HDD Contractor Pre-Qualification - Nacimiento Water Project Unit G Repair Horizontal Directional Drilling.pdf

REQUEST FOR STATEMENT OF

QUALIFICATIONS

FOR

PREQUALIFIED HDD CONTRACTOR

SEEKING TO QUALIFY FOR THE

NACIMIENTO WATER PROJECT UNIT G REPAIR

HORIZONTAL DIRECTIONAL DRILLING

CONTRACTORS/SUBCONTRACTORS

RSOQ No. 1989

August 2026

San Luis Obispo County TABLE OF CONTENTS Page 1 of 2 Pre-Qualification of General Contractors

Table of Contents

NOTIFICATION ANNOUNCEMENT

SECTION 1: GENERAL INSTRUCTIONS AND INFORMATION

1. General Instructions and Information

2. Data Required

3. Current Financial Information

4. District’s Reservation of Rights

5. Appeal Rights

SECTION 2: PROJECT OVERVIEW

1. Project Location

2. Project Description

3. Construction Plans

4. Anticipated Timeline (Subject to Change)

SECTION 3: APPLICATION FOR PRE-QUALIFICATION

1. Part I: Organization Information

2. Part II: Essential Criteria Questions

3. Part III: Organization, History, Performance, Compliance with Law

4. Part IV: Recent Similar Construction Experience

5. Part V: Certification

6. Part VI: Required Attachments

SECTION 4: SCORING CRITERIA

1. Part I: Organization Information

2. Part II: Essential Criteria Questions

3. Part III: Organization, History, Performance, Compliance with Law

4. Part IV: Recent Construction Projects

5. Part V: Required Attachments

6. Part VI: Certification

San Luis Obispo County NOTIFICATION ANNOUNCEMENT Page 2 of 3

NOTIFICATION ANNOUNCEMENT

NOTIFICATION OF PRE-QUALIFICATION OF HORIZONTAL DIRECTIONAL

DRILLING (HDD) SUBCONTRACTORS ASSOCIATED WITH THE NACIMIENTO

WATER PROJECT UNIT G REALIGNMENT COMMENCING WITH FORTHCOMING

PUBLIC WORK BID

Notice is hereby given that San Luis Obispo County Flood Control and Water Conservation District (“District”) has determined that all horizontal directional drilling (“HDD”) subcontractors or Contractors planning to self-perform the HDD work (collectively, “Subcontractors”) on the Nacimiento Water Project Unit G Realignment (“Project”) to be undertaken by the District must be pre-qualified prior to submitting a bid on the Project. It is mandatory that all Subcontractors who intend to submit a bid or participate in the Project fully complete the pre-qualification questionnaire, provide all materials requested herein, and be approved by District to be on the final qualified Subcontractors list. No bid will be accepted from a contractor who has failed to comply with these requirements or whose Subcontractor has failed to comply with these requirements.

The prequalification evaluation is solely for the purpose of determining which Subcontractors are deemed prequalified for the successful performance of the construction of the Project and does not guarantee that a Subcontractor will receive a contract in connection with the Project.

Submission of Pre-Qualification Applications

Pre-qualification applications are posted on the District’s Purchasing website:

https://www.slocounty.ca.gov/departments/central-services/purchasing-services/services/bid-rfp-opportunities

Any changes, additions, or deletions to the application process will be in the form of written addenda issued by the District. Any addenda will be posted on the website. Prospective applicants must check the website for addenda or other relevant new information during the response period. The District is not responsible for the failure of any prospective applicants to receive such addenda. All addenda so issued shall become a part of this application request.

All prospective applicants are required to acknowledge and confirm receipt of every addendum in their applications.

Requests for clarification of the process or application documents must be submitted no later than 3:00 p.m. (PST), September 11, 2026. Requests submitted after said date may not be considered.

All requests for clarification must be made in writing through the Purchasing website. Questions and responses will be posted on the Purchasing website and can be viewed by accessing the request for pre-qualification located on the Purchasing website. The identity of the entity submitting the request for clarification will not be posted. The District reserves the right to determine the appropriateness of comments / questions that will be posted on the website.

If you or your firm is interested and qualified, please submit one (1) electronic copy of your proposal, in Adobe Acrobat Portable Data Format (pdf), through the County’s Purchasing website at the address listed above by 3:00 P.M. (PST) on September 18, 2026. No fax or e-mail copies will be accepted. Submittals received after the specified time and date will not be considered. THIS

SUBMISSION DEADLINE WILL BE STRICTLY ENFORCED.

https://www.slocounty.ca.gov/departments/central-services/purchasing-services/services/bid-rfp-opportunities https://www.slocounty.ca.gov/departments/central-services/purchasing-services/services/bid-rfp-opportunities

San Luis Obispo County NOTIFICATION ANNOUNCEMENT Page 3 of 4

SECTION 1: GENERAL INSTRUCTIONS AND INFORMATION

1. General Instructions and Information

An HDD subcontractor must have a current California Pipeline Class C-34 Contractors license in order to participate in bids for the construction contract on this Project. If a HDD subcontractor does not currently hold a Class C-34 license, the HDD subcontractor must (1) state all of the reasons why it does not currently hold a Class C-34 license, and (2) provide all facts and documents that show how it satisfies the State’s requirements for issuance of a Class C-34 license, and (3) state the reasons why it is reasonably likely that the HDD subcontractor will have a Class C-34 license before the District awards the construction contract on this Project.

Pre-qualification by the District for this Project shall remain valid until the contract for construction is awarded or until responding firms are notified in writing by the District that the final pre-qualification list has expired. No bid will be accepted from a general contractor whose HDD subcontractor has failed to pre-qualify.

2. Data Required

All portions of the application shall be completed with additional information attached if the space provided does not suffice. Answers to questions contained in the attached questionnaire and the most recent reviewed or audited financial statements, with accompanying notes and supplemental information, are required. District reserves the right to check other sources available. The District’s decision will be based on the Scoring Criteria.

Each questionnaire must be signed under penalty of perjury in the manner designated at the end of the form, by an individual who has the legal authority to bind the Subcontractor on whose behalf that person is signing. If any information provided by a Subcontractor becomes inaccurate, the Subcontractor must immediately notify District and provide updated accurate information in writing, under penalty of perjury.

The pre-qualification applications (questionnaire answers and financial statements) submitted by Contractors or subcontractors are not public records and are not open to public inspection. All information provided will be kept confidential to the extent permitted by law. However, the contents may be disclosed to third parties for purpose of verification, or investigation of substantial allegations, or in an appeal. State law requires that the names of Subcontractors applying for pre-qualification status shall be public records subject to disclosure, and the first page of the questionnaire will be used for that purpose.

All documents submitted to the District as part of the pre-qualification process will become the exclusive property of the District and may be returned to the Subcontractor or kept by the District in the District’s sole discretion.

3. Current Financial Information

Subcontractor shall provide a complete financial statement indicating the organization’s financial condition. Financial statements provided by Subcontractors shall not be older than six (6) months prior to the date of filing this application. The financial statements are to be reviewed or audited financial statements, with accompanying notes and supplemental information. The District reserves the right to reject financial statements in which the financial condition reported is of a date six (6)

San Luis Obispo County GENERAL INSTRUCTIONS AND INFORMATION Page 4 of 5 months prior to the date of filing.

4. District’s Reservation of Rights

District may refuse to grant pre-qualification where the requested information and materials are not provided, or not provided by September 18th, 2026. There is no appeal from a refusal for an incomplete or late application, but re-application for a later project is permitted.

District reserves the right to adjust, increase, limit, suspend or rescind the pre-qualification rating based on subsequently learned information. Subcontractors whose rating changes sufficient to disqualify them will be notified, and given an opportunity to appeal a pre-qualification rating.

District reserves the right to waive minor irregularities and omissions in the information contained in the pre-qualification application submitted, to make all final determinations, and to determine at any time that the pre-qualification procedures will not be applied to a specific future public works project.

While it is the intent of the pre-qualification questionnaire and documents required therewith to assist the District in determining bidder responsibility prior to bid and to aid the District in selecting the lowest responsible bidder, neither the fact of pre-qualification, nor any pre-qualification rating, will preclude the District from a post-bid consideration and determination of whether a bidder has the quality, fitness, capacity and experience to satisfactorily perform the proposed work, and has demonstrated the requisite trustworthiness.

5. Appeal Rights

Where a timely and completed application results in a rating below that necessary to pre-qualify, an appeal can be made. An appeal is begun by the Subcontractor delivering notice to the District of its appeal of the decision with respect to its pre-qualification rating, no later than ten (10) business days following the date of written notification from the District that the Contractor or subcontractor does not meet the rating established by the District. Without a timely appeal, the Subcontractor waives any and all rights to challenge the decision of the District, whether by administrative process, judicial process or any other legal process or proceeding.

If the Subcontractor gives the required notice of appeal and requests a hearing, the hearing shall be conducted so that it is concluded no later than ten (10) business days after the District’s receipt of the notice of appeal. The hearing shall be an informal process conducted by the Director of Public Works or designee (“Hearing Officer”). At or prior to the hearing, the Subcontractor will be advised of the basis for the District’s pre-qualification determination. The Subcontractor will be given the opportunity to present information and present reasons in opposition to the rating. The Hearing Officer will render its decision promptly after the conclusion of the hearing. It is the intention of the District that the date for the submission and opening of bids for the Project will not be delayed or postponed to allow for completion of an appeal process.

Note: A contractor or subcontractor will be found not pre-qualified for bidding on the Project if they receive a rating below that necessary to pre-qualify. Additional grounds upon which a contractor or subcontractor may be found not pre-qualified include:

(1) Omission of requested information or

(2) Falsification of information

San Luis Obispo County PROJECT OVERVIEW Page 5 of 6

SECTION 2: PROJECT OVERVIEW

1. Project Location

The project is located just outside the city limits of Atascadero, CA. The project location starts at the intersection of Salinas Rd and Santa Clara Rd then follows Salinas Road and ultimately ends with and HDD section under the Salinas River on private property.

The approximate start and end coordinates of the HDD section are: (-120.6171, 35.4514) and (- 120.6177, 35.4542)

2. Project Description

The Nacimiento Water Project Unit G Repair Project relocates a portion of the Nacimiento Water Project outside of the floodplain to repair storm damages and mitigate future storm damages. The entire project consists of realigning the pipeline and installing approximately 5200 LF of pipeline installed using open trench and horizontal directional drilling methods.

The part of the Nacimiento Unit G Repair that requires installation of 1230 LF of Horizontal Directional Drilling will be 20-inch high pressure welded steel pipe.

3. Construction Plans

The 90% Design Plans are available for viewing and downloading from the purchasing web site as an attachment. Plans are for reference purposes only and are subject to change prior to final bid (Not for Construction). Plans can be downloaded from Exhibit 1 – attached separately.

4. Anticipated Timeline (Subject to Change)

The District currently anticipated conducting the procurement for the Project in accordance with the following milestones. This schedule is subject to revisions and the District reserves the right to modify this schedule as it finds necessary.

Issue Application for Pre-Qualification August 21, 2026 Deadline for Requests for Information September 11, 2026 Pre-Qualification Application Due September 18, 2026 Notification of Pre-Qualified Contractors October 16, 2026

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 6 of 7

SECTION 3: APPLICATION FOR PRE-QUALIFICATION

The specific documents that must be submitted are:

Part I – Organization Information

Part II – Essential Criteria Questions

Part III – Organization History, Performance, Compliance with Law

Part IV – Recent Construction Projects Completed

Part V – Certification

Part VI – Required Attachments

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 7 of 8

Part I: Organization Information

CONTRACTOR INFORMATION

(All Questions Must Be Answered)

Firm Name (as it appears on CSLB license):

Firm Type (Select one): Corporation LLC Partnership Sole Proprietorship Joint Venture

Contact Person/Title:

(List Owner(s) if Firm is a Sole Proprietorship or Partnership)

Local Address (P.O. Box is not acceptable):

Address 1:

Address 2:

City Zip:

Office Telephone:

Contact Mobile:

Fax Number:

E-mail Address:

List all California construction or other professional license numbers, classifications and expiration dates held by your firm:

License Number Classification Expiration Date

List your firm’s DIR Public Works Contractor (PWCR) Registration Number(s):

PWCR Number Entity Name Expiration Date

If any of your firm’s license(s) are held in the name of a corporation, limited liability company, or partnership, list below the names of the qualifying individual(s) listed on the CSLB records who meet(s) the experience and examination requirements for each license.

License Number Qualifying Individual Expiration Date

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 8 of 9

CURRENT ORGANIZATION AND STRUCTURE

Complete the section below for the appropriate type of firm:

For Firms That Are Corporations:

1a. Date incorporated:

1b. Under the laws of what state:

1c. Provide all the following information for each person who is either (a) an officer of the corporation (president, vice president, secretary, treasurer), or (b) the owner of at least ten percent of the corporation’s stock:

Name Position Years with Firm

Ownership

1d. Identify every construction firm that any person listed above has been associated with (as owner, general partner, limited partner or officer) at any time during the last five years.

NOTE: For this question, “owner” and “partner” refer to ownership of ten percent or more of the business, or ten percent or more of its stock, if the business is a corporation.

Person’s Name Construction Firm Date of Person’s Participation with

Firm

For Firms That Are Limited Liability Companies (LLC):

1a. Date Article of Organization filed:

1b. Under the laws of what state:

1c. Provide all the following information for all members of the LLC:

Name Position Years with Firm

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1d. Identify every construction firm that any person listed above has been associated with (as owner, general partner, limited partner or officer) at any time during the last five years. NOTE:

For this question, “owner” and “partner” refer to ownership of ten percent or more of the business, or ten percent or more of its stock, if the business is a corporation.

Participation with Firm

For Firms That Are Partnerships:

1a. Date incorporated: ______________________________________ 1b. Under the laws of what state: ______________________________________ 1c. Provide all the following information for each partner who owns ten percent or more of the firm.

Name Position Years with

1d. Identify every construction firm that any person listed above has been associated with (as owner, general partner, limited partner or officer) at any time during the last five years.

NOTE: For this question, “owner” and “partner” refer to ownership of ten percent or more of the business, or ten percent or more of its stock, if the business is a corporation.

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 10 of 11

For Firms That Are Sole Proprietorships:

1a. Date of commencement of business 1b. Identify every construction firm that the business owner has been associated with (as owner, general partner, limited partner or officer) at any time during the last five years.

NOTE: For this question, “owner” and “partner” refer to ownership of ten percent or more of the business, or ten percent or more of its stock, if the business is a corporation.

For Firms That Intend to Make a Bid as Part of a Joint Venture:

1a. Date of commencement of joint venture:

1b. Provide all the following information for each firm that is a member of the joint venture that expects to bid on one or more projects

Name of Construction Firm % Ownership

Note: Explain on a separate sheet. Provide all other pertinent information required in the sections above, for each Corporation, LLC, Partnership, or Sole-Proprietorship that is a part of the Joint Venture.

FOR ALL FIRMS:

2. At any time during the past five years, has your firm shared office space, warehouse space, yard, plant or shop facilities, staff, equipment, telecommunications or other assets with any other construction firm? (If yes, identify and explain below.)

Construction Firm Description of Sharing Agreement

Location of Facilities

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 11 of 12

3. State your firm’s gross revenues for each of the last three fiscal years:

Current year ($):

Previous year ($):

Year prior to previous year ($):

4. How many years has your firm been in business in California as a contractor under your present business name and license number?

5. Bonding Capacity – Provide documentation from your surety identifying the following:

Name of Bonding Company/Surety:

Name of Surety Agent:

Address:

Telephone number:

6. If your firm was required to pay a premium of more than one percent for a performance and payment bond on any project(s) on which your firm worked at any time during the last three years, state the percentage that your firm was required to pay. You may provide an explanation for a percentage rate higher than one percent, if you wish to do so.

7. List all other sureties (name and full address) that have written bonds for your firm during the last five years, including the dates on which they were issued:

Name Address Date

8. How often do you require documented safety meetings to be held for construction employees and field supervisors during the course of a project?

9. List your firm’s Experience Modification Rate (EMR) (California workers’ compensation insurance) for each of the past three premium years:

Current year rate:

Previous year rate:

Year prior to previous year rate:

10. Does your firm regularly utilize a third party consultant to review labor compliance documents of subcontractors on a public works project? Yes No

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 12 of 13

11. Provide the name, address and telephone number of the apprenticeship program (approved by the California Apprenticeship Council) from whom you intend to request the dispatch of apprentices to employ on any public works project awarded by District.

Name Address Phone

12. Provide the name, address and telephone number of the apprenticeship program (approved by the California Apprenticeship Council) from whom you have requested and/or employed apprentices in the past three years.

Name Address Phone

13. If your firm operates its own State-approved apprenticeship program:

(a) Identify the craft or crafts in which your firm provided apprenticeship training in the past year;

(b) State the year in which each such apprenticeship program was approved and attach evidence of the most recent California Apprenticeship Council approval(s);

(c) For each craft, list the number apprentices employed by your firm and the number of individuals that completed apprenticeships while employed by your firm during the last three years.

Craft Year No. Apprentices No. Completed

14. Has your firm changed names or license number in the past five years?

(If yes, explain on a separate sheet, including the reason for the change.)

Yes No

15. Has there been any change in ownership of your firm at any time during the last five years?

(If yes, explain on a separate sheet.)

Yes

No

NOTE: A corporation whose shares are publicly traded is NOT required to answer this question.

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 13 of 14

16. Is your firm a subsidiary, parent, holding company or affiliate of another construction firm? Yes No (If yes, explain on a separate sheet.)

NOTE: Include information about other firms if one firm owns 50 percent or more of another, or if an owner, partner, or officer of your firm holds a similar position in another firm.

17. Has any owner, partner and/or officer of your firm operated or been connected to a construction firm under any other name in the last five years not listed in Section A or Section B above at any time in the past five years? Yes No

(If yes, provide the person’s name, construction firm name, and dates of participation.)

Name Construction Firm Dates of Participation

FINANCIAL STATEMENT

One year of audited or reviewed financial statements by a CPA for the General Contractor.

If the general contractor is a joint venture, each member of the joint venture must submit 1‐year audited or reviewed financial statements by a CPA.

The Financial Statement shall not be older than one year prior to the date of filing this Pre-qualification Submittal. The Financial Statement shall be reviewed or audited by a CPA and submitted with any accompanying notes and supplemental information. The County of San Luis Obispo reserves the right to reject Financial Statement in which the financial condition reported is a date 12 months or more prior to the date of filing.

The CPA should submit a copy of their current license as proof of the accountant’s qualifications to issue reviewed or audited financial statements. The license shall be signed and shall indicate the license certificate number. Bearing in mind that the working capital is an important factor in considering an entity’s financial condition, the entity’s accountant will perform a valuable service for the entity and at the same time assist the County and will furnish supplemental schedules to provide any information not specifically called for by the Statement which in their opinion might be taken into consideration.

Please fill in the following blanks based on the General Contractor’s latest Financial Statement.

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 14 of 15

Current Assets:

Current Liabilities:

General Contractor

Total Net Worth: $ $

Current Ratio (Assets/Liabilities): $ $

Working Capital (Current Assets - Current Liabilities): $ $

18. Has the latest copy of an audited or reviewed financial statement prepared by an independent Certified Public Accountant (no more than one‐year old) with accompanying notes attached for the General Contractor etc.? (An audited or reviewed financial statement with accompanying notes of a parent company guarantor may be substituted. A financial statement that is not audited or reviewed is not acceptable. A letter verifying availability of a line of credit is not a substitute for the required financial statement.) Yes No

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 15 of 16

1. Part II: Essential Criteria Questions

Circle Answer

1. Does your firm possess a valid and current California Contractor’s or other professional license as required by law for the project or projects for which it intends to submit a bid?

Yes No

2. Is your firm registered with DIR as a Public Works Contractor for the current fiscal year?

3. Does your firm have or have the ability to obtain a liability insurance policy with a policy limit of at least $2,000,000 per occurrence and $4,000,000 aggregate?

4. Does your firm have current workers’ compensation insurance policy as required by the Labor Code or is your firm legally self- insured pursuant to Labor Code section 3700 et. seq.?

2. Have you attached your firm’s latest copy of reviewed or audited financial statements with accompanying notes and supplemental information? *

NOTE: Financial statements that are not either reviewed or audited are not acceptable. A letter verifying availability of a line of credit may also be attached; however, it will be considered as supplemental information only, and is not a substitute for the required financial statements.

3. Omitted

4. Has your contractor’s or other professional license been revoked at any time in the last five years?

5. Omitted

6. Is your firm, any of its officers, supervisors, managers, or any firm or individual identified above in Part I, ineligible to bid on or be awarded a public works contract, or perform as a subcontractor on a public works contract, pursuant to Labor Code section 1777.1, Labor Code section 1777.7, or any other federal, state, county, municipal or other local law providing for the debarment of contractors from public works?

7. Has your firm, any of its officers, supervisors, managers, or any firm or individual identified above in Part I been convicted of a crime involving the awarding of a contract of a government construction project, the bidding or performance of a government contract, antitrust statutes, racketeering statutes, safety and health regulations, environmental laws, laws banning workplace discrimination, laws governing wages, hours or labor standards, or laws involving fraud, theft, or any other act of dishonesty?

8. Omitted

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9. Has your firm, any of its officers, supervisors, managers, or any firm or individual identified above in Part I ever been terminated from a public works contract, including but not limited to termination based on any misconduct, such as failure to comply with contractual, statutory, or other legal obligations from any public construction project?

10. Does your firm, any of its officers, supervisors, managers, or any firm or individual identified above in Part I currently have any delinquent liability to an employee, the state, or any awarding body for any assessment of back wages or related damages, interest, fines or penalties pursuant to any final judgment, order, or determination by any court or any federal, state, or local administrative agency, including a confirmed arbitration award?

* Public Contract Code section 20101(e) exempts from this requirement a contractor who has qualified as a small business pursuant to Government Code section 14837(d)(1), if the bid is “no more than 25 percent of the qualifying amount provided in section 14837(d)(1).” As of January 1, 2001, the qualifying amount is $10 million, and 25 percent of that amount, therefore, is $2.5 million.

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 17 of 18

3. Part III: Organization, History, Performance, Compliance with Law

Circle Answer

1. Has your firm, or any of its officers, supervisors, or managers, declared bankruptcy at any time during the last five years?

(If yes, attach a copy of the bankruptcy petition showing the case number and the date on which the petition was filed, a copy of the Bankruptcy Court’s discharge order or any other document that concluded the case if no discharge order was issued.)

2. Has your firm, or any of its officers, supervisors, or managers, had an injunction, judgment, order, or lien entered against it for outstanding taxes assessed or fines, penalties and/or unpaid employee wages at any time in the last five years?

Yes No

(Explain on a separate sheet. Provide details, including the name of the government agency, caption, date, case or docket number, and disposition. Be sure to note any judgments or liens that have not been fully satisfied.)

3. Omitted.

4. How many times in the past five years, has your firm, or any of its officers, supervisors, or managers, been a party in any civil litigation or administrative proceeding alleging a violation by a subcontractor hired by your firm of any of the following: contract antitrust statutes, racketeering statutes, safety and health regulations, environmental laws, labor standards, or laws involving fraud, theft, or any other act of dishonesty?

0 1 2 2+

(Explain on a separate sheet. Provide details including the nature of the claims and defenses, caption, date, case or docket number, name of the court or agency before which the case is pending or which it was heard, and current status.)

5. How many times in the past five years, has your firm, or any of its officers, supervisors, or managers, paid any amount, fine or otherwise, regardless of characterization, to settle any of the allegations listed in Questions 3 and 4 above, whether with or without an admission of responsibility or liability?

0 1 2 2+

(Explain on a separate sheet. Provide details, including the caption, date, case or docket number, and name of the court or agency before which the case was brought.)

6. How many times has your firm, or any of its officers, supervisors, or managers, been debarred, suspended, disqualified, denied a classification rating or pre-qualification or otherwise been declared not responsible to/or prevented from bidding or performing work on any public works contract or subcontract in the last five years?

0 1 2 2+

(Explain on a separate sheet. State whether the firm involved was the firm applying for pre-qualification here or another firm. Identify by name of the company, name of the person within your firm who was associated with that company, date, owner of the project, project name and information, basis for the action, and case or docket number.)

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 18 of 19

7. How many times in the last five years has your firm been assessed and paid liquidated damages after completion of a project under a construction contract with either a public or private owner?

0 1 2 2+

(Explain on a separate sheet. Identify all such projects by owner, owner’s address, date of completion of the project, amount of liquidated damages assessed and all other information necessary to fully explain the assessment of liquidated damages.)

8. How many times during the past five years, has any surety company made any payments on your firm’s behalf as a result of a default, to satisfy any claims made against a performance or payment bond issued on your firm’s behalf, in connection with a construction project, either public or private?

0 1 2 2+

(Explain on a separate sheet. Identify the amount of each such claim, name and telephone number of the claimant, date of claim, grounds for claim, present status of claim, date of resolution of such claim if resolved, method by which claim was resolved if resolved, nature of resolution and amount, if any, at which claim was resolved.)

9. How many times in the last five years has any insurance carrier, for any form of insurance, refused to renew an insurance policy for your firm?

0 1 2 2+

(Explain on a separate sheet. Name the insurance carrier, form of insurance, and year of refusal.)

10. Omitted

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Criminal Matters and Civil Suits Circle Answer

11. How many times has your firm, or any of its officers, supervisors, or managers, ever been convicted of a crime involving any federal, state, or local law related to construction?

0 1 2 2+

(Explain on a separate sheet. Identify who was involved, name of the public agency, date of conviction, and grounds for conviction.)

12. How many times has your firm, or any of its officers, supervisors, or managers, ever been found liable in a civil suit or convicted of a federal or state crime of fraud, theft, or involving any other act of dishonesty, such as making any false claim or material misrepresentations?

0 1 2 2+

(Explain on a separate sheet. Identify the person or persons convicted or found liable, court [the county if a state court, the district or location if federal court], year, and conduct involved.)

NOTE: The following two questions refer only to disputes between your firm and the owner of a project. You need not include information about disputes between your firm and a supplier, another contractor, or subcontractor. You need not include information about “pass-through” disputes in which the actual dispute is between a sub-contractor and a project owner. Also, you may omit reference to all disputes involving amounts of less than $50,000.

13. How many times in the last five years has any claim against your firm concerning your firm’s work on a construction project been filed in court or arbitration?

0 1 2 2+

(Explain on a separate sheet. Identify the claim(s) by providing the project name, date of the claim, name of the claimant, a brief description of the nature of the claim, the court in which the case was filed and a brief description of the status of the claim [e.g.

"pending" or, if resolved, a brief description of the resolution].)

14. How many times in the last five years has your firm made any claim against a project owner concerning work on a project or payment for a contract and filed that claim in court or arbitration?

0 1 2 2+

(Explain on a separate sheet. Identify the claim(s) by providing the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court in which the case was filed and a brief description of the status of the claim [e.g. "pending" or if resolved, a brief description of the resolution].)

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 20 of 21

Occupational Health and Safety Compliance Circle Answer

15. How many times in the last five years has CalOSHA cited and assessed penalties against your firm for any “serious,” “willful” or “repeat” violation(s) or the federal Occupational Safety and Health Administration cited and assessed penalties against your firm for violation(s) of safety or health regulations?

0 1 2 2+

NOTE: If you have filed an appeal of a citation, and the Occupational Safety and Health Appeals Board has not yet ruled on your appeal, you need not include information about it.

16. How many times in the last five years has the EPA or any Air Quality Management District or any Regional Water Quality Control Board cited and assessed penalties against either your firm or the owner of a project on which your firm was the contractor?

0 1 2 2+

(Explain on a separate sheet describing each citation.)

NOTE: If you have filed an appeal of a citation and the Appeals Board has not yet ruled on your appeal, or if there is a court appeal pending, you need not include information about the citation.

17. How many times within the last five years has there ever been a period when your firm had employees but was without workers’ compensation insurance or state-approved self-insurance?

0 1 2 2+

(Explain the reason for each absence of workers’ compensation insurance on a separate sheet. If “None,” please provide a statement by your current workers’ compensation insurance carrier that verifies periods of workers’ compensation insurance coverage for the last five years. If your firm has been in the construction business for less than five years, provide a statement by your workers’ compensation insurance carrier verifying continuous workers’ compensation insurance coverage for the period that your firm has been in the construction business.)

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 21 of 22

Prevailing Wage and Apprenticeship Compliance Circle Answer

18. How many times during the last five years, has your firm been required to pay back wages and/or penalties related to state or federal prevailing wage laws for work performed by your firm?

0 1 2 2+

(Explain on a separate sheet. Describe the nature of each violation and identify the name of the project, date of its completion, public agency for which it was constructed, number of employees underpaid, and amount(s) of back wages and penalties your firm was required to pay.)

NOTE: Question 18 refers only to the violation of prevailing wage laws by your firm, not to violations by a subcontractor.

19. How many times during the last five years, has your firm or any subcontractors hired by your firm been required to pay back wages and/or penalties related to state or federal prevailing wage laws for work performed by a subcontractor?

0 1 2 2+

(Explain on a separate sheet. Identify the subcontractor’s business name and CSLB license number, describe the nature of each violation, and identify the name of the project, date of its completion, public agency for which it was constructed, number of employees underpaid, and amount(s) of back wages and penalties your firm was required to pay.)

NOTE: This question refers only to the violation of prevailing wage laws by subcontractors, not to violations by your firm.

20. How many times during the last five years, has your firm paid any penalties related to any provision of California apprenticeship laws or regulations, or the laws pertaining to use of apprentices on public works projects, including Labor Code sections 1777.5 and 1777.7?

0 1 2 2+

(Explain on a separate sheet. Provide the date(s) of such findings, case number(s), and attach copies of the Department’s final decision(s).)

21. How many times during the last five years, has any subcontractor hired by your firm paid any penalties related to any provision of California apprenticeship laws or regulations, or the laws pertaining to use of apprentices on public works projects, including Labor Code sections

1777.5 and 1777.7?

0 1 2 2+

(Explain on a separate sheet. Provide the date(s) of such findings, case number(s), and attach copies of the Department’s final decision(s).)

NOTE: Omissions, misrepresentations and any failure to disclose associations with other firms or any prior history of alleged violations may lead to loss of your eligibility to register as a Public Works Contractor, disqualification of bids, and/or grounds for termination of a contract.

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 22 of 23

4. Part IV: Recent Similar Construction Experience

Provide information about the firm’s recent Similar HDD drives within the last ten (10) years that have construction elements as specified below. Names and contact information must be current and verifiable. A Similar HDD drive is defined as an HDD drive with the following characteristics:

• Length greater than 800 feet;

• Carrier Pipe outside diameter not less than 15 inches;

• Ground Conditions with groundwater present, an N-Value of between 6 and 50 blows per foot, and Unified Soil Classification System (USCS, ASTM B-2487) materials that include any of the following:

o Well-graded SAND with Gravel (SW);

o Cobbles;

o Poorly Graded SAND (SP);

o Sandy Silty CLAY (CL-ML);

o Well-graded SAND with Silt (SW-SM);

o Well-graded SAND with Clay (SW-SC) o Sandy SILT (ML); or o Clayey Sand (SC)

• Steel Pipe with a Butt Weld.

Use separate sheets of paper that contain all of the information listed above. A firm may list multiple Similar HDD drives from one construction project to meet the minimum requirements.

Firms seeking pre-qualification must meet the following requirements:

1. Subcontractor Experience. Subcontractor shall demonstrate that they completed at least five (5) Similar HDD drives in the last ten (10) years as required above. (Pass/Fail)

2. Superintendent Experience. Subcontractor shall provide a resume of their superintendent, which shall demonstrate that they have completed at least five (5) Similar HDD drives in the last ten

(10) years.

3. Drill Operator Experience. Subcontractor shall provide a resume of their drill operator, which shall demonstrate that they have completed at least three (3) Similar HDD drives in the last ten

(10) years.

4. Drilling Fluid and Separation Plant Specialist. Subcontractor shall provide a resume of their drilling fluid and separation plant specialist, which shall demonstrate that they have completed at least three (3) Similar HDD drives in the last ten (10) years.

5. HDD Engineer Experience. Subcontractor shall provide a resume of their HDD engineer, which shall demonstrate that they have completed at least five (5) Similar HDD drives in the ten (10) years.

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 23 of 24

SUBCONTRACTOR EXPERIENCE

You may list projects your firm performed as the general contractor or as a subcontractor. For projects performed as a subcontractor, indicate the general contractor’s name and contact information.

Project Name: ____________________________________________________________________ Location: Owner: _________________________________________________________________ Owner Contact (name and current phone number): ______________________________________________ Architect or Engineering Firm: ______________________________________________________

Architect or Engineer Contact (name and current phone number): ___________________________________________________________ Construction Manager (name and current phone number): _________________________________________

Inspector of Record (name and current phone number): ___________________________________________ Date of Drive: ______________________________________________________ HDD Diameter: ______________________________________________________ HDD Pull Length: _____________________________________________

Soil Classification: _____________________________________________ N Value: _____________________________________________ Groundwater Present? [Yes] or [No] (Mark one) HDD Material: _____________________________________________ Type of Weld: _____________________________________________

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 24 of 25

5. Part V: Certification

Questionnaires submitted by corporations must be signed with the legal name of the corporation, followed by the name of the state of incorporation and by the signature and designation of the chairman of the board, president or any vice president, and then followed by a second signature by the secretary, assistant secretary, the chief financial officer or assistant treasurer. All persons signing must be authorized to bind the corporation in the matter. The name of each person signing shall also be typed or printed below the signature. Satisfactory evidence of the authority of each officer signing on behalf of a corporation shall be furnished.

Questionnaires submitted by partnerships must furnish the full name of all partners and must be signed in the partnership name by a general partner with authority to bind the partnership in such matters, followed by the signature and designation of the person signing. The name of the person signing shall also be typed or printed below the signature.

Each person signing below makes the following representations under penalty of perjury:

The submitter of the foregoing answers to the questionnaire has read the same and the matters stated therein are true to the best of his or her own personal knowledge. This information is provided for the purpose of qualifying to bid on the Project, and any individual, company or other agency named herein is hereby authorized to supply the awarding body with any information necessary to verify the Subcontractor’s statements. By signing below, the submitter and the named Subcontractor hereby grant permission to the District to contact any or all of the above listed persons or entities to confirm facts or otherwise investigate the above facts and issues.

The submitter understands that any statement which is proven to be false shall be grounds for immediate disqualification from bidding on the Project. The submitter whose signature appears below represents and warrants that he or she has authority to bind the named contractor.

I, (Name), the undersigned, am the (Title), with the authority to act for and on behalf of (Contractor Entity Name), declare under penalty of perjury under the laws of the State of California that the foregoing information provided in this Pre-qualification Questionnaire is true, full, and correct.

I understand that making a false statement may result in disqualification from bidding on any public works project, registering as a Public Works Contractor with the Department of Industrial Relations, and may be grounds for termination of a public works contract.

Executed on this: day of at .

(Date) (Month / Year) (City / State)

Name of Subcontractor Representative: ___________________________________________

Signature of Subcontractor Representative: _________________________________________

San Luis Obispo County APPLICATION FOR PRE-QUALIFICATION Page 25 of 26

6. Part VI: Required Attachments

The following document shall be filed with the District. Failure to provide all these attachments may be cause for disqualification for this Project.

• Attachment 1 – Reviewed or Audited Financial Statements

• Attachment 2 – Copies of Documents or Explanations Required by Part III (if applicable)

• Attachment 3 – Project Information Required by Part IV

San Luis Obispo County SCORING Page 26 of 27

SECTION 4: SCORING CRITERIA

This section sets forth a uniform system of rating Subcontractors who are prospective bidders on the Project, based on the objective criteria and scoring methods below.

The application consists of six parts which must be completed by a prospective bidder seeking prequalification.

1. Part I: Organization Information

This part is not scored, but must be completed in order to be eligible to pre-qualify. Failure to include the information called for may result in disqualification.

2. Part II: Essential Criteria Questions

All questions in this part are pass/fail. The prospective bidder must provide an acceptable answer on all questions in order to be eligible to pre-qualify.

3. Part III: Organization, History, Performance, Compliance with Law

Subcontractor must receive a score of 60 points or more (of a maximum possible score of 93) to be eligible to pre-qualify.

4. Part IV: Recent Similar Construction Experience

This part requires Subcontractors to provide information on recent similar construction experience of the organization and key personnel.

All information requested in this part is pass/fail. Subcontractor must provide all of the requested information meeting the criteria listed in Part IV in order to be eligible to pre-qualify.

The District may, but is not required to, contact owners or other key personnel listed of the reference projects to confirm the accuracy of submissions. Failure to include the information called for or provision of inaccurate information may result in disqualification.

5. Part V: Required Attachments

This part is not scored, but all attachments must be submitted in order to be eligible to pre-qualify.

Failure to include the information called for may result in disqualification.

6. Part VI: Certification

This part is not scored, but must be completed in order to be eligible to pre-qualify. Failure to include the certification called for may result in disqualification.

San Luis Obispo County SCORING Page 27 of 28

Scoring for Questions from Part II: Essential Criteria Questions

Question 1. Subcontractor possesses a valid and current California Contractor’s license for the project or projects for which it intends to submit a bid.

Valid California Contractor’s License Qualification Yes Ok No Disqualification Before submitting bid OK

Question 2. Firm registered with DIR as a Public Work Contractor for the current fiscal year.

DIR Registration Qualification Yes Ok No Disqualified

Question 3. Firm has or has the ability to obtain a liability insurance policy with a policy limit of at least $2,000,000 per occurrence and $4,000,000 aggregate, Subcontractor has ability to obtain a liability insurance policy with specified limits

Qualification

Question 4. Firm has current worker’s compensation insurance policy as required by the Labor Code or is legally self-insured pursuant to Labor Code section 3700 et seq.

Subcontractor has Current Worker’s Comp or Self-Insured

Qualification

Question 5. Attached firm’s latest copy of reviewed or audited financial statements with accompanying notes and supplemental information.

Attached Copy of Reviewed or Audited Financial Statement

Qualification

Question 6. Question is omitted and not scored.

Question 7. Contractor’s or other professional license revoked at any time in the last five years.

License Revocation in Last 5 Years Qualification

San Luis Obispo County SCORING Page 28 of 29

Question 8. Question is omitted and not scored.

Question 9. Debarment.

Firm Ineligible to Bid on Public Works Contract

Qualification

Yes Disqualified No Ok

Question 10. Conviction of a relevant crime.

Firm Convicted of Relevant Crime Qualification

Question 11.