5--7- Exhibit A- Contractor Responsibility Questionnaire- PAR133709.pdf

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SLCo PAR133709 Acord Ice Center Ammonia Condenser Replacement - CONST
Solicitation number
SLCo PAR133709 Acord Ice Center Ammonia Condenser Replacement - CONST
Issued by
Utah

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This is a Contractor Responsibility Questionnaire exhibit for Salt Lake County related to construction services for the Acord Ice Center Ammonia Condenser Replacement Project (PAR133709). The project involves the removal and replacement of an ammonia condenser system at an ice rink facility. All prospective contractors must complete this questionnaire as a mandatory component of their bid package submission; failure to answer all questions may result in the proposal being deemed non-responsive or non-responsible.

The questionnaire requires contractors to demonstrate specific qualifications and experience across multiple technical areas. Contractors must confirm completion of prior construction projects without liquidated damages assessments, maintain OSHA recordable incident rates at or below Utah industry averages, and provide evidence of successful ice rink refrigeration system experience within the past five years. Additionally, contractors must certify they have completed a minimum of five ammonia refrigeration systems serving ice rinks, possess demonstrated experience with major component installation including screw compressors, shell-and-tube chillers, evaporative condensers, and ammonia receivers, and hold all required contractor licenses including B-100, S350, and S410 certifications where applicable. Contractors must also confirm their ability to procure and deliver specified equipment within twenty-two weeks of the Notice to Proceed date and complete full procurement, delivery, installation, connection, and startup of equipment within 184 days. The questionnaire further requires confirmation of qualified key personnel experienced with ammonia refrigeration systems and the contractor's willingness to support third-party building systems commissioning if required. The County reserves the right to conduct further investigation into any responses provided.

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Proposer must answer all questions below or the Proposer may be deemed non-responsive and/or non-responsible.

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EXHIBIT: [EXHIBIT A]
STANDARD: CONTRACTOR RESPONSIBILITY QUESTIONNAIRE.
CONST: CONSTRUCTION SERVICES FOR:
ID: PAR133709
OWNER: SALT LAKE COUNTY - SMALL PROJECT
NO: NO
01: 01
02: 02
03: 03
04: 04
05: 05
Check Box 04b: Off
06: 06
07: 07
CONTRACTOR:
TITLE:
COMPANY:
COMPANY TEXT: COMPANY NAME
SIGNOR TEXT: SIGNER
TITLE TEXT: TITLE
PROJ TEXT: PROJ. ID.
QUESTION 03: Completed all construction projects without assessment or payment of Liquidated Damages?
08: 08
09: 09
CHECK 09A: Off
CHECK 09B: Off
CHECK 08A: Off
CHECK 08B: Off
CHECK 07A: Off
CHECK 07B: Off
CHECK 06A: Off
CHECK 06B: Off
CHECK 05A: Off
CHECK 05B: Off
CHECK 04A: Off
CHECK 03A: Off
CHECK 03B: Off
CHECK 02A: Off
CHECK 02B: Off
CHECK 01A: Off
CHECK 01B: Off
10: 10
CHECK 10A: Off
CHECK 10B: Off
YES: YES
QUESTIONS: QUESTIONS
CONTRACT 01: In the last five years, has your firm, acting as the General Contractor:
CONTRACT: CONTRACT SPECIFIC PERFORMANCE:
PROJECT: ACORD ICE CENTER - AMMONIA CONDENSER REPLACEMENT PROJECT
PROJ PERF: PROJECT SPECIFIC PERFORMANCE:
Text2: This form must be included in your bid package as part of the required forms for submittal.

The County reserves the right to investigate further, any of the responses to the above questions.

QUESTION 02: Is your OSHA recordable incident rate at or below the Utah industry average?
QUESTION 01: Completed all construction projects without the owner(s) calling in or involving sureties to assist in completing or assuming responsibility for completing a project?
11: 11
CHECK 11A: Off
CHECK 11B: Off
12: 12
CHECK 12A: Off
CHECK 12B: Off
QUESTION 04: Ice Rink Experience - Has your firm and/or proposed subcontractor successfully completed work on ice rink refrigeration systems within the past five (5) years? Experience shall include work associated with ammonia refrigeration systems and may include, but is not limited to screw compressors, shell-and-tube chillers, ammonia receivers, evaporative condensers, refrigeration controls, ice rink refrigeration piping, ice rink floors and refrigeration piping embedded within ice rink floors, and ammonia refrigeration system installation, replacement, repair, or servicing.
QUESTION 05: Ammonia Refrigeration System Experience - Within the past five (5) years, has your firm and/or proposed subcontractor successfully installed, replaced, serviced, repaired, or commissioned a minimum of five (5) ammonia refrigeration systems serving ice rinks?
QUESTION 06: Ammonia Refrigeration Equipment Experience - Does your firm and/or proposed subcontractor have demonstrated experience working with the major components typically associated with ice rink ammonia refrigeration systems, including screw compressors, shell-and-tube chillers, evaporative condensers, ammonia receivers, refrigeration controls and control systems, ammonia refrigeration piping, and ice rink floor refrigeration piping?
QUESTION 07: Contractor Licensing - Does your firm and/or proposed subcontractor currently hold all contractor licenses required to perform the proposed work, including, at a minimum, the following licenses where applicable: B-100, S350, and S410?
QUESTION 08: Key Personnel Experience - Does your firm have qualified personnel with demonstrated experience performing work on ammonia refrigeration systems serving ice rinks?
QUESTION 09: Equipment Procurement and Delivery - Is your firm able to procure and deliver the specified equipment to the project site within twenty-two (22) weeks from the Notice to Proceed (NTP) date?
QUESTION 11: Equipment Procurement, Delivery, and Installation - Is your firm able to procure, deliver, install, connect, and startup the specified equipment on the project site within 184 days from the Notice to Proceed (NTP) date?
QUESTION 10: Will your firm and your sub-contractors support third-party building systems commissioning if required on this project?
QUESTION 12: Will your firm and your sub-contractors support third-party building systems commissioning if required on this project?

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