3-CSOQ.docx
DOCX document 60 KB Posted
- Attached to
- RFQ FOR RESIDENTIAL SOUND REDUCTION PROGRAM: OUTREACH, QUALIFICATIONS, AND DESIGN SERVICES
- Solicitation number
- 0000034420
- Issued by
- Sacramento County, San Francisco City, California
About this file
This is a Consultant Statement of Qualifications (CSOQ) form from UC Davis Health's Facilities Design & Construction department, located in Sacramento, California. The form is designed to collect comprehensive information from potential design professionals and consultants seeking to work with UC Davis Health. It requests detailed company information including main office location, branch offices, and remittance addresses, along with key contact information.
The form requires firms to provide staffing information, including principals and associates with their educational credentials, average staff numbers over the past five years, and management approach. Firms must detail up to three major projects completed within the past five years, including project costs, square footage, construction timelines, and descriptions. The form also requests information about key personnel qualifications, professional references, and how firms typically learn about University projects. The document includes a privacy notification pursuant to the State of California Information Practices Act of 1977, indicating that all requested information is mandatory for consideration in the selection process.
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| File | Type | Posted |
|---|---|---|
| residential-sound-program-rfq.pdf |
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Text version
GENERAL INFORMATION
FIRM NAME:
MAIN (STREET) ADDRESS:
CITY:
STATE:
ZIP CODE:
BRANCH (STREET) ADDRESS:
CITY:
STATE:
ZIP CODE:
REMIT TO ADDRESS:
CITY:
STATE:
ZIP CODE:
CONTACT
CONTACT NAME & TITLE:
TELEPHONE:
FAX:
EMAIL:
WEB PAGE:
STAFF [PRINCIPAL (P) AND ASSOCIATE (A) (CHECK "P" OR "A" FOR EACH)]
| NAME |
| P |
| A |
| DEGREE OR CERTIFICATE |
| INSTITUTION |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
| |_| |
AVERAGE STAFF EMPLOYED IN LOCAL OFFICE: (AVERAGE OF PAST 5 YEARS)
| LICENSED PROFESSIONALS: |
| PROFESSIONALS ON LICENSURE TRACK: |
| TECHNICAL SUPPORT: |
| CLERICAL: |
| OTHER: |
WHAT IS YOUR MANAGERIAL APPROACH, TEAM APPROACH AND QUALITY CONTROL PROGRAM? (PROVIDE ATTACHMENT, IF NECESSARY)
INDICATE PREVIOUS UC PROJECT EXPERIENCE (IF ANY).
PROJECT EXPERIENCE
LIST UP TO THREE (3) MAJOR PROJECTS WITHIN THE PAST FIVE (5) YEARS THAT INDICATES YOUR EXPERIENCE (LIST MOST RECENT FIRST).
| Project No. 1 Name: |
| Owner (include phone): |
| Contract Award Amount: |
| Final Project Cost: |
| Project Sq. Ft.: |
| Original Construction Time: |
| Actual Construction Time: |
| Year of Completion: |
| Type of Facility: |
Project Description:
| Project No. 2 Name: |
| Owner (include phone): |
| Contract Award Amount: |
| Final Project Cost: |
| Project Sq. Ft.: |
| Original Construction Time: |
| Actual Construction Time: |
| Year of Completion: |
| Type of Facility: |
Project Description:
| Project No. 3 Name: |
| Owner (include phone): |
| Contract Award Amount: |
| Final Project Cost: |
| Project Sq. Ft.: |
| Original Construction Time: |
| Actual Construction Time: |
| Year of Completion: |
| Type of Facility: |
Project Description:
FACILITIES DESIGN & CONSTRUCTION
UC DAVIS HEALTH
4800 2ND AVENUE, SUITE 3010
SACRAMENTO, CA 95817
EMAIL: LCCOUCEIRO@UCDAVIS.EDU
CONSULTANT STATEMENT OF QUALIFICATIONS
| UC Davis Health | Page 1 of 3 | Rev. 01-2016 |
| UC Davis Health | Page 2 of 3 | Rev. 01-2016 |
KEY PERSONNEL INFORMATION
| PROJECT ROLE |
| NAME |
| DEGREES |
| INSTITUTION |
| YEARS OF PROF. EXPERIENCE |
| DISCIPLINE, LICENSE NUMBER, EXPIRATION DATE & STATE |
| YEARS W/FIRM |
REFERENCES [PROVIDE TWO (2)]
| Name: |
| Title: |
| Firm: |
| Telephone: |
| Name: |
| Title: |
| Firm: |
| Telephone: |
| Where do you normally look for information about proposed University projects? |
Please attach to this form any other information you wish us to consider, such as your firm's brochure or a discussion of your recent work.
PRIVACY NOTIFICATION
The State of California Information Practices Act of 1977 (effective July 1, 1978) requires the University of California to provide the following information to individuals who are asked to supply personal information about themselves.
The principal purpose for requesting the information on this form is for use in the selection process for Design Professionals and Consultants commissioned by the University. University Policy authorizes maintenance of this information.
Furnishing all information requested on this form is mandatory – failure to provide such information will delay or may even prevent completion of the action for which the form is being filled out. Information furnished on this form will be used by the Facilities Design & Construction Office in the consideration of commissions to Design Professionals and Consultants.
Individuals have the right to have access to this record as it pertains to themselves.
The official responsible for maintaining the information contained on this form is the Manager, Facilities Design and Construction.
FACILITIES DESIGN & CONSTRUCTION
UC DAVIS HEALTH
4800 2ND AVENUE, SUITE 3010
SACRAMENTO, CA 95817
UC Davis Health Page 3 of 3 Rev. 07-2019 image1.jpeg
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