices on perimeter of excavation as specified;

• Install ramps and rock anchor/shotcrete shoring systems to support NF site access ramps, including ramp extending into TA-48 laydown yards and craft trailer;

• Install compacted surfacing material on the access ramps as indicated in the design;

• Install barricades and guardrails on access ramps as required;

• Remove existing abandoned-in-place electrical duct bank at the NF construction site;

Install compacted earth pad and shoring systems to support temporary power distribution system on the north east corner of the NF site; and provide foundation for two tower cranes. Embeds for tower crane will be supplied by subcontractor of CP-28d.

Phasing of the work will be required. Subcontractor shall provide sufficient resources to complete the work in accordance with the Schedule. Multiple crews for activities should be considered. Anticipated duration to perform the Work is approximately one year. Coordination with other projects and other Subcontractors will be required.

SUBCONTRACTOR shall be responsible for full coordination of the individual and cumulative Work of CP Package CP-2, and CP-3, and CP-34. The Work shall be performed as one Subcontract.

The Work shall include:

• Location of Existing Utilities

• Survey and layout for all Work included within CP-2, CP-3 and CP-34.

• Clearing and Grubbing

• Storm Water Pollution Prevention Plan (SWPPP) Permit, Excavation/Fill Soil Disturbance Permit, Traffic Control Plan, Dust Control Plan and Air Quality Permit.

• Provision of SWPPP BMPS Installation, maintenance and removal of same.

• Independent Concrete Testing in accordance with the Subcontract Documents.

• Demolition.

• Cutting and capping of existing utilities.

• Excavation and backfill with approved materials, including required imported material.

• Provision of electrical duct bank, secure telecommunication duct banks and all grounding required by the Subcontract Documents.

• Water, Sanitary Sewer and Storm Sewer work.

• Traffic Control in accordance with Subcontractor’s LANL approved Traffic Control Plan.

• Piping pressure and video testing.

• Grounding testing.

Request for Expression of Interest, Subcontract Page 4 of 4

Exclusions to the Scope of Work:

• Furnish and install new power poles and 15 kV over cable from Puye Road, along the south side of Pajarito Road to TA-46.

• Demolition of the existing overhead power lines and poles running through the center of TA-46 and TA-63.

• Soil testing.

• Tie-in of utilities.

SAFETY PREREQUISITES:

Subcontractor must demonstrate safety performance equal to or lower than the following standards:

Statistical Standards

Experience Modification Rate

The “EMR” is a number that is assigned to your company based on the insurance premium you pay and your loss statistics. Contact your insurance company for these numbers.

Maximum Allowable Average:

1.00

Total Recordable Injury/Illness Case Rate

(from Company OSHA 300 log)

Rate =

Total Recordable Injuries/Illnesses x 200,000 Total Employee Hours Worked

Maximum

3.2

DART Case Rate (Days Away From Work, Restriction, or Job Transfer) (from Company

OSHA 300 log)

Rate =

Total Days Away/Restricted/Transferred Work Day Cases x 200,000

Total Employee Hours Worked

Maximum

1.4

Subcontractor Questionnaire Page 1 of 10 Rev. 02, Dated September 16, 2011 159564-RFP, CP-02, CP-03, & CP-34

SUBCONTRACTOR QUESTIONNAIRE

Enter Dun and Bradstreet (DUNS) Number:

1. GENERAL INFORMATION

NAME OF COMPANY (Full Legal Name)

STREET ADDRESS CITY - STATE - ZIP CODE

MAILING ADDRESS CITY - STATE - ZIP CODE

TELEPHONE FACSIMILE E-MAIL

WEBSITE TELEX/TWX/CABLE OTHER

A. Type of Business (check box or boxes) CORPORATION OR

COMPANY SUBSIDIARY DIVISION PARTNERSHIP

Name and location of Parent Company DUNS No.

If a Division, enter name and location of Corporate Headquarters

DUNS No.

If more than one DUNS number applies to your operation, attach additional explanatory page(s).

B. Type of Subcontractor (check box or boxes)

MANUFACTURER/

FABRICATOR* DISTRIBUTOR/

SUPPLY HOUSE* MANUFACTURERS

REPRESENTATIVE* GENERAL

CONTRACTOR

CONSTRUCTION* ARCHITECTURAL/

ENGINEERING* TECHNICAL

SERVICE* OTHER*

* Specialization/Description As Follows:

C. Enter Applicable SIC Codes:

D. Enter Applicable NAICS Codes (North America):

E. Date Business Founded: Under Present Ownership Since:

F. Number of Permanent Employees: Manual: Non-Manual:

G. Small, Disadvantaged, Women-Owned or Veteran Status (Reference Questionnaire - Appendix “A” For Definitions)

Check Applicable Boxes SMALL WOMEN-OWNED DISADVANTAGED: HUB ZONE

VETERAN OWNED SERVICE DISABLED VETERAN OWNED

2. FINANCIAL INFORMATION (This section MUST BE COMPLETED for consideration. Information is kept CONFIDENTIAL.)

A. Bank Name: Agent: Phone No.:

B. Annual Sales Volume (Last 3 Years):

Year:

20___ $ Year:

20___ $ Year:

20___ $

C. Present Net Worth

D. Can you furnish a Payment and Performance Bond? Yes No

If “Yes”, indicate Max Dollar Limit: $250,000 $500,000 $1,000,000 $5,000,000 $10,000,000 >$25,000,000

Surety Name: Agent: Phone No.:

E. If required, can you furnish a Bank Guarantee or Letter of Credit? Yes No

If “Yes”, indicate Max Dollar Limit: $250,000 $500,000 $1,000,000 $5,000,000 $10,000,000 >$25,000,000

Surety Name: Agent: Phone No.:

Subcontractor Questionnaire Page 2 of 10

F. Current Financial Ratios (Public companies only) Not Applicable Working Capital / Total Assets Retained Earnings / Total Assets

Earnings Before Interest and Taxes / Total Assets Market Value of Equity / Total Liabilities

Sales / Total Assets

G. Current Financial Ratios (Private companies only) Not Applicable (Current Assets-Current Liabilities) / Total Assets Retained Earnings / Total Assets

Earnings Before Interest and Taxes / Total Assets Book Value of Equity / Total Liabilities

Sales / Total Assets

3. PERSONNEL (State “Not Applicable” if the position does not exist )

A. President: D. QA/QC Manager:

B. Sales Manager: E. Field Support Manager:

C. Engineering Manager : F. Safety Manager:

4. LABOR RELATIONS

(List all crafts with which you have contracts and/or working agreements. Not Applicable

CRAFT EXPIRATION DATE CRAFT EXPIRATION DATE

1. 3.

2. 4.

5. QUALITY

A. Do you have a Quality Assurance/ program written to comply with the following:

Nuclear related activities – 10CFR 830, Subpart A and DOE Order O 414.1C, Contractor requirements document (Attachments 2, 3 and 4) as implemented through a quality assurance program compliant with ASME NQA-1-2008, with 2009 addenda.

Other: Specify_______________________________________________________________________________________________________ Non Nuclear related activities – 10 CFR 830, Subpart A and DOE Order O 414.1.C, Contractor requirements document (Attachments 2, 3 and 4) as implemented through a quality assurance program compliant with ISO 9001-2000 Other: Specify_______________________________________________________________________________________________________

Nuclear Yes No Other Certification (Please Specify)

ISO 9001 Yes No Other Certification (Please Specify)

For your Quality Assurance/Quality Control program(s), attach the Table of Contents from relevant manual(s) or, on additional pages, describe the method and level of compliance standard(s).

6. BIDDING INTEREST AND QUALIFICATIONS

A. Indicate your relevant experience and qualifications as described in the attached “Scope of Work”.

(Attach additional pages if necessary)

B. Indicate appropriate Contract/Purchase Order dollar range within which you prefer, and are currently able, to bid (i.e., $250,000 to $1,500,000)

$ to $

C. Indicate Industry or Code Certifications (ASME, API, TEMA, Class of Code-Stamp, etc.)

CERTIFICATION EXPIRATION DATE CERTIFICATION EXPIRATION DATE

1. 4.

2. 5.

3. 6.

Subcontractor Questionnaire Page 3 of 10

D. Subcontract Services (List type of work normally subcontracted to others)

7. PROFESSIONAL LICENSES

Indicate the work category you are licensed for and the area(s) (Country/State/Province) in which you hold each. Attach additional pages, if necessary.

TYPE OF LICENSE LOCATION TYPE OF LICENSE LOCATION

1. 4.

2. 5.

3. 6.

8. CONTRACTORS’ SPECIFIC NON-MANUAL, ENGINEERING, ARCHITECTURAL AND CONSTRUCTION TYPE LISTINGS:

A. List Personnel by Discipline (Number on Staff) – (State “Not Applicable” if the position does not exist )

Project Managers Structural Engineers Construction Inspectors

Administrators Sanitary Engineers Laborers

Estimators Transportation Engineers Carpenters

Architects Technical Writers Operators

Chemical Engineers Surveyors Painters

Electrical Engineers Superintendants Electricians

Mechanical Engineers Foremen Iron Workers

9. WORK HISTORY (Complete the attached Work History form per Appendix “B” and attach to this Questionnaire) Also attach a list of permanent offices and any brochures that further describe your company's activities and capabilities. Please do not include product catalogs, inventory or price lists.

10. SAFETY & HEALTH EXPERIENCE (Complete the attached S&H form per Appendix “C” and attach to this Questionnaire)

11. SOCIAL AND ENVIRONMENT SUSTAINABILITY INITIATIVES (Check all that are employed or achieved through company initiatives)

Written environmental policy Leadership in Energy and Environmental Design (LEED) Certification

Environmental performance integrated into corporate mission Policies and practices to minimize fuel usage or use of alternative energy

Social performance integrated into corporate mission Initiatives to mitigate environmental impacts of on-site services

Annual report detailing its mission-related performance (e.g. corporate social and environmental targets)

Code of conduct holding sub suppliers accountable for social and environmental performance

12. COMPLETED BY:

SIGNATURE TITLE

NAME DATE

APPENDICES:

APPENDIX “A” – GLOSSARY FOR SMALL, DISADVANTAGED, WOMEN-OWNED AND VETERAN ENTERPRISES

APPENDIX “B” – CONTRACTOR/SUPPLIER WORK HISTORY

APPENDIX “C” – CONTRACTOR SAFETY & HEALTH QUALIFICATION DATA

Subcontractor Questionnaire Page 4 of 10

APPENDIX A

GLOSSARY FOR SMALL, DISADVANTAGED, WOMEN-OWNED, AND VETERAN ENTERPRISES

Following are definitions of small business concerns, veteran-owned small business concerns, service-disabled veteran-owned small business concerns, HUB Zone small business concerns, minority business enterprises, small disadvantaged business concerns, women-owned small business concerns and labor surplus area business concerns (all called “Enterprises”) as defined by the U.S. Federal Acquisition Regulations:

Small-Business Concern Firms, including affiliates, that are independently owned and operated, not dominant in the field of operation in which they are bidding on Government contracts, and that qualify under the criteria and size standards for small businesses in 13 CFR Part 121 as determined by the SBA.

HUB Zone A historically underutilized business zone which is located within one or more qualified census tracts, qualified metropolitan counties, or lands within the external boundaries of an Indian reservation. HUBZone’s appear on the List of Qualified HUBZone Small Business Concerns maintained by the SBA.

Veteran-owned Small Business Concern

A small business concern – (1) not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and (2) the management and daily business operations of which are controlled by one or more veterans.

Service-disabled Veteran-owned small Business Concern

(1) A small business concern – (i) not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and (ii) The management and daily business operations of which are controlled by one or more service-disabled or, in the case of a veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. (2) Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16).

Small Disadvantaged Business Concern (Minority)

An offeror that represents, as part of its offer, that it is a small business under the size standard applicable to the acquisition; and either – It self certifies as a small disadvantaged business concern consistent with 13 CFR part 124, subpart B; and (i) No material change in disadvantaged ownership and control has occurred since its certification; (ii) Where the concern is owned by one or more disadvantaged individuals upon whom the certification is based does not exceed $750,000 after taking into account the applicable exclusions set forth at 13 CFR 124.104(c)(2); and (iii) It is identified, on the date of its representation, as a self certified small disadvantaged business concern in the database maintained by the SBA (Central Contractor Registration (CCR)).

Women-Owned Small Business Concern

A small business concern – 1) which is at least 51 percent owned by one or more women: or in the case of any publicly owned business, at least 51 percent of the stock which is owned by one or more women; and 2) whose management and daily operations are controlled by one or more women.

Subcontractor Questionnaire Page 5 of 10

APPENDIX B

SUBCONTRACTOR WORK HISTORY

The Contractor submits the following statement as to its experience qualifications:

1. If stated in the cover letter, provide only experience in work similar in type and magnitude to the identified Work Scope.

2. All awarded contracts have been satisfactorily completed, except as follows (Name any and all exceptions and reasons therefore, attaching additional pages if necessary):

3. The following contracts are currently in progress or have been satisfactorily completed within the last three years or the period specified in the cover letter.

4. If you have not worked in the country specified in the cover letter within the period outlined in 3 above, add a separate page listing any work ever performed in that country. [Item

4 does not apply to U.S. work.]

5. Column Completion Notes:

a. Name and Address. For past work, include an asterisk (*) to identify any work that required nuclear quality assurance.

b. Work Description. Describe work scope and then indicate if prime or subcontract.

c. Start/Stop. Provide starting date and actual/forecast completion by mo/yr, e.g., Jan 93/Sep94.

d. Schedule and Budget. State either "over", "on", or "under" the contract schedule and budget.

Contractor/SUPPLIER WORK HISTORY

Customer Name, address, representative and phone no.

Work Description Location Value Start/Stop Schedule Budget

Subcontractor Questionnaire Page 6 of 10

List any awarded Contracts/Purchase Orders that were not satisfactorily completed: (List any and all exceptions and reasons therefore, attaching additional pages if necessary):

Subcontractor Questionnaire Page 7 of 10

APPENDIX C

SUBCONTRACTOR SAFETY AND HEALTH QUALIFICATION DATA

NAME OF COMPANY:

The above named Company submits the following Safety & Health qualification data:

1. SAFETY PERFORMANCE

1.1.a Provide a brief description of each fatality your firm has incurred in the three most recent years (add pages if required):

Year 20[ ] Year 20[ ] Year 20[ ]

1.1.b Provide a brief description of each fatality by any sub-tier subcontractor working under your direction has incurred in the three most recent years (add pages if required):

Year 20[ ] Year 20[ ] Year 20[ ]

1.2.a Provide the following information on your firm for the three most recent years:

20[ ] 20[ ] 20[ ]

a. Number of lost workday cases.

b. Number of restricted workday cases.

c. Number of cases with medical attention only.

d. Number of fatalities.

e. Number of hours worked.

1.2.b Provide the following information on any sub-tier subcontractor working under your direction for the three most recent years:

20[ ] 20[ ] 20[ ]

a. Number of lost workday cases.

b. Number of restricted workday cases.

c. Number of cases with medical attention only.

d. Number of fatalities.

e. Number of hours worked.

Subcontractor Questionnaire Page 8 of 10

2. Are accident reports and report summaries sent to the following and how often?

No Yes Monthly Quarterly Annually

a. Project Superintendent/Site Manager.

b. Vice President/Manager of Construction

c. Safety Director

d. President of Firm

3. Do you hold site safety meetings for field employees both Manual and Non-Manual?

Yes No

How Often?

Weekly Bi-Weekly Monthly Less Often, As needed

4. Do you conduct project safety inspections?

If yes, who conducts this inspection?

TITLE HOW OFTEN?

5. How are accident records and accident summaries kept? How often are they reported?

No Yes Monthly Annually

a. Accidents totaled for the entire company

b. Accidents totaled by project

(1) Subtotaled by superintendent

(2) Subtotaled by foreman

6. How are costs of individual accidents kept? How often are they reported?

No Yes Monthly Annually

a. Costs totaled for the entire company

b. Costs totaled by project

(1) Subtotaled by superintendent

(2) Subtotaled by foreman

7. List key Safety and Health personnel planned for this project. Please list name and expected position. When a project has not been specified, list key company personnel.

NAME POSITION PROPOSED / CURRENT PROJECT

Subcontractor Questionnaire Page 9 of 10

8. Do you have a written safety & health program?

9. Do you have an orientation program for new hires?

If yes, submit a copy for evaluation. Does it include instruction on the following?

Yes No Yes No

a. Head protection i. Fire protection

b. Eye protection j. First aid facilities

c. Hearing protection k. Emergency procedures

d. Respiratory protection l. Toxic substances

e. Safety belts and lifeline m. Trenching and excavation

f. Scaffolding n. Signs, barricades, flagging

g. Perimeter guarding o. Electrical safety

h. Housekeeping p. Rigging and crane safety

q. Road Safety (Driving)

10. Do you have a program for newly hired or promoted foremen?

If yes, submit a copy for evaluation. Does it include the following?

Yes No Yes No

a. Safe work practices e. First aid procedures

b. Safety supervision f. Accident investigation

c. Toolbox meetings g. Fire protection and prevention

d. Emergency procedures h. New worker orientation

11. Do you hold craft “toolbox” safety meetings?

How Often?

Weekly Bi-Weekly Monthly Less Often, As needed

12. Do you have a written Hazard Communication program?

If yes, how is it implemented on each project?

Subcontractor Questionnaire Page 10 of 10

13. Do you have/require Material Safety Data Sheets (M.S.D.S.) for material/chemicals/equipment?

If yes, explain field procedure for informing craft workers about potential hazards:

14. List three (3) client references that could verify the quality and management commitment of your safety program.

Name Address Phone No.

a.

b.

c.

Subcontractor Quality Questionnaire Page 1 of 3 Rev. 00, Dated October 12, 2011 159564-RFP, CP-02, CP-03, & CP-34

SUPPLIER QUALITY ASSURANCE

QUESTIONNAIRE

Supplier or Sub-Tier Name:

Location/Address of Supplier facility (ies):

Product Description:

102385-SPEC-CON-002, -003, -034 – Items and Services Associated With NF Temporary Utilities for TA-46, TA-63 and CMRR Nuclear Facility (NF) Construction Site Areas; NF Site Preparation/Lay-Down Yards; CMRR NF Excavation In TA-55 and Storm Water Runoff Basin In TA-50 Does the manufacturer (distributors should obtain the assistance of the manufacturer to complete this) or contractor have a written Quality Assurance Program (QAP) Management System that is developed, implemented and maintained?

Yes No [Hint: Double-click on a box to default to checked, then cut and paste box for the rest of the answers.]

QA/QC MANUAL TITLE ________________________________

REVISION AND ISSUE DATE _________________

ATTACH A TABLE OF CONTENTS OR LISTING AND OTHER SUPPORTING INFORMATION TO THE QUESTIONNAIRE

QA/QC program table of contents and other supporting information attached? Yes No

IDENTIFY CODES AND/OR STANDARDS WITH WHICH YOUR QA/QC PROGRAM COMPLIES

Codes/Standards/Supplements Yes No Comments/Equivalent

1. DOE Order 414.1__ (identify version), Attachment 2

2. ASME NQA-1 ________ (identify year)

3. ASME Section _____ (Certificate No.___________)

4. ISO _______ (Certificate No. _____________)

5. What industry standards do you currently use to develop software/firmware? _______________________________

6. Other Codes and Standards:__________________________________________________________________

ASME NQA-1-2008/ASME NQA-1a-2009

Indicate whether your QA/QC Manual and/or implementing procedures address the following:

(Limited) ASME NQA-1 Program Elements Yes No Procedure/Manual

ASME NQA-1, Requirement 1, Organization (Section 100 only) ASME NQA-1, Requirement 2, Quality Assurance Program (Section 100 only) ASME NQA-1, Requirement 3, Design Control (Section 100 only) ASME NQA-1, Requirement 4, Procurement Document Control (Section 100 only) ASME NQA-1, Requirement 5, Instructions, Procedures, and Drawings (Section 100 only) ASME NQA-1, Requirement 6, Document Control (Section 100 only) ASME NQA-1, Requirement 7, Control of Purchased Items and Services (Section 100 only) ASME NQA-1, Requirement 8, Identification and Control of Items (Section 100 only) ASME NQA-1, Requirement 9, Control of Special Processes (Section 100 only)

Subcontractor Quality Questionnaire Page 2 of 3

(Limited) ASME NQA-1 Program Elements Yes No Procedure/Manual

ASME NQA-1, Requirement 10, Inspection (Section 100 only) ASME NQA-1, Requirement 11, Test Control (Section 100 only) ASME NQA-1, Requirement 12, Control of Measuring and Test Equipment (Section 100 only) ASME NQA-1, Requirement 13, Handling, Storage, and Shipping (Section 100 only) ASME NQA-1, Requirement 14, Inspection, Test, and Operating Status (Section 100 only) ASME NQA-1, Requirement 15, Control of Nonconforming Items (Section 100 only) ASME NQA-1, Requirement 16, Corrective Action (Section 100 only) ASME NQA-1, Requirement 17, Quality Assurance Records (Section 100 only) ASME NQA-1, Requirement 18, Audits (Section 100 only)(Assessments may be substituted for audits)

DOE ORDER 414.1

Indicate whether your QA/QC Manual and/or implementing procedures address the following:

DOE ORDER 414.1 Requirement Yes No Procedure/Manual DOE Order 414.1, Attachment 2, Quality Assurance Criterion (1) - Program Establish an organizational structure, functional responsibilities, levels of authority, and interfaces for those managing, performing, and assessing work. Establish management processes, including planning, scheduling, and providing resources for work.

(An NQA-1 QA program will need to describe the management process for providing resources.)

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (2) - Personnel Training and Qualification Train and qualify personnel to be capable of performing assigned work. Provide continuing training to personnel to maintain job proficiency.

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (3) - Quality Improvement Establish and implement processes to detect and prevent quality problems. Identify, control, and correct items, services, and processes that do not meet established requirements.

Identify the causes of problems and work to prevent them. Review item characteristics, process implementation, and other quality-related information to identify items, services, and processes needing improvement.

(The DOE Order extends the requirements of NQA-1 to all problems including all conditions [not limited to significant] adverse to quality and to all nonconforming items [not limited to generic]).

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (4) - Documents and Records Prepare, review, approve, issue, use, and revise documents to prescribe processes, specify requirements, or establish design. Specify, prepare, review, approve, and maintain records.

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (5) - Work Processes Perform work consistent with technical standards, administrative controls, and hazard controls adopted to meet regulatory or contract requirements using approved instructions, procedures, etc. Identify and control items to ensure their proper use. Maintain items to prevent their damage, loss, or deterioration. Calibrate and maintain equipment used for process monitoring or data collection.

Subcontractor Quality Questionnaire Page 3 of 3

DOE ORDER 414.1 Requirement Yes No Procedure/Manual

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (6) - Design Design items and processes using sound engineering/scientific principles and appropriate standards. Incorporate applicable requirements and design bases in design work and design changes. Identify and control design interfaces. Verify/validate the adequacy of design products using individuals or groups other than those who performed the work.

Verify/validate work before approval and implementation of the design.

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (7) - Procurement Procure items and services that meet established requirements and perform as specified.

Evaluate and select prospective suppliers on the basis of specified criteria. Establish and implement processes to ensure that approved suppliers continue to provide acceptable items and services.

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (8) - Inspection and Acceptance Testing Inspect and test specified items, services, and processes using established acceptance and performance criteria. Calibrate and maintain equipment used for inspections and tests.

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (9) - Management Assessment Ensure that managers assess their management processes and identify and correct problems that hinder the organization from achieving its objectives.

DOE Order 414.1, Attachment 2, Quality Assurance Criterion (10) - Independent Assessment Plan and conduct independent assessments to measure item and service quality and the adequacy of work performance and to promote improvement. Establish sufficient authority and freedom from line management for independent assessment teams. Ensure that persons conducting independent assessments are technically qualified and knowledgeable in the areas to be assessed.

DOE Order 414.1, Suspect/Counterfeit Items Preventing the introduction and use of S/CIs through engineering involvement, design, procurement, testing, inspection, maintenance, evaluation, disposition, reporting, trend analysis, and lessons learned work process controls. Training and informing managers, supervisors, and workers on S/CI processes and controls (including prevention, detection, and disposition of S/CIs). Identifying and disposing of S/CIs on site. Restricting S/CI use to only those items that have been found acceptable through engineering analysis and formal disposition process. Collecting, maintaining, disseminating, and using the most accurate, up-to-date information on S/CIs and associated suppliers using all available sources.

(An NQA-1 QA program will need to be expanded to address Suspect/Counterfeit items.)

General

Preparer_____________________ Signature_______________ Title________________________ Date_________

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If no, please provide your comments or suggestions. Also, provide any additional information relevant to your quality assurance program.