23-028 Audits RFQ Attachment H Forms 1 2 3.docx
DOCX document 46 KB Posted
- Attached to
- 23-028 Energy Audit for Schools
- Solicitation number
- S-33000-00008950
- Issued by
- Marion County, Oregon
About this file
This document is an Attachment H containing Forms 1, 2, and 3 related to a Request for Qualifications (RFQ) for Energy Audits for School Buildings in the state of Oregon. The RFQ, numbered 23-028, is being issued by unspecified agencies and involves conducting energy audits in Marion County and the city of Salem. The RFQ requires firms to provide information on their energy audit experience, key personnel, energy modeling capabilities, and available software and equipment. Firms must complete the three forms included in Attachment H to demonstrate their qualifications. No due dates, site visits, or award details are provided in the attachment.
The attachment outlines the required information to be submitted, including firm and personnel details, areas of energy audit and modeling expertise, software used, and equipment available. Firms must attest to having the necessary software and equipment to complete the work described in the RFQ. No information is provided on pricing terms, set-asides, incumbent contractors, funding sources, or other commercial terms.
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Other files
| File | Type | Posted |
|---|---|---|
| 23-028 Attachment E Cost.docx | DOCX document | |
| 23-028 Attachment F Cert Disadvantaged Bus Outreach.doc | DOC document | |
| 23-028 Attachment A Sample Agreement RFQ.pdf | ||
| 23-028 Attachment B Disclosure Exemption.doc | DOC document | |
| 23-028 Attachment D References.docx | DOCX document | |
| 23-028 Energy Audits for Schools RFQ 12-19-23.pdf | ||
| Addendum #2 S-C26014-00008953 On-Call Real Estate Research Consulting and Related Services.pdf | ||
| 23-028 Attachment C Info and Cert.doc | DOC document | |
| 23-028 Attachment G Responsibility Inquiry.doc | DOC document |
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Text version
ATTACHMENT H – FORMS 1, 2, & 3
FORM 1 – ENERGY AUDIT FIRM AND KEY PERSONNEL INFORMATION
Name of Energy Audit Firm: Enter Audit Firm Name Date Completed: Enter Date Address (include City, State & Zip): Enter Address including City, State & Zip Federal Tax ID#: Enter Federal Tax ID# Geographic Availability: ☐ Check box if available to work in all Oregon counties If not, please list any counties in which the firm is not available to work: Enter Geographic Availability
Please list all key personnel and their contact information.
Single Point of Contact (contracts, questions, quality and firm issues):
| Name |
| Phone Number |
Qualified Staff (staff who qualify may be listed for multiple roles) Must list at least one Senior Reviewer and Energy Auditor
| Name |
| Phone Number |
| Senior Reviewer |
| Energy Auditor |
| Energy Modeler |
Other Staff (not in qualified roles but support work for Program)
| Name |
| Phone Number |
| Roles and Responsibilities |
FORM 2 – EXPERIENCE
Complete one form per individual
Energy Audit Firm: Enter Audit Firm Name Name of Individual: Enter Name of Individual Total Years of Energy Audit Experience: Enter Number of Years Total Years of Energy Modeling Experience: Enter Number of Years
Use the descriptions of Energy Audits and areas of expertise in the RFQ to complete this form. Indicate the number of years of experience in each area as well as the number of buildings audited.
| Area of Expertise |
| Energy Auditing |
| Energy Modeling |
| Years Exp. |
| # of Projects |
| Years Exp. |
| # of Projects |
Chilled water systems
Hot water systems
Steam systems
Air handling units
HVAC packaged units
Refrigeration (VRV)
Terminal units
Unit heaters
Motors (VFD)
Lighting systems (interior and exterior)
Heat recovery systems
Domestic water systems
Controls (pneumatic, electric, direct digital, DCV)
Building envelope
Signature of individual: Date: Enter Date (Signature acknowledges the experience represented in this form is true and accurate)
Forms 1, 2 and 3 Energy Audits for School Buildings RFQ #23-028 Updated: 12/19/2023
These documents, including their content and format, should not be changed in any way.
Alteration to these forms may result in disqualification from the RFQ process and Prequalification.
FORM 3 - SOFTWARE AND EQUIPMENT
Software List energy modeling software used by each key personnel requesting Energy Modeling Qualification:
| Software |
| Key modeling personnel |
| Total Years experience* |
| Number of Projects completed |
*Must comprise 50% of annual duties to count as experience
Equipment List all data collection and monitoring equipment used by your energy audit firm and key personnel:
| Equipment (power, pressures, flow, light/temp, CO2, etc.) |
| Brand & Model |
| Number of units available |
| Typical Use (week, |
month, annual)
Attestation Does your firm and key personnel have the software and equipment necessary to complete all of the work described in this RFQ? ☐ Yes ☐ No
If not, described how your firm plans to address this requirement: Enter text here
File details come from the government source that posted it. Updated .