IFB 158770 Attachments.pdf

ATTACHMENT _____

State Corporation Commission Form

Failure to complete and return this attachment may result in your bid being deemed NON-RESPONSIVE.

Solicitation #:

Virginia State Corporation Commission (SCC) registration information.

The bidder:

is a corporation or other business entity with the following SCC identification number:

-OR-

is not a corporation, limited liability company, limited partnership, registered limited liability partnership, or business trust -OR-is an out-of-state business entity that does not regularly and continuously maintain as part of its ordinary and customary business any employees, agents, offices, facilities, or inventories in Virginia (not counting any employees or agents in Virginia who merely solicit orders that require acceptance outside Virginia before they become contracts, and not counting any incidental presence of the bidder in Virginia that is needed in order to assemble, maintain, and repair goods in accordance with the contracts by which such goods were sold and shipped into Virginia from bidder’s out-of-state location) -OR-is an out-of-state business entity that is including with this bid an opinion of legal counsel which accurately and completely discloses the undersigned bidder’s current contacts with Virginia and describes why those contacts do not constitute the transaction of business in Virginia within the meaning of § 13.1-757 or other similar provisions in Titles

13.1 or 50 of the Code of Virginia.

**NOTE** >> Check the following box if you have not completed any of the foregoing options but currently have pending before the SCC an application for authority to transact business in the Commonwealth of Virginia and wish to be considered for a waiver to allow you to submit the SCC identification number after the due date for bids (the Commonwealth reserves the right to determine in its sole discretion whether to allow such waiver):

A

158770

SBSP-IFB PIM-40

Small Business Subcontracting Plan

IFB # ____________

It is the goal of the Commonwealth that over 42% of its purchases be made from small businesses. All potential bidders are required to include this document with their bid response in order to be considered responsive.

Small Business: "Small business (including micro)” means a business which holds a certification as such by the Virginia Department of Small Business and Supplier Diversity (DSBSD) on the due date for bids.

This shall also include DSBSD-certified women- owned and minority-owned businesses and businesses with DSBSD service disabled veteran owned status when they also hold a DSBSD certification as a small business on the bid due date. Currently, DSBSD offers small business certification and micro business designation to firms that qualify.

Certification applications are available through DSBSD online at www.SBSD.virginia.gov (Customer Service).

Bidder Name:

Preparer Name: Date:

Who will be doing the work: □ I plan to use subcontractors □ I plan to complete all work

Instructions A. If you are certified by the DSBSD as a micro/small business, complete only Section A of this form.

B. If you are not a DSBSD-certified small business, complete Section B of this form. For the bid to be considered and the bidder to be declared responsive, the bidder shall identify the portions of the contract that will be subcontracted to DSBSD-certified small business for the initial contract period in relation to the bidder’s total price for the initial contract period in Section B.

Section A If your firm is certified by the DSBSD provide your certification number and the date of certification.

Certification number: Certification Date:

Section B If the “I plan to use subcontractors box is checked,” populate the requested information below, per subcontractor to show your firm's plans for utilization of DSBSD-certified small businesses in the performance of this contract for the initial contract period in relation to the bidder’s total price for the initial contract period. Certified small businesses include but are not limited to DSBSD-certified women-owned and minority-owned businesses and businesses with DSBSD service disabled veteran-owned status that have also received the DSBSD small business certification. Include plans to utilize small businesses as part of joint ventures, partnerships, subcontractors, suppliers, etc. It is important to note that these proposed participation will be incorporated into the subsequent contract and will be a requirement of the contract. Failure to obtain the proposed participation percentages may result in breach of the contract.

B

SBSP-IFB PIM-40

B. Plans for Utilization of DSBSD-Certified Small Businesses for this Procurement

Subcontract #1

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #2

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #3

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #4

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

Subcontract #5

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % (Initial Term): Contact Address:

Description of Work:

ATTACHMENT ______

Solicitation #:

SUBCONTRACTOR APPROVAL REQUEST

No portion of the work (including equipment) shall be subcontracted to another firm or individual without prior written consent of Virginia Department of Transportation (herein referred to as VDOT). In the event that the contractor desires to subcontract some part of the work specified herein, the contractor shall furnish VDOT with the names, qualifications, and experience of their proposed subcontractors for agency approval. The primary contractor shall, however, remain fully liable and responsible for the work performed by its subcontractor(s) and shall assure compliance with all requirements of the contract.

List proposed subcontractor(s), including name, address, contact person, and type of work to be performed under this contract below.

FIRM INDIVIDUAL’S

NAME & ADDRESS

CONTACT PERSON AND

PHONE NUMBER

TYPE OF WORK TO BE

PERFORMED

TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE

QUALIFICATIONS / EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR

Please indicate which above proposed subcontractors are certified (with DSBSD) as Small, Women Owned or Minority Businesses.

Certification Number(s):

FOR VDOT USE ONLY:

The proposed subcontractor(s) listed above is/are approved and accepted under the terms and conditions of the contract requirements herein.

Signature of Authorized VDOT Representative Date Telephone Number

C

ATTACHMENT ____

NORMAL AND EMERGENCY CONTACTS

Solicitation # ___________

Send Contracts To:

Bidder's Name/Title

Primary Phone Number

Bidder's Mailing Address E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

Contact Person’s Name

Cellular Telephone Number

Telephone Number - Normal Work Hours Telephone Number - After Work Hours Fax Number

E-mail Address

D

Solicitation # ____________

REFERENCES

Bidders should provide a list of at least 3 references where similar goods and/or services have been provided. Each reference shall include the name of the organization, the complete mailing address, the name of the contact person, the email, and the telephone/fax number.

FIRM’S NAME AND ADDRESS CONTACT PERSON EMAIL ADDRESS TELEPHONE / FAX #

E

ATTACHMENT ____

VIRGINIA CODE RED OZONE DAYS

Solicitation # ___________

The contactor shall suspend the use of gasoline and diesel tractors, powered mowers, weed eaters, wood chippers, chainsaws, sprayer rigs and other similar field/yard maintenance equipment in ozone non-attainment or maintenance areas on predicted “code red ozone days”. The ozone season in Virginia is from May through September. The number of “code red ozone days” varies, but typically does not exceed ten (10) per season. The following counties are subject to this provision:

Commonwealth of Virginia Ozone Nonattainment, Maintenance, and Early Action Compact Areas

Ozone Nonattainment Area: An area that exceeds the Environmental Protection Agency’s (EPA) National Ambient Air Quality Standards (NAAQS) for ozone.

Ozone Maintenance Area: An area that that has previously exceeded the EPA NAAQS for ozone, but has since come back into compliance and has adopted an ozone maintenance plan.

Ozone Early Action Compact Area: An area that has previously exceeded the EPA NAAQS for ozone, but voluntarily opted-in to the Early Action Compact program to avoid an official ozone nonattainment designation.

Table 1. Jurisdictions by VDOT District located in either an Ozone Nonattainment, Maintenance, or Early Action

Compact area.

* 8-hour ozone Early Action Compact Area

DISTRICT

Northern Virginia Fredericksburg Staunton Hampton

Roads Richmond Salem

JU

R

IS

D

IC

T

IO

N

Alexandria Arlington Fairfax (County & City) Falls Church Loudoun Manassas Manassas Park Prince William

Fredericksburg Spotsylvania Stafford Gloucester

Frederick* Winchester*

Chesapeake Hampton Isle of Wight James City Newport News Norfolk Poquoson Portsmouth Suffolk Virginia Beach Williamsburg York

Charles City Chesterfield Colonial Heights Hanover Henrico Hopewell Petersburg Prince George Richmond

Botetourt* Roanoke (County & City)* Salem* Vinton*

F

COMMONWEALTH of VIRGINIA

DEPARTMENT OF LABOR AND INDUSTRY

Virginia Department of Labor and Industry Wage Determination Decision

Project Name Grounds & Lawn Maintenance Services

State Project Code IFB 158770

DOLI Project Number VDOT-24-0062

County or Independent City Multiple Counties

Publication Date 03/11/2024

Construction Type Highway

SPOTSYLVANIA COUNTY

Wage Determinations Wage Fringe Carpenter (Includes Form Work) $20.97 Cement Mason/Concrete Finisher $20.70 $8.03 Electrician, Includes Traffic Signalization $30.55 $11.51 Fence Erector $15.28 Ironworker, Reinforcing $34.18 Ironworker, Structural $34.18 Laborer: Asphalt, Includes Raker, Shoveler, Spreader and Distributor $19.05 $1.75 Laborer: Common or General $16.66 Laborer: Grade Checker $14.88 Laborer: Pipelayer $20.48 Laborer: Power Tool Operator $15.69 Operator: Asphalt Spreader and Distributor $20.58 $2.31

Main Street Centre 600 East Main Street, Suite 207

Richmond, Virginia 23219

PHONE (804) 371-2327

FAX (804) 371-6524

Gary G. Pan

COMMISSIONER

Wage Determinations Wage Fringe Operator: Backhoe/Excavator/Trackhoe $23.93 Operator: Bobcat/Skid Steer/Skid Loader $19.00 $3.49 Operator: Broom/Sweeper $17.40 $2.01 Operator: Bulldozer, Including Utility $20.64 Operator: Crane $29.46 Operator: Drill $24.89 Operator: Gradall $19.26 Operator: Grader/Blade $23.21 Operator: Hydroseeder $16.64 Operator: Loader $18.92 Operator: Mechanic $22.84 Operator: Milling Machine $23.19 $2.94 Operator: Pavement Planer $21.14 Operator: Pavement Planer Groundsmen $19.75 Operator: Paver (Asphalt, Aggregate, and Concrete) $20.33 $2.81 Operator: Piledriver $21.83 $4.08 Operator: Roller $18.92 Operator: Roller (Finishing) $18.73 Operator: Screed $22.13 $4.89 Pavement Marking Operator $22.15 Pavement Marking Truck Driver $18.78 Traffic Control: Flagger $13.64 Traffic Sign Mechanic $23.00 Truck Driver: Fuel and Lubricant Service $18.25 Truck Driver: Heavy 7CY & Under $15.53 Truck Driver: Heavy Over 7CY $18.05 Truck Driver: Multi Axle $18.84

STAFFORD COUNTY

Carpenter (Includes Form Work) $20.97 Cement Mason/Concrete Finisher $20.70 $8.03 Electrician, Includes Traffic Signalization $30.55 $11.51 Fence Erector $15.28 Ironworker, Reinforcing $34.18 Ironworker, Structural $34.18 Laborer: Asphalt, Includes Raker, Shoveler, Spreader and Distributor $19.05 $1.75 Laborer: Common or General $15.77 Laborer: Grade Checker $14.88 Laborer: Pipelayer $20.48

Laborer: Power Tool Operator $15.69 Operator: Asphalt Spreader and Distributor $20.58 $2.31 Operator: Backhoe/Excavator/Trackhoe $23.93 Operator: Bobcat/Skid Steer/Skid Loader $19.00 $3.49 Operator: Broom/Sweeper $17.40 $2.01 Operator: Bulldozer, Including Utility $20.64 Operator: Crane $29.46 Operator: Drill $24.89 Operator: Gradall $19.26 Operator: Grader/Blade $23.21 Operator: Hydroseeder $16.64 Operator: Loader $18.92 Operator: Mechanic $22.84 Operator: Milling Machine $23.19 $2.94 Operator: Pavement Planer $21.14 Operator: Pavement Planer Groundsmen $19.75 Operator: Paver (Asphalt, Aggregate, and Concrete) $20.33 $2.81 Operator: Piledriver $21.83 $4.08 Operator: Roller $18.92 Operator: Roller (Finishing) $18.73 $3.23 Operator: Screed $22.13 $4.89 Pavement Marking Operator $22.15 Pavement Marking Truck Driver $18.78 Traffic Control: Flagger $13.64 Traffic Sign Mechanic $23.00 Truck Driver: Fuel and Lubricant Service $18.25 Truck Driver: Heavy 7CY & Under $15.53 Truck Driver: Heavy Over 7CY $18.05 Truck Driver: Multi Axle $18.84

Additional Notes

All rates are determined by DOLI and any appeals of specific classifications may be made through the Wage Determination Appeal form available at https://doli.virginia.gov/wp-content/uploads/2022/05/Appeal-for-Clarification-of-Wage- Determination.pdf

Any additional classifications may be requested through the Additional Wage Classification form available at https://doli.virginia.gov/wp-content/uploads/2022/10/Request-for-Additional-Wage-Classification-10-2022.pdf

Understand your duties as a contractor under Virginia law by referencing our Contractor Responsibilities information sheet available at http://www.doli.virginia.gov/wp-content/uploads/2021/04/PREVAILING-WAGE- CONTRACTOR-RESPONSIBILITIES.pdf

Your employees have specific rights, which can be found on our List of Employee Rights information sheet available at http://www.doli.virginia.gov/wp-content/uploads/2021/04/PREVAILING-WAGE-EMPLOYEE-RIGHTS.pdf

Any further questions should be directed to PrevailingWage@doli.virginia.gov

Part I- Request Location:

Scope of Work

Yes No Vsit Date:

Number of days for contractor to complete upon recceipt of Work Order:

VDOT Contact Phone:

Part II- Estimate Contractor

Labor Costs Total Material Total Project Cost

Remarks:

Attachments:

Signature: Date:

Part III- Authorization (Completed by Requestor)

Signature: Date:

Part IV- Documentation (Completed by Contractor)

Part V- Completion of Project (Completed by Requestor)

Date Work Completed: Was work completed to the satisfaction to VDOT? Yes / No Remarks:

ATTACHMENT H - Work Request / Estimate Form

Work Order # Work Order Date

Site Visit Necessary:

Total: $___________Hourly Rate: $ _____________Estimated Hours _________Labor Category ___________ Labor Category ___________Estimated Hours _________ Hourly Rate: $ _____________ Total: $___________ Labor Category ___________Estimated Hours _________ Hourly Rate: $ _____________ Total: $___________ Labor Category ___________Estimated Hours _________ Hourly Rate: $ _____________ Total: $___________

This signature authorizes that work can be performed. It is understood the invoice submitted for the project shall be based on actual labor and material cost and that this might differ from the estimate. The actual cost invoiced shall be supported by actual hours worked and actual original invoiced cost of materials. A change order will be processed to reflect the actual cost of the project.

When the project is completed indicate reasons why the estimate differs from the actual cost.

Note: If the original estimate is to be exceeded by 10% of the estimate contact the Contrafctor Administrator ahead of time for approval to proceed.