8-01.1 General Contractors Statement of Qualificatons Part 1 Fillable.pdf
PDF 198 KB Posted
- Attached to
- Re-Bid Modular Home Contractor and Construction Services State and local contract opportunity
- Solicitation number
- RFP-2026-11BK
- Issued by
- Doña Ana County, New Mexico
About this file
This is a General Contractor's Statement of Qualifications form for the State of New Mexico, specifically for a modular home and teacher housing construction project in the Gallup and McKinley County jurisdiction. The form requests comprehensive information about the contractor's organization, licensing, personnel experience, capacity to perform work, and past project experience. Contractors must demonstrate they possess a valid New Mexico Construction Industries Division license, maintain current business licenses from state and local authorities, and provide detailed information about their workforce, including superintendents, journeymen, apprentices, safety managers, and administrative staff. The solicitation requires contractors to submit documentation of similar projects of comparable capacity and scope, current active projects valued under $500,000, and a detailed management plan explaining how the contractor would oversee the project, including staffing arrangements and emergency response procedures.
The qualification statement requires contractors to demonstrate their financial and operational capacity through documentation of average annual construction work performed over the past five years, current surety company information with bonding capacity, and proof of ability to obtain required insurance coverage at minimum limits of $1 million per occurrence and $5 million in aggregate. Contractors must provide three years of OSHA safety records, including Total Recordable Injury/Illness Case Rates and Lost Workday Case Rates, along with evidence of a written safety program and designated safety manager. The form also requires certification of freedom from debarment, suspension or revocation of licenses, false claims, labor code violations, prevailing wage violations, and subcontractor fair practices violations within the past five years. Contractors must disclose any past schedule delays, liquidated damages assessments, and pending litigation. The submission includes six required attachments detailing project experience, current projects, labor code compliance documentation, management plans, and any necessary clarifications or explanations.
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| 9-01.2 General Contractors Statement of Qualifications Part 2 Attachments Fillable.pdf |
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Text version
GENERAL CONTRACTOR’S STATEMENT OF QUALIFICATIONS
General Contractor Statement of Qualifications Page 1
PART 1
1. ORGANIZATION
Name:
Address:
Principal Office
[ ] Corporation [ ] Partnership [ ] Sole Proprietorship [ ] Joint Venture
[ ] Other
a. How many years has your organization been in business as a Contractor?
b. How many years has your organization been in business under its present business name?
c. Under what other or former names has your organization operated?
2. LICENSING
a. Name of the license holder (or qualifying party) exactly as on file with the State of New Mexico Construction Industries Division:
b. License Classification: License Code:
c. License Number:
d. Issue Date: Expiration Date:
e. Is the firm’s contractor’s license free of ever being suspended or revoked by the CID or by the appropriate licensing agency in any other state?
[ ] Yes, Free of suspension or revocation [ ] No (Attach Explanation)
f. Does your firm hold all applicable Business licenses required by the State of New
Mexico or Local (Gallup, McKinley County) authority?
License Number: Jurisdiction:
Name of License Holder, exactly as it appears on file with jurisdictional authorities.
Issue Date: Expiration Date:
General Contractor Statement of Qualifications Page 2
i. Total number of current employees: Superintendent:
Journeyman:
Apprentice:
Safety Manager:
Tradesman:
Administration:
Others:
g. Is your firm free from formal debarment from public work, federal, state or local jurisdictions? [ ] Yes [ ] No (attach explanation)
3. PERSONNEL EXPERIENCE
Please note that more consideration will be given to those meeting or exceeding the required qualifications stated below. (Attach additional list if necessary)
NAME TRADE/CLASSIFICATION LICENSE NO./ISSUE DATE
4. CAPACITY AND CAPABILITY TO PERFORM THE WORK
a. Resources
General Contractor Statement of Qualifications Page 3
ii. Does your firm have the immediate capacity to perform the work required in this solicitation?
[ ] Yes [ ] No
b. Project Description of Similar Capacity and Scope (Attachment A).
5. EXPERIENCE
a. State the average annual amount of construction work performed during the past five years:
b. List the categories of work your organization normally performs with its own forces.
(Attach list)
c. Projects currently under contract valued less than $500,000 (Attachment B).
6. SURETY
a. Firm’s current surety company:
Will this surety be used for the construction contract for this project?
[ ] Yes [ ] No (explain) Contact Agent: Name: Telephone:
Years Utilizing this surety: Maximum Capacity:
Aggregate Total of current surety in force:
b. Is the surety company to be used on this project licensed to do business in the State of New Mexico?
[ ] Yes [ ] No (explain)
c. Is your firm free of having any construction contracts taken over by a surety for completion in the past five (5) years?
d. Has your firm used other surety companies since 2015? [ ] Yes (list) [ ] No
Surety Company Contact
General Contractor Statement of Qualifications Page 4
e. Is your firm able to obtain bonding if needed for an assigned project?
7. SAFETY
a. Does your firm have a written safety program compliant with current State regulations?
b. Provide a list of key safety personnel, including the designated safety manager who will be assigned to oversee work under this contract, and list specific duties:
Name and Title Specific Duties
c. Provide the information requested below for the years shown using U.S. Bureau of Labor Statistics guidelines to determine recordability and lost workdays from your firm’s OSHA 300 logs.
Total Recordable Injury/Illness Case Rate:
2022: 2023: 2024: 3-year average:
Lost Workday Case Rate:
2022: 2023: 2024: 3-year average:
d. Is your firm free of committing serious or willful violations of federal or state safety laws as determined by a final non-appealable decision of a court or government agency?
General Contractor Statement of Qualifications Page 5
8. INSURANCE & CLAIMS HISTORY
a. Is your firm free from any court judgments, pending litigation, arbitration and final agency decisions filed within the last five (5) years in a construction- related matter in which the contractor, or any officer, is or was party?
b. Has your firm during the past five (5) years been free of a determination by a court of competent jurisdiction that it filed a false claim with any Federal, State, or local government entity?
c. Does your firm have the ability to provide the required insurance in the limit stated in the project documents (General Liability and Comprehesive Auto at $1M per occurrence and $5M in the aggregate)?
9. QUALITY ASSURANCE
a. Does your firm have a written Quality Assurance Program?
10. PROJECT SCHEDULING
a. Has the firm been involved with a construction project within the past ten (10) years where the schedule was not met?
b. If yes, please indicate the projects (Refer to Attachment A).
i. Project:
Reason for Delay:
ii. Project:
General Contractor Statement of Qualifications Page 6
iii. Project:
c. Has the firm been assessed liquidated damages due to scheduling for any project in the past ten (10) years? (Refer to Attachment A).
d. If yes, List Projects
11. LABOR CODE VIOLATIONS
a. Has your firm, during the past five (5) years, been free of any determinations by a court or an administrative agency of repeated or willful violations of laws and/or regulations pertaining to the payment of prevailing wages or employment of apprentices of public works projects?
[ ] Yes [ ] No (Explain)
b. Please provide documentation to substantiate this (Attachment C).
c. Is the firm free of all Sub-contractor Fair Practices Act violations for the past five (5) years?
[ ] Yes [ ] No (Explain)
12. MANAGEMENT PLAN
On a separate sheet, please describe how you would manage this project, including staffing, after hours/weekend “emergency” calls/needs. Explain.
Please comment on how your team would describe success in this effort (Attachment D).
13. CLARIFICATIONS/EXPLANATIONS (if necessary)
a. Please provide further explanation of items indicated requiring explanation, or other additional information to further explain any of the questions asked in this Qualification Statement (Attachment E).
b. Additional information provided as outlined in the Request for Proposal (written qualification limitation of 15 pages) will be attached (Attachment F).
General Contractor Statement of Qualifications Page 7
The undersigned certifies that all the Qualification information submitted with this form is true and correct.
Name and Title Firm Name
Signature Address of Firm
E-mail Address City, State Zip Code
Telephone Number Facsimile Number
General Contractors are reminded to include a copy of each requested sub-contractor’s Statement of Qualifications with this Qualification Document.
ATTACHMENTS INCLUDED:
(Please check all attachments included in this Submittal)
[ ] A Project Experience of Similar Capacity and Scope [ ] B Current Active Project List Valued Less Than $500,000 [ ] C Substantiation of Non-Violation of Labor Codes [ ] D Management Plan [ ] E Clarifications and Explanations [ ] F Additional Information (Optional)
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