161107 Attachments.pdf

ATTACHMENT _____

State Corporation Commission Form Failure to complete and return this attachment may result in your bid being REJECTED or deemed NON-RESPONSIVE.

Solicitation #:

Virginia State Corporation Commission (SCC) registration information.

The bidder:

is a corporation or other business entity with the following SCC identification number:

-OR-

is not a corporation, limited liability company, limited partnership, registered limited liability partnership, or business trust -OR-is an out-of-state business entity that does not regularly and continuously maintain as part of its ordinary and customary business any employees, agents, offices, facilities, or inventories in Virginia (not counting any employees or agents in Virginia who merely solicit orders that require acceptance outside Virginia before they become contracts, and not counting any incidental presence of the bidder in Virginia that is needed in order to assemble, maintain, and repair goods in accordance with the contracts by which such goods were sold and shipped into Virginia from bidder’s out-of-state location) -OR-is an out-of-state business entity that is including with this bid an opinion of legal counsel which accurately and completely discloses the undersigned bidder’s current contacts with Virginia and describes why those contacts do not constitute the transaction of business in Virginia within the meaning of § 13.1-757 or other similar provisions in Titles

13.1 or 50 of the Code of Virginia.

**NOTE** >> Check the following box if you have not completed any of the foregoing options but currently have pending before the SCC an application for authority to transact business in the Commonwealth of Virginia and wish to be considered for a waiver to allow you to submit the SCC identification number after the due date for bids (the Commonwealth reserves the right to determine in its sole discretion whether to allow such waiver):

A

SBSP-IFB PIM-40

Small Business Subcontracting Plan

IFB # ____________

It is the goal of the Commonwealth that over 42% of its purchases be made from small businesses. All potential bidders are required to include this document with their bid response in order to be considered responsive.

Small Business: "Small business (including micro)” means a business which holds a certification as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD) on the due date for bids.

This shall also include DSBSD-certified women- owned and minority-owned businesses and businesses with DSBSD service disabled veteran owned status when they also hold a DSBSD certification as a small business on the bid due date. Currently, DSBSD offers small business certification and micro business designation to firms that qualify.

Certification applications are available through DSBSD online at www.SBSD.virginia.gov (Customer Service).

Bidder Name:

Preparer Name: Date:

Who will be doing the work: □ I plan to use subcontractors □ I plan to complete all work

Instructions A. If you are certified by the DSBSD as a micro/small business, complete only Section A of this form.

B. If you are not a DSBSD-certified small business, complete Section B of this form. For the bid to be considered and the bidder to be declared responsive, the bidder shall identify the portions of the contract that will be subcontracted to DSBSD-certified small business for the initial contract period in relation to the bidder’s total price for the initial contract period in Section B.

Section A If your firm is certified by the DSBSD provide your certification number and the date of certification.

Certification number: Certification Date:

Section B If the “I plan to use subcontractors box is checked,” populate the requested information below, per subcontractor to show your firm's plans for utilization of DSBSD-certified small businesses in the performance of this contract for the initial contract period in relation to the bidder’s total price for the initial contract period. Certified small businesses include but are not limited to DSBSD-certified women-owned and minority-owned businesses and businesses with DSBSD service disabled veteran-owned status that have also received the DSBSD small business certification. Include plans to utilize small businesses as part of joint ventures, partnerships, subcontractors, suppliers, etc. It is important to note that these proposed participation will be incorporated into the subsequent contract and will be a requirement of the contract. Failure to obtain the proposed participation percentages may result in breach of the contract.

B

SBSP-IFB PIM-40

B. Plans for Utilization of DSBSD-Certified Small Businesses for this Procurement

Subcontract #1

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #2

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #3

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #4

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #5

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

ATTACHMENT ______

Solicitation #:

SUBCONTRACTOR APPROVAL REQUEST

No portion of the work (including equipment) shall be subcontracted to another firm or individual without prior written consent of Virginia Department of Transportation (herein referred to as VDOT). In the event that the contractor desires to subcontract some part of the work specified herein, the contractor shall furnish VDOT with the names, qualifications, and experience of their proposed subcontractors for agency approval. The primary contractor shall, however, remain fully liable and responsible for the work performed by its subcontractor(s) and shall assure compliance with all requirements of the contract.

List proposed subcontractor(s), including name, address, contact person, and type of work to be performed under this contract below.

FIRM INDIVIDUAL’S

NAME & ADDRESS

CONTACT PERSON AND

PHONE NUMBER

TYPE OF WORK TO BE

PERFORMED

TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE

QUALIFICATIONS / EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR

Please indicate which above proposed subcontractors are certified (with DSBSD) as Small, Women Owned or Minority Businesses.

Certification Number(s):

FOR VDOT USE ONLY:

The proposed subcontractor(s) listed above is/are approved and accepted under the terms and conditions of the contract requirements herein.

Signature of Authorized VDOT Representative Date Telephone Number

C

ATTACHMENT ____

NORMAL AND EMERGENCY CONTACTS

Solicitation # ___________

Send Contracts To:

Bidder's Name/Title

Primary Phone Number

Bidder's Mailing Address E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

D

Solicitation # ____________

REFERENCES

Bidders should provide a list of at least 3 references where similar goods and/or services have been provided. Each reference shall include the name of the organization, the complete mailing address, the name of the contact person, the email, and the telephone/fax number.

FIRM’S NAME AND ADDRESS CONTACT PERSON EMAIL ADDRESS TELEPHONE / FAX #

E

ATTACHMENT ____

CONTRACTOR/SUBCONTRACTOR LICENSE REQUIREMENT

Solicitation #: ___________

By my signature on this solicitation, I certify that this firm/individual and subcontractors is properly licensed for providing the goods/services specified. Furthermore, the contractor and subcontractors shall maintain the required license throughout the term of the contract. The contractor or their subcontractor shall immediately notify the contracting agency in writing in the event the license has been revoked.

Contractor Name: _____________________________________

License # _________________ Type ________________

Subcontractor Name: _________________________

License # _________________ Type ________________

CONTRACTOR REGISTRATION: If a contract for construction, removal, repair or improvement of a building or other real property is for $120,000 or more, or if the total value of all such contracts undertaken by bidder within any 12-month period is $750,000 or more, the bidder is required under Title 54.1-1100, Code of Virginia (1950), as amended, to be licensed by the State Board of Contractors a “CLASS A CONTRACTOR.” If such a contract is for $10,000 or more but less than $120,000, or if the total value of all such contracts undertaken by bidder within any 12-month period is $150,000or more, but less than $750,000 or more, the bidder is required to be licensed as a “CLASS B CONTRACTOR.” If such a contract is over $1,000 but less than $10,000, or if the contractor does less than $150,000 in business in a 12-month period, the bidder is required to be licensed as a “CLASS C CONTRACTOR.” The board shall require a master tradesmen license as a condition of licensure for electrical, plumbing and heating, ventilation and air conditioning contractors. The bidder shall place on the outside of the envelope containing the bid and shall place in the bid over his signature whichever of the following notations is appropriate, inserting his contractor license number:

Licensed Class A Virginia Contractor No. _______________Specialty _______________

Licensed Class B Virginia Contractor No. _______________Specialty _______________

Licensed Class C Virginia Contractor No. _______________Specialty _______________

If the bidder shall fail to provide this information with his bid and shall fail to promptly provide said contractor license number to the Commonwealth in writing when requested to do so before or after the opening of bids, he shall be deemed to be in violation of § 54.1-1115 of the Code of Virginia (1950), as amended, and his bid will not be considered.

If a bidder shall fail to obtain the required license prior to submission of his bid, the bid shall not be considered

F

COMMONWEALTH of VIRGINIA

DEPARTMENT OF LABOR AND INDUSTRY

Virginia Department of Labor and Industry Wage Determination Decision

Project Name General Contractor Service

State Project Code IFB 161107

DOLI Project Number VDOT-26-0158 UPDATE

County or Independent City Multiple Localities

Publication Date 8/10/2026

Construction Type Building

BLAND COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

James S. Frederick

COMMISSIONER

Brookfield Place 6606 West Broad Street, Suite 500

Richmond, Virginia 23230

PHONE (804) 371-2327

FAX (804) 371-6524

ATTACHMENT G

PREVAILING WAGE RATE DETERMINATION(S)

BUCHANAN COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

DICKENSON COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

GRAYSON COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48

Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

LEE COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

RUSSELL COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44

Truck Driver: Dump Truck $12.77 $0.57

SCOTT COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Boilermaker $38.97 $27.39 Bricklayer $23.54 $6.73 Carpenter $14.68 Electrician $21.78 $9.31 Ironworker: Reinforcing $25.36 $6.68 Ironworker: Structural and Ornamental $37.86 $25.86 Laborer: Common or General $12.77 Laborer: Mason Tender - Brick $13.41 $3.15 Laborer: Mason Tender - Cement/Concrete $15.32 Laborer: Pipelayer $12.77 $1.17 Operator: Backhoe/Excavator/Trackhoe $16.24 $0.87 Operator: Bobcat/Skid Steer/Skid Loader $18.95 $4.03 Operator: Bulldozer $16.00 Operator: Forklift $19.40 $7.00 Operator: Loader $21.28 $3.17 Operator: Roller $16.25 $4.88 Painter: Brush and Roller $20.01 Painter: Spray Only $29.16 $11.86 Pipefitter $40.25 $20.29 Plumber $21.15 $3.92 Power Equipment Operator: Cranes 90 Tons & Over Capacity; Tower & Climbing Cranes With Controls 100 Ft. Above Ground $40.99 $18.05 Power Equipment Operator: Cranes Under 90 Tons $39.99 $18.05 Roofer $16.17 $3.73 Sheet Metal Worker (Includes HVAC Duct Installation) $18.38 $3.30 Tile Finisher $23.40 Tile Setter $27.80 $10.25 Truck Driver: Dump Truck $16.58 $1.73

SMYTH COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17

Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

TAZEWELL COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

WASHINGTON COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Boilermaker $38.97 $27.39 Bricklayer $23.54 $6.73 Carpenter $14.68 Electrician $21.78 $9.31

Firestopper (Includes the application of materials or devices within or around penetrations and openings in all rated wall or floor assemblies, in order to prevent the passage of fire, smoke of other gases. The application includes all components involved in creating the rated barrier at perimeter slab edges and exterior cavities, the head of gypsum board or concrete walls, joints between rated wall or floor components, sealing of penetrating items and blank openings.)** $30.21 $10.43 Ironworker: Reinforcing $25.36 $6.68 Ironworker: Structural and Ornamental $37.86 $25.86 Laborer: Common or General $12.77 Laborer: Mason Tender - Brick $13.41 $3.15 Laborer: Mason Tender - Cement/Concrete $15.32 Laborer: Pipelayer $12.77 $1.17 Operator: Backhoe/Excavator/Trackhoe $16.24 $0.87 Operator: Bobcat/Skid Steer/Skid Loader $18.95 $4.03 Operator: Bulldozer $16.00 Operator: Forklift $19.40 $7.00 Operator: Loader $21.28 $3.17 Operator: Roller $16.25 $4.88 Painter: Brush and Roller $20.01 Painter: Spray Only $29.16 $11.86 Pipefitter $40.25 $20.29 Plumber $21.15 $3.92 Power Equipment Operator: Cranes 90 Tons & Over Capacity; Tower & Climbing Cranes With Controls 100 Ft. Above Ground $40.99 $18.05 Power Equipment Operator: Cranes Under 90 Tons $39.99 $18.05 Roofer $16.17 $3.73 Sheet Metal Worker (Includes HVAC Duct Installation) $18.38 $3.30 Tile Finisher $23.40 Tile Setter $27.80 $10.25 Truck Driver: Dump Truck $16.58 $1.73

WISE COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrical Installer (Sound and Communication System) $20.00 $2.00 Electrician $37.95 $18.02 Glazier $16.95 $2.48 Laborer: Common or General $12.77

Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

WYTHE COUNTY

Wage Determinations Wage Fringe Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* $40.77 $20.17 Carpenter $15.84 $1.42 Electrician $37.95 $18.02

Firestopper (Includes the application of materials or devices within or around penetrations and openings in all rated wall or floor assemblies, in order to prevent the passage of fire, smoke of other gases. The application includes all components involved in creating the rated barrier at perimeter slab edges and exterior cavities, the head of gypsum board or concrete walls, joints between rated wall or floor components, sealing of penetrating items and blank openings.)** $30.21 $10.43 Glazier $16.95 $2.48 Laborer: Common or General $12.77 Operator: Backhoe/Excavator/Trackhoe $12.77 $0.50 Pipefitter $20.89 $6.63 Plumber $18.45 $3.05 Power Equipment Operator: Bulldozer $38.79 $18.05 Roofer $15.56 $3.06 Sheet Metal Worker (HVAC Duct Installation Only) $17.73 $6.44 Truck Driver: Dump Truck $12.77 $0.57

FRINGE

*Asbestos Worker/Heat & Frost Insulator: Mechanical (Duct, Pipe & Mechanical System Insulation)* A. Paid Holidays: New Year’s Day, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Veterans' Day, Thanksgiving Day, the day after Thanksgiving and Christmas Day provided the employee works the regular workday before and after the paid holiday*

**Firestopper** A. Paid Holidays: New Year’s Day, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Veterans' Day, Thanksgiving Day, the day after Thanksgiving and Christmas Day provided the employee works the regular workday before and after the paid holiday**

ADDITIONAL NOTES

All rates are determined by DOLI and any appeals of specific classifications may be made through the Wage Determination Appeal form available at https://www.doli.virginia.gov/wp-content/uploads/2022/05/Appeal-for-Clarification-of-Wage-Determination.pdf

Any additional classifications may be requested through the Additional Wage Classification form available at https://www.doli.virginia.gov/wp-content/uploads/2022/10/Request-for-Additional-Wage-Classification-10-2022.pdf

Understand your duties as a contractor under Virginia law by referencing our Contractor Responsibilities information sheet available at https://doli.virginia.gov/prevailing-wage-law/#CR

Your employees have specific rights, which can be found on our List of Employee Rights information sheet available at https://doli.virginia.gov/prevailing-wage-law/#ERB

Any further questions should be directed to PrevailingWage@doli.virginia.gov

ATTACHMENT H

VDOT BRISTOL DISTRICT LOCATIONS

Lot 1

Abingdon Residency:

Washington County

Abingdon Area Headquarters and Shop

14381 Enterprise Road

Abingdon, VA 24210

Greendale Area Headquarters

15190 Rich Valley Road

Abingdon, VA 24210

Abingdon Residency

700 East Main St

Abingdon, VA 24212

Konnarock sub AHQ

21671 Azen Road

Damascus, VA 24236

Bristol District Complex

2111 Bonham Rd

Bristol, VA 24201

North Bristol Area Headquarters

9495 Reedy Creek Road

Bristol, VA 24201

Glade Spring sub-station

34397 Lee Highway

Glade Spring, VA 24340

Smyth County

Broadford Sub Area Headquarters

4581 Sagewood Lane

Saltville, VA 24370

Marion Area Headquarters

729 Matson Drive

Marion, VA 24354

Chilhowie Area Headquarters

154 Shop Road

Chilhowie, VA 24319

Sugar Grove sub-station

218 Dickey’s Creek Road

Sugar Grove, VA 24375

Wytheville Residency:

Bland County

Bland Area Headquarters

159 Seddon Street

Bland, VA 24315

Rt. 717 Chemical Storage Building

2211 Krenning Rd

Wytheville, VA 24382

Rocky Gap Sub Area Headquarters

7146 N. Scenic Highway

Bastian, VA 24314

Grayson County

Baywood Area Headquarters

120 State Shed Lane

Galax, VA 24333

Independence Sub Area Headquarters

125 Klondike

Independence, VA 24348

Elk Creek Sub Area Headquarters

706 Victory Lane

Elk Creek, VA 24326

Volney Area Headquarters

3290 Troutdale Highway

Mouth of Wilson, VA 24363

Wythe County

Fort Chiswell Area Headquarters

251 Apache Run

Max Meadows, VA 24360

Wytheville Residency (new) and AHQ

2843 Chapman Road

Wytheville, VA 24382

Speedwell Area Headquarters

187 Spraker Road

Crockett, VA 24323

Wytheville Residency (old)

1960 West Lee Highway

Wytheville, VA 24382

Lot 2:

Lebanon Residency:

Buchanan County

Big Rock Area Headquarters

2531 Home Creek Road

Grundy, VA 24614

Oakwood Area Headquarters and shop

12644 Riverside Drive

Oakwood, VA 24631

Deskins Area Headquarters

1185 Deskins Housing Drive

Vansant, VA 24656

Russell County

Blackford Area Headquarters

2831 Red Bud Highway

Honaker, VA 24260

Lebanon Residency

1067 Fincastle Road

Lebanon, VA 24266

High Point Area Headquarters

5663 High Point Road

Castlewood, VA 24224

Tazewell County

Claypool Hill Area Headquarters

12518 Gov. George C. Peery Highway

Pounding Mill, VA 24637

Springville Area Headquarters

2401 Lynn Hollow Road

North Tazewell, VA 24630

Claypool Hill Shop

511 Drews Lane

Pounding Mill, VA 24637

Tazewell Residency

715 E. Riverside Drive

Tazewell, VA 24651

Wise Residency:

Dickenson County

Fremont Area Headquarters

433 Dante Mountain Road

Clinchco, VA 24226

New Fremont Headquarters

1075 Caney Ridge Rd

Clintwood, VA 24228

Lee County

Dryden Area Headquarters

131 Lewis Heights Road

Dryden, VA 24243

Jonesville Residency

32000 Wilderness Road

Jonesville, VA 24263

Ewing Area Headquarters

453 Giles Hollow Road

Rose Hill, VA 24281

Scott County

Fort Blackmore Area Headquarters

8833 Veterans Memorial Highway

Fort Blackmore, VA 24250

Nickelsville Area Headquarters

12526 Nickelsville Highway

Nickelsville, VA 24271

Gate City Area Headquarters

185 Bristol Highway

Weber City, VA 24290

Pattonsville Area Headquarters

4096 Purchase Ridge Road

Duffield, VA 24244

Wise County

Coeburn Area Headquarters

3701 Dungannon Road

Coeburn, VA 24230

Glamorgan Area Headquarters

7204 Indian Creek Road

Wise, VA 24293

East Stone Gap Area Headquarters

1929 Tate Springs Road

Big Stone Gap, VA 24219

Wise Residency and Shop

703 Hurricane Road NE

Wise, VA 24293

CII/SSI Guide, Version 8, July 18, 2024 Page 1 Copyright 2005 by Virginia Department of Transportation, SEMD

CII/SSI Policy Guide

For

Employees, Vendors, Contractors or other

Persons Accessing VDOT’s CII/SSI

An Accompanying Guide to CII/SSI Policy Version 8.0, 18, July 2024

ATTACHMENT I

CII/SSI POLICY GUIDE

CII/SSI Guide, Version 8, July 18, 2024 Page 2

Table of Contents

I. PURPOSE

II. GUIDELINES FOR DESIGNATING AND MARKING VDOT INFORMATION AS CII/SSI

Designating CII/SSI Marking CII/SSI Marking Maritime Related SSI

III. GUIDELINES FOR HANDLING, STORING AND REPRODUCING CII/SSI

IV. GUIDELINES FOR RELEASING DOCUMENTS DESIGNATED AS CII/SSI

V. SAMPLE DOCUMENTS

Frequently Asked Questions Quick Reference to Identifying CII/SSI CII/SSI Designation Decision Flowchart Multi-Purpose Non-Disclosure Agreement

NOTE: The Multi-Purpose Non-Disclosure Agreement form included in this document is a sample form and should not be used as the actual form. The actual Multi-Purpose Non-Disclosure

Agreement form may be downloaded from the Inside VDOT Forms page.

CII/SSI Guide

CII/SSI Guide, Version 8, July 18, 2024 Page 3

I. Purpose

This Guide will provide general guidance the user/originator can use to designate CII/SSI in your sections and develop specific procedures for handling, marking, disseminating, releasing, and destroying CII/SSI.

You will also find samples of the forms that should be used in the aforementioned processes.

Critical infrastructure is a system or asset so vital that its incapacity or destruction would have a debilitating impact on security, economic security, public health or safety. Critical infrastructure information (CII) is the designation used by VDOT to identify information that is not appropriate for public release without a need-to-know. Sensitive security information (SSI) is the designation used to identify information related to maritime critical infrastructure that is not appropriate for public release without a need-to-know.

A page containing Frequently Asked Questions has been included in this Guide for your reference. If you have questions that are not answered in this guide, you may submit your questions to your contract manager. VDOT employees may submit questions via email, to

CriticalInfrastructure@VDOT.Virginia.gov .

II. Guidelines for Designating and Marking VDOT Information as CII/SSI

Designating CII/SSI

Each Manager should perform a review of the documents in his/her custody to determine if the document contains CII/SSI and ensure proper markings are affixed. Additionally each vendor/contractor should review documents created in connection with the VDOT contract to ensure CII/SSI is properly marked and handled. This Guide contains a CII/SSI Designation Decision Process flowchart and Quick Reference document to provide you with the necessary tools in determining proper CII/SSI designation.

Marking CII/SSI

Once a document has been designated as CII/SSI, it should be marked according to the following:

It is the responsibility of the document originator; VDOT employee or contractor/vendor to make sure that

CII/SSI contained within the document is identified and marked, whether it has been previously marked or not. However, if you are the person handling a document which you feel contains CII/SSI and the document has not been properly marked; please refer the document back to the originator for designation and proper marking.

The marking shown below (frame and format optional) should be placed appropriately on all pages or sections containing CII material. It should be located either at the top or bottom of the page consistently throughout the document. The format and arrangement of the words may be modified to accommodate different situations but the wording should remain consistent. Appropriate font color needs to be utilized to ensure the markings are readily visible.

– Restricted – Critical Infrastructure Information

CII/SSI Guide, Version 8, July 18, 2024 Page 4

Marking Maritime Related SSI

Documents designated as SSI should be marked at the top of every page in the document and at the following locations in the document:

• The outside of any front cover,

• The outside of any back cover,

• Any binder cover or folder (front and back)

• Any title page

The marking at the top of the page should be:

Sensitive Security Information

The marking at the bottom of each page of the document should be:

WARNING: This record contains Sensitive Security Information that is controlled under 49 CFR parts 15 and 1520. No part of this record may be disclosed to persons without a ‘‘need-to-know’’, as defined in 49 CFR parts 15 and 1520, except with the written permission of the Administrator of the Transportation Security Administration or the Secretary of Transportation. Unauthorized release may result in civil penalty or other action. For U.S. government agencies, public disclosure is governed by 5 U.S.C. 552 and 49 CFR parts 15 and 1520.

III. Guidelines for Handling, Storing and Reproducing CII/SSI

CII/SSI shall be protected at all times, either by appropriate storage or having it under the personal observation and control of a person authorized to receive it. Each person who works with protected

CII/SSI is personally responsible for taking proper precautions to ensure that unauthorized persons do not gain access to it.

During working hours, reasonable steps shall be taken to minimize the risks of access to CII/SSI by unauthorized personnel. After working hours, CII/SSI shall be stored in a secure container, such as a locked desk, file cabinet or facility where contract security is provided.

CII/SSI shall be transmitted only by VDOT courier, US first class, express, certified or registered mail, or through secure electronic means.

CII/SSI in electronic format should be released in a protected format such as a locked PDF or password protected WORD document.

Material containing CII/SSI shall be disposed of by any method that prevents unauthorized retrieval and in accordance with established records retention policy.

Documents or materials containing CII/SSI may be reproduced to the minimum extent necessary to carry out official duties provided that the reproduced material is marked and protected in the same manner as the original material.

IV. Guidelines for releasing documents designated as CII/SSI

Before CII/SSI can be released the following criteria need to be met;

• The requestor has a need-to-know the information, CII/SSI Guide, Version 8, July 18, 2024 Page 5 Copyright 2005 by Virginia Department of Transportation, SEMD

• The requestor has been cleared for access to CII/SSI material through VDOT’s Criminal History

Records Check process as required in DPM: 1-25,

• And the requestor completes and signs a Non Disclosure Agreement Form (NDA).

If the requestor does not have a need-to-know, refuses to sign the NDA form or does not meet the requirements outlined in DPM 1-25 do not release the information to them. If the requestor takes issue with this decision contact the contract manager if the request is contract related. For contract managers or if the request is not contract related please submit questions to

CriticalInfrastructure@VDOT.Virginia.gov.

When non-disclosure agreements are completed for VDOT employees the signed non-disclosure agreements should be returned to the Human Resource Department to be filed in the employee’s personnel folder. Contractor or Vendor NDA forms are to be maintained by the VDOT Contract Officer and should be filed with the procurement documents. When NDA forms are completed to release CII/SSI to a non-employee, contractor, or vendor the NDA form shall be maintained by the releasing custodian of the CII/SSI. A sample non-disclosure agreement has been included for your reference.

V. References and Forms

This Guide contains the following references:

• Frequently Asked Questions

• Quick Reference to Identifying CII/SSI

• CII/SSI Designation Decision Process flowchart

This Guide contains the following sample Form:

• Non-Disclosure Agreement

CII/SSI Guide, Version 8, July 18, 2024 Page 6

Frequently Asked Questions

1. What is CII?

Critical infrastructure information (CII) is the designation used by VDOT to identify information that is not appropriate for public release without a need-to-know.

2. What is SSI?

Sensitive security information (SSI) is the designation used to identify information related to maritime critical infrastructure that is not appropriate for public release without a need-to-know.

3. What is need-to-know?

The legitimate requirement of a person or organization to know, access, or possess sensitive or classified information that is critical to the performance of an authorized, assigned mission (i.e. a VDOT related project). The necessity for access to, or knowledge or possession of, specific information required to carry out official duties. The information is intended for use only by individuals who require the information in the course of performing their job function.

4. What is Public Knowledge?

Information about which knowledge or use is accessible to the general public if there has been no deliberate attempt to keep it hidden or secret. Knowledge that is available to anyone. Something might be considered public knowledge if it could be seen in a public area versus being located in a locked or non-public area. In some instances, the object itself may be public knowledge but it’s location or use in that specific instance is not (e.g., an electrical panel in a reception area is recognizable and not hidden but, if the panel is locked, what the various circuit breakers control is not public knowledge).

For example, if a circuit breaker box is located in the lobby of a building, the location of that box would not be CII/SSI.

However, the identification of the circuits/devices controlled by the breakers in the box might be CII/SS depending on the function of the devices controlled by the individual breakers (Security Systems, Alarm Systems, etc.). If the box is located in a locked room in an area not normally open to the public, it could be considered CII/SSI.

5. Who has to do the review and marking?

It is the responsibility of the document creator to review the document for potential CII/SSI information and to mark the document accordingly. If a document recipient receives a document which contains CII/SSI information the recipient should forward the document back to the creator for proper marking.

6. Can A/E firms mark CII/SSI as the plans/specs are developed?

The Contract Officer should inform the A/E firm at the time the contract is awarded that the project contains CII/SSI and the firm’s responsibilities for marking information. As such, plans/specifications must be marked accordingly as they are developed. A/E firms, or any other outside entity, who work as agents of VDOT must mark the CII/SSI in accordance with the

Policy.

7. Can Vendors or Contractors release CII/SSI information to third parties?

Vendors and Contractors can release CII/SSI to business partners or sub-contractors in connection with work performed under the terms of the contract only if a need-to-know has been established. The Vendor or Contractor will notify the VDOT Contract

Officer who will ensure the Non Disclosure Agreement form is completed and the protocols outlined in DPM 1-25 are followed prior to the release of the CII/SSI.

8. What about solicitations that involve information and site visits that contain/show CII/SSI?

The current approach to handling CII/SSI in public advertisements:

• Do not include CII/SSI in the public advertisement.

The current approach to handling CII/SSI in pre-bid meetings:

• Require pre-registration for a mandatory pre-bid conference.

• Obtain signed non-disclosure agreements and verify identity with photo-id of all participants prior to allowing entry into the pre-bid meeting.

CII/SSI Guide, Version 8, July 18, 2024 Page 7 Copyright 2005 by Virginia Department of Transportation, SEMD

• Sanitize CII/SSI material to work being solicited and to the extent needed to prepare a formal bid.

• Monitor pre-bid meeting and conduct site visits at the time of the pre-bid.

• Collect and account for all CII/SSI material after pre-bid meeting (no take away documents)

• Limit access and photography to that which is necessary to prepare a formal bid.

Note: By following the guidance above, access to the CII/SSI material is “restricted” and therefore no Criminal History

Records Check is required as indicated in DPM 1-25. If the guidance above is not followed, or if the extent of the project requires the contractors or vendors to leave the pre-bid meeting with the CII/SSI material then the access becomes

“unrestricted” and a Criminal History Records Check is required as indicated in DPM 1-25.

CII/SSI Guide, Version 8, July 18, 2024 Page 8

Quick Reference to Identifying CII/SSI

Information identified as either Critical Infrastructure Information or Sensitive Security Information (CII/SSI) should be marked as specified in the CII/SSI Policy.

Points to consider when determining what constitutes CII/SSI…

• What impact could the information have if it was inadvertently transferred to an unintended audience?

• Does the information provide details concerning security procedures and capabilities?

• Could someone use the information to target personnel, facilities or operations?

• How could someone intent on causing harm misuse the information?

• Could the use of this information be dangerous if combined with other publicly available information?

• Look at the material from an adversary’s point of view.

Answer the following: Y/N

Is the information customarily public knowledge? (Information that is accessible to the general public if there has been no deliberate attempt to keep it hidden or secret.)

Does the general public have a need to know? (Access to, or knowledge or possession of, specific information required to carry out official duties ) (Note: Contractors should be considered employees, not general public.)

If “yes” to either, then it is not CII/SSI, otherwise continue.

If the item under consideration shows describes or is itself listed below, it might be CII/SSI.

1 Documentation or other information that describes the design, function, operation or access control features of any security system, manual or automated, used to control access to or use of any automated data processing or telecommunications system.

2 Plans and information to prevent or respond to terrorist activity, the disclosure of which would jeopardize the safety of any person, including:

• Critical infrastructure sector or structural components

• Operational, procedural, transportation, and tactical planning or training manuals

• Vulnerability assessments • Staff meeting minutes or other records

Engineering or architectural records or portions of, that reveals the location or operation of:

• Security equipment and systems • Elevator equipment and systems

• Ventilation equipment and systems • Fire protection equipment and systems

• Emergency equipment and systems • Electrical equipment and systems

• Utility equipment and systems • Telecommunications equipment and systems

3 Information (including drawings, manuals, or other records) which reveals:

• Surveillance techniques • Alarm or security systems or technologies

• Personnel deployments¹ • Operational and transportation plans or protocols

4 Information concerning threats against transportation.

¹ Only as it relates to security operations. (E.g. Staffing levels in critical operational areas such as Smart Traffic Centers, Control Rooms, Guard schedules, number present and location, etc.)

CII/SSI Guide, Version 8, July 18, 2024 Page 9

NO

YES

NO

NO NO NO

NO

YES

YES

YES

Owner

Should Not

Designate

Information as CII/SSI

Start

Owner

Should

Designate

Information as CII/SSI

Reference: Code of Virginia § 2.2-3705.2

Does the information contain engineering or architectural records that reveal the location or operation of Critical

Infrastructure?

See Code of Virginia § 2.2-3705.2

Does information (e.g., drawings, manuals, or other records) reveal surveillance techniques, personnel deployments, security systems or operational and transportation plans?

Does information describe threats against transportation or plans developed to respond to terrorist activity?

Does information describe the design, function, operation or access control features of any security system used to control access to or use of any automated data processing or telecommunications system?

Is the information readily accessible to the general public and considered public information?

Does the general public have a need-to-know in order to carry out official duties?

CII/SSI Guide, Version 8, July 18, 2024 Page 10

CII/SSI Designation Decision Flowchart

CII/SSI Guide, Version 8, July 18, 2024 Page 11

Critical Infrastructure Information/Sensitive Security Information (CII/SSI)

Multi-Purpose Non-Disclosure Agreement

Retain a copy of both the front and back sides of this form for future reference

VDOT requires CII/SSI be protected and not disclosed to unauthorized persons.

PART A: To Be Completed By Individual VDOT or Company Employee

I agree with the following as a condition of being granted access to CII/SSI:

CII/SSI, which is valuable and sensitive, is protected by law and by strict VDOT policies. The intent of these laws and policies is to assure that

CII/SSI will remain confidential - that is, it will be used only as necessary to accomplish VDOT’s mission. Disclosure of CII/SSI in any manner that permits interception by unauthorized persons could compromise safety and security and is prohibited. CII/SSI may be released only to persons with a need-to-know.

I might have access to this information in various formats including but not limited to documents and drawings, physical structures, and computer based systems. I have no right or ownership interest in any VDOT CII/SSI.

VDOT may at any time revoke my authorization allowing access to CII/SSI.

Willful violation of this agreement may subject me to discipline which might include, but is not limited to, removal from current VDOT projects;

exclusion from further VDOT related work; and legal liability. My obligations with respect to the confidentiality and security of all CII/SSI disclosed to me shall survive the termination of any agreement or relationship with VDOT. My execution of this agreement shall not nullify or affect in any manner any other agreement, non-disclosure or otherwise, which I have executed or may execute with VDOT or the Commonwealth of

Virginia.

I am obligated to protect this information from unauthorized disclosure in accordance with the terms of this agreement. I will only use CII/SSI that I obtain to perform my legitimate VDOT related duties. I will conduct myself in a strict conformance to applicable laws and VDOT policies governing

CII/SSI. I will safeguard the confidentiality of all CII/SSI at all times. I will be responsible for my misuse or my wrongful disclosure of CII/SSI.

Each provision of this agreement is severable. If any administrative or judicial tribunal should find any provision of this agreement to be unenforceable, all other provisions shall remain in full force and effect.

I make this agreement in good faith, without mental reservation or purpose of evasion.

Printed Name Date

VDOT District/Division OR Company Name Phone Number

Company Address

Signature Signature of Authorized Agent (Not required for VDOT employees)

PART B: To Be Completed By Company Agent Only:

In addition to the provisions above, I certify:

All employees of this company involved with this VDOT project, regardless of location, who will have access to CII/SSI, myself included, will complete Part A of the Critical Infrastructure Information/Sensitive Security

Information Multi-Purpose Non-Disclosure Agreement. The Agreement will be signed by me and accepted by VDOT prior to being granted access to CII/SSI. We will only access CII/SSI for which we have a need-to-know.

We will safeguard the confidentiality of all CII/SSI at all times. We will conduct ourselves in strict conformance to applicable laws and VDOT policies governing CII/SSI. Obligations with respect to the confidentiality and security of all CII/SSI disclosed to us shall survive the termination of any agreement or relationship with VDOT.

Authorized Company Agent:

Signature of Authorized Agent Date

Printed Name Title

Company Name Phone Number

Company Address

VDOT Contract Name and Number

CII/SSI Guide, Version 8, July 18, 2024 Page 12

Critical Infrastructure Information/Sensitive Security Information (CII/SSI)

Multi-Purpose Non-Disclosure Agreement

Back Page

Retain a copy of both the front and back sides of this form for future reference.

Handling CII/SSI

You are responsible for safeguarding Critical Infrastructure Information/Sensitive Security Information

(CII/SSI) in your custody or under your control.

The extent of protection afforded CII/SSI shall be sufficient to reasonably foreclose the possibility of its loss or compromise.

The terms of this clause (Handling CII/SSI), including this paragraph, must be included in any dissemination of any document, in whole or in part, that contains CII/SSI.

Protection - CII/SSI shall be protected at all times, either by appropriate storage or having it under the personal observation and control of a person authorized to receive it. Each person who works with protected CII/SSI is personally responsible for taking proper precautions to ensure that unauthorized persons do not gain access to it.

Use and Storage - During working hours, reasonable steps shall be taken to minimize the risks of access to

CII/SSI by unauthorized personnel. After working hours, CII/SSI shall be secured in a secure container, such as a locked desk, file cabinet or facility where contract security is provided.

Reproduction - Documents or material containing CII/SSI may be reproduced to the minimum extent necessary consistent with the need to carry out official duties provided that the reproduced material is marked and protected in the same manner as the original material.

Disposal - Material containing CII/SSI shall be disposed of by any method that prevents unauthorized retrieval (e.g. shredding, burning, returning to original source, etc.).

Transmission - CII/SSI shall be transmitted only by VDOT courier, US first class, express, certified or registered mail, or through secure electronic means.