ATTACHMENT H - FIRM PROFILE 26-189 ESCO EPID RFQ Final.docx

ATTACHMENT H – AGENCY RFQ NUMBER 26-189 ESCO EPID; OREGONBUYS SOLICITATION NUMBER S-33000-00018034

ATTACHMENT H – FIRM PROFILE

1. GENERAL ESCO FIRM INFORMATION

Firm Name:

Mailing Address:

Physical Address:

Names, titles, phone numbers and Email addresses of two principal contact persons:

Name Title

Phone Email

Name Title

Phone Email

List any division or branch offices that have or will participate in the development of the Statement of Qualifications, in its evaluation prior to submittal to Agency, or in the performance of any Services:

Name of Office:

Address:

Name and Address of Parent Company (if applicable):

Name:

Address:

Oregon CCB Number:

2. DATE PREPARED:

3. TYPE OF ENTITY

4. FEDERAL EMPLOYER IDENTIFICATION NUMBER:

5. YEAR ESCO FIRM ESTABLISHED:

6. FIVE-YEAR SUMMARY OF CONTRACT DOLLAR AMOUNTS OF ENERGY PERFORMANCE CONTRACTING FOR YOUR FIRM:

Estimate of total value for all energy-related contracts that are active with your company:

$ (total value) as of (date).

7. CORPORATE BACKGROUND

a. Years Under Present Name Provide the number of years your firm has been in business under its present business name, beginning and ending dates registered under that name and the Oregon Secretary of State registration number.

b. All Former Names Indicate all other names by which your firm has been known, the beginning and ending dates registered under that name and the Oregon Secretary of State registration number for each name.

c. Years in ESCO Business How many years has your firm been providing energy-efficiency related services?

years How many years has your firm offered performance contracting services?

years

d. Number of Contracts Indicate the number of energy savings performance contracts actually implemented by your firm over the last 5 years that have completed the Measurement and Verification phase (at a minimum, firm must have successfully completed the M&V phase for three separate projects).

# energy savings performance contracts

If your firm conducts business nationally or globally, how many projects were managed directly by the specific branch or division assigned to Oregon?

# energy savings performance contracts

e. State Qualification Identify all states in which your firm is legally authorized to do business.

f. Lawsuit Involvement Has your firm been involved in a construction-related lawsuit (other than labor or personnel litigation) during the past five (5) years? _____Yes _____No. If yes, please explain in detail the nature of the claim, circumstances, amount in dispute, date suit was filed, and the outcome of the case.

Note: If your firm is currently under licensure suspension by any regulatory entity, your SOQ may not be accepted.

g. Construction Arbitration Involvement Has your firm been involved in any construction arbitration demands, or have any liens been placed against your firm during the past five (5) years? _____Yes _____No. If yes, identify the nature of the claim, amount in dispute, parties involved, and ultimate resolution of the proceeding.

Note: Your SOQ may not be accepted if more than two major arbitrations occurred in the last five years, or if there are current unresolved arbitrations.

h. National Labor Relations Board or Similar Involvement Has your firm been involved in any lawsuits, administrative proceedings or hearings involving the National Labor Relations Board, State of Oregon Bureau of Labor and Industries, or a similar state or federal agency during the past five (5) years? _____Yes _____No. If yes, identify the nature of the claim and the ultimate resolution of the proceeding.

Note: Your SOQ may not be accepted if you have been involved in two or more labor relations lawsuits in the last five years.

i. OSHA-Type Proceedings Has your firm been involved in any lawsuits, administrative proceedings or hearings involving the Occupational Safety and Health Administration or a similar state or federal agency during the past five (5) years, regarding the safety of one of your firm’s projects? _____Yes _____No. If yes, identify the nature of the claim and the ultimate resolution of the proceeding.

Note: Your SOQ may not be accepted if your firm has been involved in two or more OSHA-type claims in the last five years.

j. Bankruptcy Involvement Has your firm, or any of its parents or subsidiaries, ever had a bankruptcy petition filed in its name, voluntarily or involuntarily? _____Yes _____No. If yes, explain in detail the circumstances, date the protection order was filed and the resolution of the case (or current status, if still ongoing).

Note: Current bankruptcy proceedings will disqualify your firm from consideration.

8. FINANCIAL INFORMATION

SOQs will be reviewed for completeness and analyzed for financial soundness. All SOQs will be subject to standards that include a Current Ratio of no less than 1.75 and a Debt to Equity Ratio of no more than 2.00. Working capital will be evaluated for sufficient liquidity available to run the business, including the ability to stay current with short term obligations.

a. Statement of Financial Conditions Attach an annual audited Statement of Financial Conditions, including balance sheet, income statement and statement of cash flows, dated within the past twelve (12) months.

b. Contact Information Provide the name, address, and phone number of the firm(s) that prepared the financial statements.

Name:

Address:

Phone:

c. Past Financial Statements Provide audited annual financial statements for each of the last three (3) years.

d. Insurance and Bonding Capacity Attach a certificate of insurance that shows your firm’s current coverage, including per occurrence and aggregate limits for the following types of coverage: Commercial General Liability, Professional Liability, Automobile Liability, and any Excess Liability or Umbrella insurance.

Also attach a letter or other signed documentation from a surety company authorized to transact business in Oregon stating your firm’s bonding limits or capacity for ESPC projects (performance and payment bonds).

9. PERSONS OR ENTITY PROVIDING ENERGY SAVINGS GUARANTEES

Indicate whether Energy Savings Guarantees are provided by your firm or a third party. If a third party guarantees the ESPC, provide the name, address and phone number of the third party.

Name:

Address:

Phone:

Email:

AGENCY RFQ NUMBER 26-189 ESCO EPID; OREGONBUYS SOLICITATION NUMBER S-33000-00018034 Page 2 of 2