8-j. Certified Cleared Employee Form (Non-Construction).pdf

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Attached to
Wellness Program Administrator
Solicitation number
RFP No. 26-16
Issued by
Rock Island County, Illinois

About this file

This document is a Certified Cleared Employee List form from Illinois, specifically related to compliance with 105 ILCS 5/10-21.9, a state legal requirement for vendors, suppliers, professional services firms, or contractors. The form requires a thorough background check process for employees, including a fingerprint-based criminal history records check, a Statewide Sex Offender Database check, and a Statewide Child Murderer and Violent Offender Against Youth Database check.

The form mandates that the vendor certify that all employees have not been convicted of enumerated criminal or drug offenses and do not appear on the specified databases. The document provides a table for listing employees with columns for number, last name, middle initial, first name, last four digits of social security number, criminal history status, and database checks. The form must be signed by an authorized owner, officer, member, or partner and notarized, serving as a legal certification of employee background clearance for potential work or contract engagement with state entities.

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Rev. 09-2020

CERTIFIED CLEARED EMPLOYEE LIST

The undersigned , a vendor, supplier, professional services firm or contractor, hereby certifies under oath as follows:

1- a fingerprint based criminal history records check, a Statewide Sex Offender Database check and a Statewide Child Murderer and Violent Offender Against Youth Database check has been conducted for all employees as indicated by a check mark in the appropriate box in accordance with 105 ILCS 5/10-21.9 (the Act); and

2- that such employees have not been convicted of any of the enumerated criminal or drug offenses listed in the Act and their name does not appear on the noted Databases; and

3-the undersigned is an owner (if sole proprietor) or officer, member or partner of the undersigned authorized to execute this document binding the undersigned.

No. Last Name M.I. First Name SS # (last four) Crim. Hst. Databases

By:

This certificate Subscribed and Sworn to before me this ___ day of _________, 20___.

Notary Public Commission Expires :_____________

Vendor Cert. Employee List No.___

102102

000 Cover Page
00 Table of Contents
01 Invitation to Bid
02 Statement of no interest
03 Bid Label
04 AIA A701-1997 Instructions to Bidders
06a AIA A701 pg1
06a AIA A701-2007
05 Supplemental Instructions to Bidders version 12092013
SUPPLEMENTARY INSTRUCTIONS TO BIDDERS
SUPPLEMENTARY INSTRUCTIONS TO BIDDERS
SUPPLEMENTARY INSTRUCTIONS TO BIDDERS
06 General Terms and Conditions rev 03072014
GENERAL TERMS AND CONDITIONS
06a Supplementary Conditions rev 03072014
SUPPLEMENTARY CONDITIONS
SUPPLEMENTARY CONDITIONS
4. APPLICATION FOR PAYMENTS:
SUPPLEMENTARY CONDITIONS
07 Winnebago County Prevailing Wage for July 2015
Local Disk
Winnebago County Prevailing Wage for July 2015
08 A201-2007 Gen Condition of the Contract for Construction
08 A201 pg1
08 A201-2007
09 Bid form Addendum v05092014
12 Required Forms Check List - Construction
12a Bid Form
12b Required Forms
Vendor Cert. Employee List No.___
12c W9 Form fy14
13 ROE Called Inspections Form
14 AIA A305-1986
15 AIA A101-2007 05-09-14
16 Sample Certificate of Insurance
Beyer Roof Bid set Bradley & Bradley2016.07.04
Beyer Bound Specs
TITLE PAGE
Board Of Education
Architect
Table of Contents
00001(time needed)
Section 00001 - Invitation to Bid
00002
00003
00004(time needed)
A101-2007
A201-2007
A310- pre 2007
A312
A701
G702 -1992
G703 -1992
01100
PART 1 - GENERAL
1.1 SUMMARY
A. Section includes:
1. Project information.
2. Work covered by Contract Documents.
3. Phased construction.
4. Access to site.
5. Coordination with occupants.
6. Work restrictions.
7. Specification and drawing conventions.
B. Related Section:
1. Division 1 Section "Temporary Facilities and Controls" for limitations and procedures governing temporary use of Owner's facilities.
1.2 PROJECT INFORMATION
A. Project Identification: 2016 Life Safety Program – Roofing.
1. Project Location:
a. Beyer Elementary School, 333 15th Avenue, Rockford, IL 61104.
B. Owner: Rockford School District 205, 501 South 7th Street, Rockford, Illinois 61104.
1. Owner's Representative: Anita Schauer, Life Safety Architect.

C. Architect: The Contract Documents, dated June 30, 2016, were prepared for Project by Bradley & Bradley, 924 North Main Street, Rockford, IL 61103.

1.3 WORK COVERED BY CONTRACT DOCUMENTS
A. The Work of the Project is defined by the Contract Documents and consists of the following:
1. The Work includes selective demolition and roofing.
B. Type of Contract.
a. Project will be constructed under a single prime contract.
1.4 PHASED CONSTRUCTION
A. The Work shall be conducted in a single phase. The work shall commence August 20, 2016 and be substantially complete and ready for occupancy November 15, 2016.
1.5 ACCESS TO SITE
A. General: Contractor shall have limited use of Project site for construction operations as indicated on Drawings by the Contract limits and as indicated by requirements of this Section.
B. Use of Site: Limit use of Project site to work in areas indicated. Do not disturb portions of Project site beyond areas in which the Work is indicated.
1. Driveways, Walkways and Entrances: Keep driveways and entrances serving premises clear and available to Owner, Owner's employees, and emergency vehicles at all times. Do not use these areas for parking or storage of materials.
a. Schedule deliveries to minimize use of driveways and entrances by construction operations.
b. Schedule deliveries to minimize space and time requirements for storage of materials and equipment on-site.

C. Condition of Existing Building: Maintain portions of existing building affected by construction operations in a weather tight condition throughout construction period. Repair damage caused by construction operations.

1.6 COORDINATION WITH OCCUPANTS
A. Full Owner Occupancy: Owner will occupy site and existing buildings during entire construction period. Cooperate with Owner during construction operations to minimize conflicts and facilitate Owner usage. Perform the Work so as not to interfere ...
1. Maintain access to existing walkways, corridors, and other adjacent occupied or used facilities. Do not close or obstruct walkways, corridors, or other occupied or used facilities without written permission from Owner and approval of authorities h...
2. Notify the Owner not less than 72 hours in advance of activities that will affect Owner's operations.
B. Owner Limited Occupancy of Completed Areas of Construction: Owner reserves the right to occupy and to place and install equipment in completed portions of the Work, prior to Substantial Completion of the Work, provided such occupancy does not inte...
1. Architect will prepare a Certificate of Substantial Completion for each specific portion of the Work to be occupied prior to Owner acceptance of the completed Work.
1.7 WORK RESTRICTIONS
A. Work Restrictions, General: Comply with restrictions on construction operations.
1. Comply with limitations on use of public streets and other requirements of authorities having jurisdiction.
B. On-Site Work Hours: Limit work in the existing building to normal business working hours of 7:00 a.m. to 6:00 p.m., Monday through Friday, except as otherwise indicated.
C. Existing Utility Interruptions: Do not interrupt utilities serving facilities occupied by Owner or others unless permitted under the following conditions and then only after providing temporary utility services according to requirements indicated:
1. Notify Architect and Owner not less than two days in advance of proposed utility interruptions.
2. Coordinate buildings’ electrical power shut-off with Owner and schedule on days/times when the building is not used by students.
D. Noise, Vibration, and Odors: Coordinate operations that may result in high levels of noise and vibration, odors, or other disruption to Owner occupancy with Owner.
E. Nonsmoking Building: Smoking is not permitted within the building or anywhere on school property.
F. Controlled Substances: Use of tobacco products and other controlled substances within the existing building,or anywhere on school property, is not permitted.
G. Employee Identification: Provide identification tags for Contractor personnel working on the Project site. Require personnel to utilize identification tags at all times. Contractor personnel are to sign in and out at the school office each day t...
H. Employee Screening: Comply with Owner's requirements regarding criminal background screening of on-site Contractor personnel working on the Project site. See specifications section 00003 - Supplements to “General Conditions of the Contract for Co...
I. Maintain list of approved screened personnel with Owner's Representative
1.8 SPECIFICATION AND DRAWING CONVENTIONS
A. Specification Content: The Specifications use certain conventions for the style of language and the intended meaning of certain terms, words, and phrases when used in particular situations. These conventions are as follows:
1. Imperative mood and streamlined language are generally used in the Specifications. The words "shall," "shall be," or "shall comply with," depending on the context, are implied where a colon (:) is used within a sentence or phrase.
2. Specification requirements are to be performed by Contractor unless specifically stated otherwise.
B. Division 1 General Requirements: Requirements of Sections in Division 1 apply to the Work of all Sections in the Specifications.
C. Drawing Coordination: Requirements for materials and products identified on the Drawings are described in detail in the Specifications. One or more of the following are used on the Drawings to identify materials and products:
1. Terminology: Materials and products are identified by the typical generic terms used in the individual Specifications Sections.
2. Abbreviations: Materials and products are identified by abbreviations scheduled on Drawings.
PART 2 - PRODUCTS (Not Used)
PART 3 - EXECUTION (Not Used)
01230 SF - ALTERNATES
01250
01270 SF - UNIT PRICES
PART 1 - GENERAL
1.1 SUMMARY
A. Section includes administrative and procedural requirements for unit prices.
B. Related Requirements:
1. Section 01250 "Contract Modification Procedures" for procedures for submitting and handling Change Orders.
1.2 DEFINITIONS
A. Unit price is an amount incorporated in the Agreement, applicable during the duration of the Work as a price per unit of measurement for materials, equipment, or services, or a portion of the Work, added to or deducted from the Contract Sum by appr...
1.3 PROCEDURES
A. Unit prices include all necessary material, plus cost for delivery, installation, insurance, overhead, and profit.
B. Measurement and Payment: See individual Specification Sections for work that requires establishment of unit prices. Methods of measurement and payment for unit prices are specified in those Sections.
C. Owner reserves the right to reject Contractor's measurement of work-in-place that involves use of established unit prices and to have this work measured, at Owner's expense, by an independent surveyor acceptable to Contractor.
D. List of Unit Prices: A schedule of unit prices is included in Part 3. Specification Sections referenced in the schedule contain requirements for materials described under each unit price.
PART 2 - PRODUCTS (Not Used)
PART 3 - EXECUTION
3.1 SCHEDULE OF UNIT PRICES
A. Unit Price No. U1 – Steel roof deck:
1. Description: Steel roof deck matching the existing deck determined by the Architect to be structurally unsound.
2. Unit of Measurement: dollars per square foot.
01290
01310
01320
01330
01330b
01330c
01400
01420
01500
01600
01635
01635b
01700
01700b
01732
01770
01770b
01781
01782
01820
061053 SF - MISCELLANEOUS ROUGH CARPENTRY
PART 1 - GENERAL
1.1 SUMMARY
A. Section Includes:
1. Rooftop equipment bases and support curbs.
2. Wood blocking, cants, and nailers.
3. Plywood backing panels.
1.2 ACTION SUBMITTALS
A. Product Data: For each type of process and factory-fabricated product.
1.3 INFORMATIONAL SUBMITTALS
A. Evaluation Reports: For the following, from ICC-ES:
1. Preservative-treated wood.
2. Fire-retardant-treated wood.
3. Power-driven fasteners.
PART 2 - PRODUCTS
2.1 WOOD PRODUCTS, GENERAL
A. Lumber: DOC PS 20 and applicable rules of grading agencies indicated. If no grading agency is indicated, provide lumber that complies with the applicable rules of any rules-writing agency certified by the ALSC Board of Review. Provide lumber graded...
1. Factory mark each piece of lumber with grade stamp of grading agency.
2. Dress lumber, S4S, unless otherwise indicated.

B. Maximum Moisture Content of Lumber: 15 percent unless otherwise indicated.

2.2 WOOD-PRESERVATIVE-TREATED MATERIALS
A. Preservative Treatment by Pressure Process: AWPA U1; Use Category UC2 for interior construction not in contact with ground, Use Category UC3b for exterior construction not in contact with ground, and Use Category UC4a for items in contact with ground.
1. Preservative Chemicals: Acceptable to authorities having jurisdiction and containing no arsenic or chromium.
B. Kiln-dry lumber after treatment to a maximum moisture content of 19 percent. Do not use material that is warped or does not comply with requirements for untreated material.
C. Mark lumber with treatment quality mark of an inspection agency approved by the ALSC Board of Review.
D. Application: Treat all miscellaneous carpentry unless otherwise indicated.
2.3 MISCELLANEOUS LUMBER
A. General: Provide miscellaneous lumber indicated and lumber for support or attachment of other construction, including the following:
1. Blocking.
2. Nailers.
3. Rooftop equipment bases and support curbs.
4. Cants.
5. Furring.
6. Grounds.
7. Utility shelving.

B. Dimension Lumber Items: Construction or No. 2 grade lumber of any species.

2.4 PLYWOOD BACKING PANELS
A. Equipment Backing Panels: Plywood, DOC PS 1, Exterior, A-C, fire-retardant treated, in thickness indicated or, if not indicated, not less than 3/4-inch (19-mm) nominal thickness.
2.5 FASTENERS
A. General: Provide fasteners of size and type indicated that comply with requirements specified in this article for material and manufacture.
1. Where carpentry is exposed to weather, in ground contact, pressure-preservative treated, or in area of high relative humidity, provide fasteners with hot-dip zinc coating complying with ASTM A 153/A 153M.
B. Screws for Fastening to Metal Framing: ASTM C 1002, length as recommended by screw manufacturer for material being fastened.
C. Power-Driven Fasteners: Fastener systems with an evaluation report acceptable to authorities having jurisdiction, based on ICC-ES AC70.
PART 3 - EXECUTION
3.1 INSTALLATION, GENERAL
A. Framing Standard: Comply with AF&PA's WCD 1, "Details for Conventional Wood Frame Construction," unless otherwise indicated.
B. Set carpentry to required levels and lines, with members plumb, true to line, cut, and fitted. Fit carpentry accurately to other construction. Locate furring, nailers, blocking, grounds, and similar supports to comply with requirements for attachin...
C. Install plywood backing panels by fastening to studs; coordinate locations with utilities requiring backing panels. Install fire-retardant-treated plywood backing panels with classification marking of testing agency exposed to view.
D. Do not splice structural members between supports unless otherwise indicated.
E. Comply with AWPA M4 for applying field treatment to cut surfaces of preservative-treated lumber.
F. Securely attach carpentry work to substrate by anchoring and fastening as indicated, complying with the following:
1. Table 2304.9.1, "Fastening Schedule," in ICC's International Building Code.
2. Table R602.3(1), "Fastener Schedule for Structural Members," and Table R602.3(2), "Alternate Attachments," in ICC's International Residential Code for One- and Two-Family Dwellings.
3. ICC-ES evaluation report for fastener.
3.2 PROTECTION
A. Protect wood that has been treated with inorganic boron (SBX) from weather. If, despite protection, inorganic boron-treated wood becomes wet, apply EPA-registered borate treatment. Apply borate solution by spraying to comply with EPA-registered label.
07412 SF - STANDING-SEAM METAL ROOF PANELS
07543 SF - THERMOPLASTIC POLYOLEFIN (TPO) ROOFING
Beyer Dwgs Bound
01 BEYER A0
02 BEYER D1
03 BEYER A1
04 BEYER A2
05 BEYER A3

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