Attachment D Minimum Qualifications.pdf

WAYNE COUNTY AIRPORT AUTHORITY

REQUEST FOR BIDS #25-01753

ATTACHMENT D

ATTACHMENT D - VERIFICATION OF MINIMUM QUALIFICATIONS

FORM

Failure to complete this form or provide the required information for verification of minimum qualifications will result in your Bid being deemed nonresponsive and rejected without further evaluation.

a) The Bidder must have, as a business, a written safety program, provide evidence of implementation of the written safety program, and provide evidence of an EMR (Experience Modification Rate) with an average less than or equal to 1.0 over the past three (3) calendar years:

Bidder Name:

Include information to demonstrate that the company's safety program meets this Minimum Qualification.

Is evidence of implementation of written company safety program attached to the Bid?

Yes:

Provide the EMR for the past three calendar years:

1. 2022 EMR

2. 2023 EMR

3. 2024 EMR

Is the letter of verification attached to the Bid?

1. 2022 EMR Yes:

2. 2023 EMR Yes:

3. 2024 EMR Yes:

Provide a copy of the company's OSHA 300 forms for the past 3 years attached to the Bid.

Are the company’s OSHA 300 forms for the past 3 years attached to the Bid?

1. 2022 OSHA 300 Form Yes:

2. 2023 OSHA 300 Form Yes:

3. 2024 OSHA 300 Form Yes:

VERIFICATION OF MINIMUM QUALIFICATIONS FORM (continued)

b) The Bidder must provide evidence that a minimum of twenty-five percent (25%) of the bid amount will be assigned to and performed by a Wayne County Airport Authority Certified Small Business Enterprise. Such evidence shall be provided through completion of the table below and through completion of a Subcontractor Form, an attachment to this solicitation, for all subcontractors and suppliers proposed to be used if awarded the contract.

Show how you meet this minimum qualification.

SBE Commitment

SBE Minimum Qualification must be listed as a percentage of total contract cost. If SBE participation is to be completed through the use of subcontractors and/or suppliers, Subcontractor Forms must confirm the value and description of work to be performed.

Bidder understands that its SBE commitment, continues through the entire duration of the contract and if the contract value should change through a change order or other means of modification, then the SBE commitment follows the change, either increase or decrease.

WCAA Certified SBEs Commitment Summary Percentage

1. SBE Prime Contractor %

2. SBE Subcontractor(s) and/or Supplier(s) (Total from Subcontractor Forms) %

Bidder’s overall WCAA Certified SBE Commitment Percentage Total (Must meet or exceed 25%) %

Bidder’s overall SBE commitment percentage for this project is 25% of the total cost of the contract in its performance under this contract.

c) The Bidder must have completed at least two (2) projects requiring elevator, escalator, or moving walkway salvage & removal; installation of cast-in-place concrete within existing structures; a minimum project cost exceeding $250,000 each; and that were Substantially Completed in the year 2018 or later and by the Bid Deadline.

Bidder Name:

Provide information on a minimum of two (2) electrical construction projects below to demonstrate compliance with this Minimum Qualification. Duplicate this form as needed.

i. Project Name:

Project Location:

Project Description (Scope of work included in project):

Date of Substantial Completion:

Construction Cost: $_________________________

Client Name:

Client Contact: Title:

Phone Number: Email Address:

ii. Project Name:

Date of Substantial Completion:

Construction Cost: $_________________________

Client Name:

d) The Bidder must have on staff a Project Manager that will be assigned to the Project resulting from this RFB, that has served as the Project Manager on the construction of a minimum of two (2) projects requiring elevator, escalator, or moving walkway salvage & removal; installation of cast-in-place concrete within existing structures; a minimum project cost exceeding $250,000 each; and that were Substantially Completed in the year 2018 or later and by the Bid Deadline. Provide a resume for the Project Manager (include with Attachment D: Verification of Minimum Qualification Forms).

Project Manager Name:

Is a copy of the Project Manager’s resume included with this Bid? Yes: ______

Provide information on a minimum of two (2) projects below to demonstrate compliance with this Minimum Qualification.

Contract Value: $_________________________

Date of Substantial Completion:

Client Name:

Contract Value: $_________________________

Date of Substantial Completion:

Client Name:

e) The Bidder must have a Project Superintendent on staff that will be assigned to the contract resulting from this RFB, who will be on-site and responsible for the performance of the project that has performed in a supervisory role on a minimum of two (2) projects requiring elevator, escalator, or moving walkway salvage & removal; installation of cast-in-place concrete within existing structures; a minimum project cost exceeding $250,000 each; and that were Substantially Completed in the year 2018 or later and by the Bid Deadline. Provide a resume for the Project Superintendent (include with Attachment D: Verification of Minimum Qualification Forms).

Project Superintendent Name:

Is a copy of the Project Superintendent’s resume included with this Bid? Yes: ______

Provide information on a minimum of two (2) projects below to demonstrate compliance with this Minimum Qualification.

Contract Value: $_________________________

Date of Substantial Completion:

Client Name:

Contract Value: $_________________________

Date of Substantial Completion:

Client Name:

f) The Bidder must have on staff (or on the staff of a Team Member), a minimum of one (1) individual that will be assigned to the Project resulting from this RFB, that are licensed person(s) that will perform electrical portions of the work in accordance with the State of Michigan “Skilled Trades Regulation Act” (Act No. 407 of 2016). Information regarding this Act may be accessed on the State of Michigan website at the following weblink:

http://www.legislature.mi.gov/(S(bufluj41g15mqamy4ebruymd))/mileg.aspx?page=GetObject&objectname

=2016-PA-0407

Name of licensed Team Member:

Employer:

License Number:

Issuing State:

Copy of Electrical license included with this Bid? Yes: ____ https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.legislature.mi.gov%2F(S(bufluj41g15mqamy4ebruymd))%2Fmileg.aspx%3Fpage%3DGetObject%26objectname%3D2016-PA-0407&data=05%7C02%7CNicolas.Pridnia%40wcaa.us%7C0df7f807692f4861b52e08dc525d7649%7C3dd77ff24b51432bb1fac6b44af89de7%7C0%7C0%7C638475808574755463%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=1owb5Rj4PzWL4tKhhJlsXfLy6qyWTsuWr1Lb%2BdgzLU0%3D&reserved=0 https://gcc02.safelinks.protection.outlook.com/?url=http%3A%2F%2Fwww.legislature.mi.gov%2F(S(bufluj41g15mqamy4ebruymd))%2Fmileg.aspx%3Fpage%3DGetObject%26objectname%3D2016-PA-0407&data=05%7C02%7CNicolas.Pridnia%40wcaa.us%7C0df7f807692f4861b52e08dc525d7649%7C3dd77ff24b51432bb1fac6b44af89de7%7C0%7C0%7C638475808574755463%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=1owb5Rj4PzWL4tKhhJlsXfLy6qyWTsuWr1Lb%2BdgzLU0%3D&reserved=0

g) The Bidder must have on staff (or on the staff of a Team Member), a minimum of one (1) individual that will be assigned to the Project resulting from this RFB, that are licensed person(s) that will perform the moving walkway salvage and removal portions of the work in accordance with the State of Michigan Elevator Licensing (Act No. 333 of 1976). Information regarding this Act may be accessed on the State of Michigan website at the following weblink:

MCL - Act 333 of 1976 - Michigan Legislature

License Number:

Copy of Elevator Journeyman license included with this Bid? Yes: ____ https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-Act-333-of-1976&highlight=Elevator

h) The Bidder must have on staff (or on the staff of a Team Member), a minimum of one (1) individual that will be assigned to the Project resulting from this RFB, that are licensed person(s) that will perform the Inspecting, Structural Engineering portions of the work in accordance with the State of Michigan Occupational Code (Article 20 of Public Act 299 of 1980). Information regarding this Act may be accessed on the State of Michigan website at the following weblink:

MCL - 299-1980-20 - Michigan Legislature

License Number:

Copy of Structural Engineering license included with this Bid? Yes: ____ https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-299-1980-20