HECO-16 Standard Form for Contractors Statement of Qualifications 09.03.26.docx

University of Virginia – Fontaine Data Center

Two-Step IFB #BA090426 Charlottesville, VA SOQ Due Date: October 6, 2026, by 2:00 PM

UNIVERSITY OF VIRGINIA

STANDARD FORM

FOR

CONTRACTOR'S

STATEMENT OF QUALIFICATIONS

Contractor’s Name: ____________________

TABLE Of CONTENTS

I. General Information

II. Bonding

III. Judgments

IV. Convictions and Debarment

V. Compliance

VI. Experience

VII. Small Business Participation on Previous Projects

VIII. Signatures

(Rev. 8-6-24) HECO-16

Attachments

CONTRACTOR'S STATEMENT OF QUALIFICATIONS

I. General Information

1. Type of work you wish to qualify for:

|_| Construction Manager |_| General Construction |_| Mechanical |_| Electrical |_| Plumbing |_| Sitework |_| Specialty

|_| LEED

|_| Other Specify:

2. Contractor's Name:

Mailing Address:

Street Address: (If not the same as mailing address)

Website:

Telephone #: ( )

Fax #: ( )

Contact Person:

Contact Person’s Phone #: ( )

Contact Person’s E-mail:

State Contractor's License #:

State Corporation Commission (SCC) Identification #:

Designated Employee Registered with Virginia Board for Contractors:

Provide the name and title, direct phone number (including extension), cell phone number, and direct e-mail address of the highest-ranking individual within the organization that will have oversight responsibility for the organization's involvement with the Project (if not the designated contact person above):

If different from the location provided above, provide the organization's local or regional office information (including physical address, mailing address, phone number, fax number, and main e-mail address or web site address) to be used in delivering the requested services to be provided on the Project:

Provide the number of years that the organization has been providing services similar to those requested by this RFQ, including a delineation of this information for both the headquarters location and the local or regional office (as appropriate) that will be used in delivering the requested services on the Project:

3. Check type of organization:

Corporation ___ Partnership ___

Individual ___ Joint Venture ___

Other (describe) _________________________________

If the Proposal is being made by a legal joint venture, the response must include the information required within this section of the HECO-16 for both organizations that constitute the joint venture and a copy of the joint venture agreement must be attached.

4. If a corporation:

State of Incorporation:

Date of Incorporation:

Federal I.D. #:

Officers Name / Contact Info Years in Position

Chief Executive Officer:

Chief Financial Officer:

President:

Vice President:

Secretary:

Treasurer:

Office Manager/Director of local office that will have primary responsibility for delivering this project:

Are you a Subchapter S Corporation? Yes ___ No ___

5. If a partnership:

Date organized:

Type of partnership:

List of General Partners:

Name Phone # Years as G.P.

6. If individually owned:

Years in Business:

7. Have you ever operated under another name? Yes ___ No ___

If yes:

Other name:

Number of years in business under this name:

State license number under this name:

8. Department of Small Business and Supplier Diversity (DSBSD) Certifications:

Check all that apply:

Micro Business DSBSD Certification #:

Small Business DSBSD Certification #:

Small Woman-Owned Business DSBSD Certification #:

Small Minority-Owned Business DSBSD Certification #:

Service-Disabled Veteran-Owned Business DSBSD Certification #:

9. Please indicate whether anyone in your firm possesses the Certified in Health Care Compliance (CHC) credentials? Yes ___ No ___

Individuals Name: ___________________

Certification #: ______________________ Date of Certification: ____________________

II. Bonding

Provide a letter from your surety company listing your organization’s current single project and total projects bonding capacity, including such information for the local or regional office that will be used in delivering the services to be provided on the Project (if the local or regional office is separately bonded); attach this letter to the Form HECO-16.

1. Bonding Company's name:

Address:

Representative (Attorney-in-fact):

2. Is the Bonding Company listed on the United States Department of the Treasury list of acceptable surety corporations? Yes ___ No ___

3. Is the Bonding Company licensed to transact surety business in the Commonwealth of Virginia? Yes ___ No ___

4. Describe the capacity the organization has to meet the Project schedule and demands. Include an analysis of current workload.

III. Judgments

In the last ten (10) years, has your organization, or any officer, director, partner, or Owner, had judgments entered against it or them for the breach of contracts for construction? Yes ___ No ___

If yes, on a separate attachment, state the person or entity against whom the judgment was entered, give the location and date of the judgment, describe the project involved, and explain the circumstances relating to the judgment, including the names, addresses and phone numbers of persons who might be contacted for additional information.

IV. Convictions and Debarment

If you answer yes to any of the following, on a separate attachment, state the person or entity against whom the conviction or debarment was entered, give the location and date of the conviction or debarment, describe the project involved, and explain the circumstances relating to the conviction or debarment, including the names, addresses and phone numbers of persons who might be contacted for additional information.

1. In the last ten (10) years, has your organization or any officer, director, partner, Owner, project manager, procurement manager or chief financial officer of your organization:

a. Ever been fined or adjudicated of having failed to abate a citation for building code violations by a court or local building code appeals board? Yes ___ No ___

b. Ever been found guilty on charges relating to conflicts of interest? Yes ___ No ___

c. Ever been convicted on criminal charges relating to contracting, construction, bidding, bid rigging or bribery? Yes ___ No ___

d. Ever been convicted: (i) under Va. Code Section 2.2-4367 et seq. (Ethics in Public Contracting); (ii) under Va. Code Section 18.2-498.1 et seq. (Va. Governmental Frauds Act); (iii) under Va. Code Section 59.1-68.6 et seq. (Conspiracy to Rig Bids); (iv) of a criminal violation of Va. Code Section 40.1-49.4 (enforcement of occupational safety and health standards); or (v) of violating any substantially similar federal law or law of another state? Yes ___ No ___

e. Ever been convicted on charges relating to employment of undocumented immigrants on construction projects? Yes ___ No ___

V. Compliance

Notice: Per Virginia Code Section 2.2-4376.2, a firm awarded a UVA contract for a construction project with a total cost of five million ($5,000,000) or more is required to submit a disclosure to the UVA Office of University Counsel (email address: dshontz@virginia.edu) if the firm and certain personnel collectively made contributions to UVA or its Foundations in the past five (5) years totaling $25,000 or more. Any firm that knowingly fails to submit the disclosure required by this section shall be subject to a civil penalty of $500.

If you answer yes to any of the following, on a separate attachment, give the date of the termination order, or payment, describe the project involved, and explain the circumstances relating to same, including the names, addresses and phone numbers of persons who might be contacted for additional information.

1. Has your organization:

a. Ever been terminated on a contract for cause? Yes ___ No ___

b. Within the last five (5) years, made payment of actual and/or liquidated damages for failure to complete a project by the contracted date? Yes ___ No ___

2. Has your organization, in the last three (3) years, received a final order for willful and/or repeated violation(s) for failure to abate issued by the United States Occupational Safety and Health Administration or by the Virginia Department of Labor and Industry or any other government agency? Yes ___ No ___

3. Within the last five (5) years, has your organization been involved with a project that was issued:

a. a formal stormwater notice of violation (NOV)?

Yes ___ No ___

b. a formal solid waste notice of violation (NOV)?

Yes ___ No ___

Limit response to NOVs issued within the mid-Atlantic region.

4. Have any Performance or Payment Bond claims ever been paid by any surety on behalf of your organization? Yes ___ No ___

5. Has your organization been more than thirty (30) days late, without good cause, in achieving the contracted Substantial Completion date where there was no liquidated damages provision on more than two (2) projects in the last three (3) years? Yes ___ No ___

8. Has your organization had repeated instances on a project of installation and workmanship deviations which exceed the tolerances of the standards referenced in the contract documents? Documentation of such instances shall be the written reports and records of the Owner’s representatives on the project. Yes ___ No ___

VI. Experience

If your organization has multiple offices, provide the following information for the office that would handle the Project under this prequalification. If that office has limited history, list its experience first.

1. Attach a list of all projects, giving project name, location, size, dollar value, and completion date for each that your organization has completed in the last five (5) years. Provide for each, the name, address, and phone number, for the Owner's and A/E's contact or representative.

2. Attach a list of your organization's projects in progress, if any, at the time of this statement. At a minimum, provide project names and addresses, contract amounts, percentages complete and contact names and phone numbers for the A/E’s and Owner’s representatives.

3. Identify at least three (3) projects in the last ten (10) years that are most relevant or similar in program and size to the Project(s) for which you are seeking prequalification and provide:

Project Name:

Address:

Final or Current Contract Amount:

Size (i.e., gross square feet, height, or stories plus sub-surface levels):

Description (i.e., function of building and component building systems):

Owner's Name:

Address:

Phone #:

Contact:

A/E's Name:

Address:

Phone #:

5. Personnel Experience: For all designated key personnel (i.e., Project Manager, Superintendent, Preconstruction Manager, etc.), describe the background and experience that would qualify him or her to serve successfully on this Project. For all key personnel to be assigned to this Project, provide as an attachment a resume which includes:

a. Title (i.e., Principal, Project Manager, Superintendent, etc.).

b. Number of years of experience in the construction industry.

c. Summary of education, including the name(s) of the institution(s) from which the individual graduated and the year(s) of graduation.

d. Listing of professional registrations, including registration numbers and dates that the respective registrations were first obtained, per state, along with any certifications relevant to the individual’s proposed function on this Project.

e. List of any professional / trade organization affiliations and associations in which the individual actively participates.

f. Identification of at least three (3) similar or comparable projects on which each proposed key personnel have served in that capacity or positions of similar or comparable responsibility within the last ten (10) years, including at least one of those within the last five (5) years. Provide the names, addresses, and phone numbers of the Owner’s and A/E’s contact person for each that can be contacted to obtain an assessment of the individual’s competencies and capabilities for this Project.

VII. Small Business Participation on Previous Projects

For the most recent three (3) projects you have completed, provide:

Project Name:

Address:

Owner’s Name:

Address:

Phone #:

Contact:

Small Business Participation Percentage Proposed:

Small Business Participation Percentage Achieved:

VIII. Signatures

The undersigned certifies under oath that the information contained in this Statement of Qualifications (SOQ) and attachments hereto is complete, true, and correct as of the date of this Statement.

(Name of entity signing this SOQ)

By: Name of Signer (print)

(Signature in ink)

Title:

Date:

Notary

State of:

County/ City of:

Subscribed and sworn to before me this _______ day of __________________, 20_______

Notary Public Signature

My commission expires:

Notary Seal:

Attachments (to be provided):

1. Response to the University of Virginia's Advertised Qualification Criteria

2. Surety Statement

3. Additional information, if any, provided under Sections III, IV, V

4. Additional information provided under Section VI