ESBD_437089_1752857460948_RFB 2025-055 Prequalification Application.pdf

GENERAL CONTRACTOR PREQUALIFICATION APPLICATION

Request is hereby made to prequalify to bid on the RFB No. 2025-055 Speegleville Rd. Utility Improvements (18ST2213A)

Company Name:

By:

Title:

Telephone ( ) e-Mail Date:

This form shall be submitted to:

CITY OF WACO

PURCHASING SERVICES

PO BOX 2570

WACO, TEXAS 76702

SUMMARY OF ATTACHMENTS TO BE PROVIDED

A. Firm history B. Individuals that visited site or assisted in preparation of prequalification package C. Resumes and experience of key personnel D. Organizational chart E. Description of work to be completed by bidding organization F. Major subcontractors

F1. Horizontal Directional Drilling Subcontractor Prequalification Application G. Construction projects currently under construction H. Bidding Organization’s similar projects

Project Manager similar projects Project Superintendent similar projects

I. Safety program J. Lost day accident report

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A. GENERAL

1. Organization Doing Business As:

Business Address:

Telephone Number: ( ) e-mail:

Indicate as Applicable: Corporation

Partnership Sole Proprietorship

Principal Office Location:

Address:

Contact Person:

Telephone Number: ( ) e-mail:

2. If a CORPORATION:

Date of Incorporation:

State of Incorporation:

Chief Executive Officer’s Name:

President’s Name:

Vice President’s Name(s):

Secretary’s Name:

Treasurer’s Name:

3. If a PARTNERSHIP:

Date of organization:

State whether partnership is general or limited:

Name and address of each partner:

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4. If a SOLE PROPRIETORSHIP:

Name and business address:

5. Provide a brief history of the organization and attach to this form. Labeled as “Attachment A”. This attachment should include, at a minimum:

Parent company name, if applicable Other names Bidding Organization is currently using, or has used in the past Years of experience in the industry

6. Name and title of individuals from your organization who have visited the site of the work, reviewed the Prequalification package, assisted in preparation of the Prequalification package (other than typing). At a minimum, the following individuals shall be named: Authorized Signatory, Estimator, and Project Manager. If necessary, attached a separate sheet, labeled as “Attachment B”.

7. Is your organization legally qualified to do business in Texas?

8. How many persons are employed full-time by your company?

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B. EXPERIENCE & EQUIPMENT

1. Key Personnel Experience: Provide qualifications of the project personnel who will perform key functions. Label as “Attachment C”. Minimum information to be contained on the resume* of each individual, if applicable, shall include:

years with Bidding Organization, total years of related technical experience, managerial experience, education, position occupied on each assignment, description of duties on each assignment, professional registration and certification, professional societies and affiliations and number of years of related experience with the organization. The following positions on your project team shall be identified at this time and shall be binding throughout the duration of the project unless otherwise approved by the City of Waco.

KEY PROJECT PERSONNEL – GENERAL CONTRACTOR

Principal-in-Charge Dedicated Project Manager (committed to, and performing, the work) Project Superintendent (Site Superintendent) Safety Officer

(*Resumes shall include (1) where person was employed for the last ten years,

(2) detailed projects and experience for the last three years, and (3) any information/experience noted in Section V (“Prequalification Process and Review”) of the Request for Bids )

2. Organizational Experience

a) How many years has your organization been in business as a construction company under your present business name?

b) List any other names your organization has, does or anticipates operating under, including the names of related companies presently doing business:

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c) How many years of experience in the proposed type and size of construction work has your organization had?

1) As a General Contractor:

2) As a Joint Venture Partner:

3) As a Subcontractor:

d) Provide a brief description of the structure of your organization with a block schematic diagram (i.e., organizational chart). Include titles and names of key personnel. Label as “Attachment D”.

e) In the past ten years, has any officer or partner of your organization been an officer or partner of some other organization that failed to complete a construction contract? (Include the specific year(s) of the occurrence(s) in your answer.)

If so, state name of individual, current title, other organization and provide details:

f) In the past ten years, has any officer or partner of your organization failed to complete a construction contract for which he was Principal-in-Charge, Project Manager or Project Superintendent? (Include the specific year(s) of the occurrence(s) in your answer.)

If so, state name of individual, current title and provide details:

g) In the past ten years, has your organization failed to complete any work awarded to it? (Include the specific year(s) of the occurrence(s) in your answer.)

If so, provide details:

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h) In the past 10 years, has your organization been released from a bid?

(Include the specific year(s) of the occurrence(s) in your answer.)

If so, list the name of the project, owner’s name, address, phone number and state the reasons for each occurrence:

i) Is your organization currently engaged in litigation with respect to any claim regarding contract performance?

If so, provide details:

j) In the past ten years, has your organization been assessed liquidated damages? (Include the specific year(s) of the occurrence(s) in your answer.)

If so, provide details, including the project name, contact name, phone number and owner’s name, address and phone number:

k) In the past ten years, has your organization had a contract terminated for cause? (Include the specific year(s) of the occurrence(s) in your answer.)

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l) In regards to questions e) through k); have any of these occurred with the City of Waco? If so, provide details about the project; circumstances in which this occurred; and the final outcome or resolution.

m) What percentage of this project do you, as the general contractor, anticipate performing?

n) Provide a description of the Work that will be completed by your organization’s work force for this project. If additional space is needed, label “Attachment E”.

o) Provide a listing of “Major” subcontractors that your company proposes to utilize for the requested project. Include their company name, contact information, brief description of proposed services, key staff, years in business, and at least three projects with similar work and complexity.

“Major” subcontractor is defined as any contractor performing: 1) electrical, 2) site work. (If additional space is required, include as “Attachment F”.) (Attach all Horizontal Direction Drilling Subcontractor Prequalification Applications General Contractor would like the City to consider as “Attachment F1”.)

p) What construction projects does your organization currently have under contract? Provide the name and location of each project, name of owner and their construction manager, description of project, the anticipated completion date, contract amount and list of current disputes and/or claims.

(If additional space is required, include as “Attachment G”).

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In what other business(es) does your organization actively participate?

q) Major Scopes of Work: The information for all referenced projects in this section shall contain at a minimum the following information:

i. Name of Project

ii. Location of Project

iii. Reference Project Contact including name, address, telephone number, and email of the Owner

iv. Name of Construction Manager

v. Project Cost

vi. Description of Project demonstrating similar size and complexity as this project.

Note: Listing contact names, addresses, phone numbers, etc., indicates your organization has no objection to these persons and/or organizations being contacted for verification and/or additional information.

List at least two (2) successful gravity wastewater line projects (equal to or greater than 18-inch diameter PVC pipe with each at least 1,000 linear feet in length) and at least two (2) successful potable waterline projects (equal to or greater than 24-inch diameter PVC pipe with at least 1,000 linear feet in length) that the Bidding Organization has completed during the last 10 years and include any information noted in Section V (“Prequalification Process and Review”) of the Request for Bids. For all applicable projects provide bid completion time; actual completion time; contract price; and general description of change orders and claims. Fully describe each project. Label as “Attachment H”.

List at least two (2) successful gravity wastewater line projects (equal to or greater than 18-inch diameter PVC pipe with each at least 1,000 linear feet in length) and at least two (2) successful potable waterline projects (equal to or greater than 24-inch diameter PVC pipe with at least 1,000 linear feet in length) that the Project Manager has completed within the past 10 years. At least one project must have been completed with the Bidding Organization.

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List at least two (2) successful gravity wastewater line projects (equal to or greater than 18-inch diameter PVC pipe with each at least 1,000 linear feet in length) and at least two (2) successful potable waterline projects (equal to or greater than 24-inch diameter PVC pipe with at least 1,000 linear feet in length) that the Site Superintendent has completed within the past 10 years. At least one project must have been completed with the Bidding Organization.

3. Equipment

a) List the major types of construction equipment your organization would propose to use on the proposed work:

b) Which of these items of equipment does your organization own, and state whether or not this equipment will be available when needed for the proposed work?

c) List the major items of equipment which your organization would typically lease:

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C. CONTRACTOR’S FINANCIAL STATUS

Attach documentation showing that a bonding company will issue performance and payment bonds to the submitter if the contract is awarded. The bonding company must meet the following standards: complied with the laws and regulations of the U.S. Department of the Treasury under Title 31 U.S.C. 9304-9308 of the United States Code (“T-listing”) and be included as an acceptable surety on federal bonds in the Department of the Treasury’s Listing of Approved Sureties (Department Circular 570).

1. What is your organization’s approximate total bonding capacity?

Approximately what percentage is currently committed to other work?

2. What is the name, address, and telephone number of your organization’s primary bonding company?

3. Does your organization intend to use this company as Surety?

If not, who does your organization intend to use? Provide Surety’s name, address and telephone number.

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D. SAFETY RECORD

1. Describe the permanent safety program maintained within your organization.

(Provide your organization’s prepared safety statement, program or policy, if available, and label as “Attachment I”).

2. What is the approximate total dollar value of OSHA safety violation citations charged against your organization over the past five years?

3. Provide specific details for each OSHA citation received within the past five years.

4. Include a lost day accident report over the last three years for the job site project manager listed in Section B. (If additional space is required, include as “Attachment J”).

E. AFFIDAVITS

AT LEAST ONE OF THE FOLLOWING THREE AFFIDAVITS MUST BE EXECUTED. ANY

AFFIDAVIT THAT IS NOT APPLICABLE TO YOUR ORGANIZATION SHOULD BE LEFT BLANK.

F. INSURANCE

Insurance and Indemnification requirements are listed in Appendix C for this Request for Bids. By checking the box below, you certify that you will meet the minimum insurance requirements listed in Appendix C and that, if awarded the contract for the Speegleville Road Utility Improvements project, you will provide your Certificate of Insurance to the City of Waco and fulfill all other insurance requirements listed in Appendix C.

☐ I certify the above statement.

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PREQUALIFICATION APPLICATION:

AFFIDAVIT FOR CORPORATION (1)

State of §

County of §

, being duly sworn deposes and states:

That he/she is of the , the corporation submitting the foregoing statement of experience and financial condition; that he/she has read the same; and that the same is true and correct.

Signature

Signed and sworn to before me this day of, 20

Notary Public

My commission expires:

Note: Use full corporate name and attach corporate seal.

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AFFIDAVIT FOR PARTNERSHIP (2)

State of §

County of §

, being duly sworn deposes and states:

That he/she is of the , the partnership submitting the foregoing statement of experience and financial condition; that he/she has read same; and that same is true and correct.

Signature

Signed and sworn to before me this day of, 20

Notary Public

My commission expires:

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AFFIDAVIT FOR SOLE PROPRIETORSHIP (3)

State of §

County of §

, being duly sworn and deposes and states:

That he/she the person submitting the forgoing statement of experience and financial condition; that he/she has read same; and that same is true and correct.

Signature

Signed and sworn to before me this day of, 20

Notary Public

My commission expires:

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HORIZONTAL DIRECTIONAL DRILLING CONTRACTOR PREQUALIFICATION

APPLICATION

Request is hereby made to prequalify as a horizontal directional drilling subcontractor on the RFB No. 2025-055

Speegleville Rd. Utility Improvements (18ST2213A)

Company Name:

By:

Title:

Telephone ( ) e-Mail Date:

This form shall be submitted to:

CITY OF WACO

PURCHASING SERVICES

PO BOX 2570

WACO, TEXAS 76702

SUMMARY OF ATTACHMENTS TO BE PROVIDED

DA. Resumes and experience of key personnel DB. Bidding Organization’s similar projects

Project Manager similar projects Site Superintendent similar projects

DC. Safety program DD. Lost day accident report

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A. EXPERIENCE & EQUIPMENT

1. Key Personnel Experience: Provide qualifications of the project personnel who will perform key functions. Label as “Attachment DA”. Minimum information to be contained on the resume* of each individual, if applicable, shall include: years with Bidding Organization, total years of related technical experience, managerial experience, education, position occupied on each assignment, description of duties on each assignment, professional registration and certification, professional societies and affiliations and number of years of related experience with the organization. The following positions on your project team shall be identified at this time and shall be binding throughout the duration of the project unless otherwise approved by the City of Waco.

KEY PROJECT PERSONNEL – HORIZONTAL DIRECTIONAL

DRILLING SUBCONTRACTOR

Principal-in-Charge Dedicated Project Manager (committed to, and performing, the work)

Project Superintendent (Site Superintendent) Safety Officer (*Resumes shall include (1) where person was employed for the last ten years,

(2) detailed projects and experience for the last three years, and (3) any information/experience noted in Section V (“Prequalification Process and Review”) of the Request for Bids )

2. Organizational Experience

a) In the past ten years, has any officer or partner of your organization been an officer or partner of some other organization that failed to complete a construction contract? (Include the specific year(s) of the occurrence(s) in your answer.)

If so, state name of individual, current title, other organization and provide details:

b) Is your organization currently engaged in litigation with respect to any claim regarding contract performance?

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c) List successful horizontal directional drill projects (equal to or greater than 24-inch diameter HDPE pipe) that the Bidding Organization has completed during the last 10 years and include any information noted in Section V (“Prequalification Process and Review”) of the Request for Bids . The information for each project shall contain at a minimum: name of project and location; the name, reference contact, address, and telephone number of owner; the name of construction manager; and a project cost and description demonstrating similar size and complexity as this project. For all applicable projects provide bid completion time; actual completion time; contract price; and general description of change orders and claims.

Fully describe each project. Label as “Attachment DB”. Note: Listing contact names, addresses, phone numbers, etc., indicates your organization has no objection to these persons and/or organizations being contacted for verification and/or additional information.

List three (3) successful horizontal directional drill projects (equal to or greater than 24-inch diameter HDPE pipe) with at least one project being 1,000 linear feet in length or greater, that the Bidding Organization has completed during the last 10 years. Specifically provide the following information:

• Name of project and location

• Name, contact, address, telephone number, and email of the owner

• Name of construction manager

• Project cost and description demonstrating similar size as this project.

List two (2) successful horizontal directional drill projects for the Project Manager, and the Site Superintendent completed within the past 10 years that were equal to or greater than 24-inch diameter HDPE pipe.

Specifically provide the following information:

• Name of project and location

• Name, contact, address, telephone number, and email of the owner

• Name of construction manager

• Project cost and description demonstrating similar size as this project.

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B. SAFETY RECORD

1. Describe the permanent safety program maintained within your organization.

(Provide your organization’s prepared safety statement, program or policy, if available, and label as “Attachment DC”).

2. What is the approximate total dollar value of OSHA safety violation citations charged against your organization over the past five years?

3. Provide specific details for each OSHA citation received within the past five years.

4. Include a lost day accident report over the last three years for the job site project manager listed in Section B. (If additional space is required, include as “Attachment DD”).

C. AFFIDAVITS

AT LEAST ONE OF THE FOLLOWING THREE AFFIDAVITS MUST BE EXECUTED. ANY

AFFIDAVIT THAT IS NOT APPLICABLE TO YOUR ORGANIZATION SHOULD BE LEFT BLANK.

D. INSURANCE

Insurance and Indemnification requirements are listed in Appendix C for this Request for Bids. By checking the box below, you certify that you will meet the minimum insurance requirements listed in Appendix C and that, if awarded the contract for the Speegleville Road Utilities Project, you will provide your Certificate of Insurance to the City of Waco and fulfill all other insurance requirements listed in Appendix C.

☐ I certify the above statement.

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AFFIDAVIT FOR CORPORATION (1)

State of § County of §

, being duly sworn deposes and states:

That he/she is of the , the corporation submitting the foregoing statement of experience; that he/she has read the same;

and that the same is true and correct.

Signature

Signed and sworn to before me this day of, 20

Notary Public

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AFFIDAVIT FOR PARTNERSHIP (2)

, being duly sworn deposes and states:

That he/she is of the , the partnership submitting the foregoing statement of experience; that he/she has read same; and that same is true and correct.

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AFFIDAVIT FOR SOLE PROPRIETORSHIP (3)

, being duly sworn and deposes and states:

That he/she the person submitting the forgoing statement of experience; that he/she has read same; and that same is true and correct.

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