2. Phase 2_Worksheets to Complete by BidderR1.xlsx

Previous Relevant Experience

Gampel Pavilion Renovation Project #: 300284

PREVIOUS RELEVANT EXPERIENCE

a. First Aid

b. Recordable

c. Lost Time

b. 2

c. n/a

Proposers must meet the following requirements and describe their overall qualifications, including background in this field and the services that it provides.

It is recommended that the Proposer provide a minimum of three (3) examples of projects that are in progress or completed within the past ten (10) years, comparable in size, scope, and similar environment to this Project, with an emphasis on occupied collegiate and/or professional multi-use sports arenas

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Project Team Quals

Gampel Pavilion Renovation Project #: 300284

Project Team Qualifications

The Proposer must demonstrate the ability to staff the Project with high quality, experienced personnel. Describe the qualifications and responsibilities of the key personnel who will be assigned to the Project including their experience on similar assignments and their specific responsibilities for the proposed Project.

It is recommended that the Proposer provide resumes for the following positions: Project Superintendent/lead foreman, Project Manager, and Project Safety Officer. Only provide resumes for the key project team; do not include resumes for personnel not assigned to the team.

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Integrity Questionnaire

Gampel Pavilion Renovation Project #: 300284

Integrity Questionnaire

If YES, provide details/additional information on a separate sheet of paper.

b) Has your Company, your Company’s parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever had a conviction or entry of a plea of guilty or nolo contendere under state or federal law for embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving stolen property, or any other offense indicating a lack of business integrity or business honesty which affects responsibility as a contractor? (Connecticut General Statute 31-57c) YES / NO

If YES, provide details/additional information on a separate sheet of paper.

c) Has your Company, your Company’s parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever had a conviction or entry of a plea of guilty or nolo contendere under state or federal antitrust, collusion or conspiracy statutes arising out of the submission of bids or proposals? (Connecticut General Statute31-57c) YES / NO If YES, provide details/additional information on a separate sheet of paper.

d) Has your Company, your Company’s parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever been cited for noncompliance with contract provisions on a public project, of a character regarded by the awarding authority to be of such gravity as to indicate a lack of responsibility to perform as a state contractor, including deliberate failure, without good cause, to perform in accordance with specifications or time limits provided in a contract? YES / NO If YES, provide details/additional information on a separate sheet of paper.

e) Has your Company, your Company's parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever been cited for three or more willful or serious violations of any occupational safety and health act or of any standard, order or regulation promulgated pursuant to such act during the three (3) year period preceding the date of this Solicitation, provided such violations were cited in accordance with the provisions of any state occupational safety and health act or the Occupational Safety and Health Act of 1970 and which were not abated within the time fixed by the citation and which citation has not been set aside following appeal to the appropriate agency or court having jurisdiction? (Connecticut General Statute 31-57b) YES / NO

If YES, provide details/additional information on a separate sheet of paper.

f) Has your Company, your parent Company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever received one or more criminal convictions related to the injury or death of any employee during the three (3) year period preceding the date of this Solicitation? (Connecticut General Statute 31-57b) YES / NO

If YES, provide details/additional information on a separate sheet of paper.

g) Has your Company, your Company's parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever had any instances within the past five (5) years in which your Company or any entity in which your Company has an interest, appeared on a list published by the State of Connecticut Labor Department of persons or Companies who the Labor Department has found to have disregarded or violated your Company’s obligations to employees and subcontractors on public works projects under Connecticut General Statutes 31-53 and 31-76b (i.e. payment of prevailing wages and overtime payments) or in which you have been barred from Federal government contracts in accordance with the provisions of the Davis Beacon Act, 40 U.S. C. 276a-2? YES / NO

If YES, describe in detail the circumstances of each violation, including but not limited to, the date and nature of the violation, the project on which the violation occurred, the source, if known, of any complaint giving rise to any Department of Labor investigation, the results of any such investigation, the penalty imposed or other action taken by the Department of Labor, any remedial action which was taken and any other resolution of any such complaint or violation. (Connecticut General Statute 3153a) On the same sheet describe the policies and procedures that you would implement on this project to ensure that you will remain in compliance with the statutory wage rates and payment of wages as noted above.

h) Has your Company, your Company's parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever had an instances other than those previously described in response to the above questions, in which any complaint has been made to, or any investigation or inquiry has been conducted by, the State of Connecticut Department of Labor regarding any alleged non-compliance by your Company or by any subcontractors on your Company’s previous projects, of any provision of Part III of Chapter 557 (Connecticut General Statutes Sections 31-52 through 31-57e, prevailing wage and other requirements) and Chapter 558 (Connecticut General Statutes Sections 31-58 through 31-761, minimum wage, overtime and other requirements) during the five (5) years preceding this Submission? YES / NO

'If YES, describe in detail the circumstances of each violation, including but not limited to, the date and nature of the violation, the project on which the violation occurred, the source, the source, if known, of any complaint giving rise to any Department of Labor investigation, the results of any such investigation, the penalty imposed or other action taken by the Department of Labor, any remedial action which was taken and any other resolution of any such complaint or violation. On the same sheet of paper describe the policies and procedures that you would implement on this project to ensure that you will remain in compliance with the statutory wage rates and payment of wages as noted above.

i) Has your Company, your Company's parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company ever been named on a current list compiled by the Connecticut Commission of Human Rights and Opportunities whom it has found to be in non-compliance with anti-discrimination or contract compliance statutes, or been the subject of any unabated or unexpired Notice of Non-Compliance issued by the Commissioner, pursuant to Connecticut General Statutes Section 46a-56? YES / NO

If YES, provide details/additional information on a separate sheet of paper.

j) Has your Company, your Company’s parent company, your subsidiaries or affiliates, any officer or partner, or any member of management of your Company been barred, suspended, denied prequalification, had its prequalification certificate issued by the Connecticut Department of Administrative Services revoked, or otherwise been precluded from bidding or offering a proposal on contracts by any municipality or agency of the State of Connecticut, any other state, or the Federal Government within the past five (5) years? YES / NO

If YES, provide details/additional information on a separate sheet of paper.

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Prequalification at Award

b. Certificate of Insurance

c. 2024 Financial Statement

- Independent CPA Report (with Balance sheets, income statements, cash flow statements and notes)

- Statements shall be audited, reviewed, or compiled by an independent public accountant

d. Internal Financial Statement

- Balance Sheet and Profit & Loss for most recent month end

- Line of credit letter (if applicable)

e. Work In Progress (WIP)

- List of work in progress that identifies, project name, location, original contract amount, current contract amount, scheduled completion date, amount billed out and percent complete

*Bid packages over $250,000 will require documentation be provided for all items listed above **Bid packages ≤ $100,000 require item a. above and sign-off only *** Bid packages over $100,000 and under $250,000 will require a. and b. above

Project References Gampel Pavilion Renovation Project #: 300284

REFERENCES

GC/CM

a. GC/CM Superintendent

b. GC/CM - Project Manager

c. Owner or Owners Rep

Email:

Cell: Mike Smith Email:

Cell: Mike Smith Email:

Cell: Mike Smith Email:

Cell:

Provide a minimum of 3 references for 3 similar projects completed in the last 10 years

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