Enclosure 1 - Qualification Criteria.docx
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- 419151DH
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Department of Energy Office of Science
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ENCLOSURE 1
QUALIFICATION CRITERIA
Preparation and Painting of The Upton Road Water Tower
| J/N | 419151 | Company Name: | |
| A. | QUALIFICATION STATEMENT | ||
| 1. | Contractor has successfully completed work on at least two projects of similar scope, size and complexity as the Preparation and Painting of The Upton Road Water Tower project in the last five years. | ||
| ____Yes | No |
| 2. | Proposed Project Supervisor has supervised work on a project of similar scope, size and complexity as the Preparation and Painting of The Upton Road Water Tower project in the last seven years. | |
| ____Yes | No |
| *3. | Contractor’s 2019, 2020, and 2021 insurance Experience Modification Ratings are equal to or less than 1.0 for each year. | |
| ____Yes | No |
4. Contractor has a written Corporate Construction Safety and Training program.
____Yes No
| B. | SUBMITTALS |
| 1. | Submit two similar projects constructed during the last five years to demonstrate compliance with Qualification Criteria A.1. Indicate: |
| a) | Project Title |
| b) | Contract Amount |
| c) | Detailed Description of Work |
| d) | Name, Address and Telephone Number of Owner or Contracting Officer |
2. Submit resume for the proposed Project Supervisor to demonstrate compliance with Qualification Criteria A.2. Include:
| a) | Project Title |
| b) | Contract Amount |
| c) | Detailed Description of Work |
| d) | Name, Address and Telephone Number of Owner or Contracting Officer |
| 3. | Submit the following Contractor rating information: | ||||||||
| 2019 | 2020 | 2021 | Average | ||||||
| a) | Lost time frequency rate (DART) | = | ( ) | + | ( ) | + | ( ) | 3 = | ( ) |
| b) | Recordable Incidence Rate | = | ( ) | + | ( ) | + | ( ) | 3 = | ( ) |
| c) | Experience Modification Rate | = | ( ) | ( ) | ( ) |
Provide backup documentation from an independent source, such as insurance carrier, to verify ratings.
4. Submit copy of Contractor’s OSHA 300 logs and total number of hours worked for 2019, 2020, and 2021.
5. Submit Contractor’s Corporate Construction Safety and Training Program.
This attachment addresses the Qualification Criteria the Contractor must meet to qualify to receive award. Failure to acknowledge ‘Yes’ to any of the Qualification Criteria, and provide the required substantiating submittals with your bid, may result in your bid being considered non-responsive. BSA reserves the right to accept or reject any bid based on the Qualification Criteria requirements.
COMPANY NAME:
SIGNED/TITLE:
DATE:
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