25-00708-01-MS_BC_8_Statement_of_Qualifications.docx
DOCX document 52 KB Posted
- Solicitation number
- FY2026-RFP-164
- Issued by
- Champaign County, Illinois
About this file
This is a Statement of Qualifications form (BC 8) used by the City of Urbana, Illinois, to evaluate contractor eligibility for the Miscellaneous Electrical Repairs 2026 project (Section 25-00708-01-MS). The project encompasses unplanned repair work on traffic signal and streetlight systems owned or maintained by the City of Urbana at various locations within street and alley rights-of-way and utility easements throughout the city. The form requires applicants to provide comprehensive business information, including company name, address, contact details, Federal Employer Identification Number, and Illinois Department of Human Resources identification. Applicants must document their record of past experience, with contractors holding current IDOT prequalification in Electrical providing project information from the previous fiscal year, while those without such prequalification must submit three years of project history. All projects listed must include work performed by the contractor's own forces and exclude subcontractor work, with dollar amounts categorized by work type including earthwork, paving, landscaping, structures, drainage, electrical, concrete construction, and other relevant categories.
The form additionally requires detailed information on the technical, supervisory, and key personnel who would manage the project, including their names, positions, years of experience, type of work performed, and capacity of involvement. Applicants prequalifying with the Department for the first time must submit resumes for technical, supervisory, and key personnel, with a sample resume template provided that includes current position, job duties, previous positions, education, professional affiliations, licenses, registrations, and references. The form allows applicants to submit alternative documentation, including BC 8 forms previously submitted to IDOT within the past three years. All items on the form must be completed, with "none" or "n/a" entered where items do not apply, and applicants may attach additional sheets if needed to provide comprehensive information.
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Text version
Statement of Experience
| Business Name of Applicant |
| Business Address (Street or P.O. Box) |
| City |
| State |
| Zip Code |
| Telephone |
| ( ) |
| Telefax No. |
| ( ) |
| E-Mail Address |
| Illinois Office Address |
| City |
| Zip Code |
| Illinois Telephone No. |
| ( ) |
F.E.I.N. No.
I.D.H.R. No.
IDHR No.
Expires
Instructions
Each item must be answered. Whenever a particular item does not apply, write “none” or “n/a” (not applicable). Please complete electronically in Microsoft Word, use typewriter or print legibly in dark ink when preparing the application. If additional space is needed, attach a separate sheet.
This form is a reduced version of the IDOT Application for Prequalification (BC 8) form. It is intended for providing a Statement of Experience for evaluation by the City of Urbana. As an alternative to filling out this form, an applicant may submit information from a BC 8 form which was submitted to IDOT within the past three (3) years.
Record of Past Experience
Applicants with IDOT Prequalification in Electrical - List major projects performed by the contractor’s own forces for the previous fiscal year, including Federal, State, County, City and private work. The total dollar amounts and work category dollar amounts must be listed for each project. Do not include work performed by subcontractors.
Applicants without IDOT Prequalification in Electrical - List major projects performed by the contractor’s own forces for the previous three (3) fiscal years, including Federal, State, County, City and private work. The total dollar amounts and work category dollar amounts must be listed for each project. Do not include work performed by subcontractors.
Please see Appendix “A” of the IDOT rules for prequalification to determine the appropriate category for completed work.
Name, Address and Phone Number of Reference
Year Total in (1000’s)
Earth-work
PCC
Paving
HMA
Plant Mix
Land-scaping Agg Bases & Surf.
Str
Drain
Elect
Conc.
Const.
Other (List)
| Sub-Total |
| Sub-Total (page 4) |
| Total(s) |
Record of Past Experience
Applicants with IDOT Prequalification in Electrical - List major projects performed by the contractor’s own forces for the previous fiscal year, including Federal, State, County, City and private work. The total dollar amounts and work category dollar amounts must be listed for each project. Do not include work performed by subcontractors.
Applicants without IDOT Prequalification in Electrical - List major projects performed by the contractor’s own forces for the previous three (3) fiscal years, including Federal, State, County, City and private work. The total dollar amounts and work category dollar amounts must be listed for each project. Do not include work performed by subcontractors.
Please see Appendix “A” of the IDOT rules for prequalification to determine the appropriate category for completed work.
Name, Address and Phone Number of Reference
Year Total in (1000’s)
Earth-work
PCC
Paving
HMA
Plant Mix
Land-scaping Agg Bases & Surf.
Str
Drain
Elect
Conc.
Const.
Other (List)
| Sub-Total |
| Printed 1/7/2026 | Page 6 of 26 | BC 8 (Rev. 07/01/16) |
| What is the construction experience of the technical, supervisory and key personnel of the company? |
Individual’s Name Present Position Years Experience
Type of Work In What Capacity
Resume
Contractors prequalifying with the Department for the first time are required to submit a resume of technical, supervisory and key personnel who would manage a project. Provided below is a sample resume for the contractor’s use. Personalized resumes are also accepted. In addition, this form may be used for the appraiser of equipment or real estate.
| Name: |
| Address: |
| Dates: |
| Current Position: |
| Job Duties: |
| Dates: |
| Previous Position: |
| Job Duties: |
| Dates: |
| Previous Position: |
| Job Duties: |
Education
| Diploma(s)/Degree(s) Held: |
| Additional Education (include any follow-up or self-improvement courses, programs or seminars): |
| Professional Affiliations, Licenses or Registrations: |
| Other (any pertinent information that would be beneficial in considering this prequalification application): |
| References (required for equipment or real estate appraiser only): |
Printed 1/7/2026 Page 14 of 26 BC 8 (Rev. 07/01/16)
File details come from the government source that posted it. Updated .