GENERAL CONTRACTOR QUALIFICATION STATEMENT PACKAGE FOR VICTOR VALLEY COMMUNITY COLLEGE

Transcription

1 GENERAL CONTRACTOR QUALIFICATION STATEMENT PACKAGE FOR VICTOR VALLEY COMMUNITY COLLEGE ASBESTOS ABATEMENT and DEMOLITION Music Building

2 VICTOR VALLEY COMMUNITY COLLEGE DISTRICT CONTRACTOR'S STATEMENT OF EXPERIENCE AND FINANCIAL CONDITION SECTION A - INSTRUCTIONS 1. Request for Bidder's Qualifications Statement: The District requires from bidders answers to questions contained in this questionnaire including a complete statement of bidder's financial ability and experience in performing asbestos removal particularly in public schools. The questionnaire and financial statements are not public records and are not open to public inspection. Only one copy of the qualification package is required to be submitted. 2. District qualification standards review includes: (a) contractor's statement of experience (b) appropriate California Contractor's License (c) contractor's financial condition and bondability 3. Life of Qualification Package: A contractor's qualification statement is valid until the financial information shown in the statements on file is more than one year old. Statements will be held on file until the financial information is fifteen months old at which time it will be destroyed. DISTRICT reserves the right to reject statements in which the financial information is more than six months old. All applicable portions of the form should be completed with schedules attached if the space provided does not suffice. Failure to provide the information called for may result in the DISTRICT declaring the bid nonresponsive. 4. Bondability: The bonding surety is required to be an admitted surety in the state of California as well as be listed in the current Federal Treasury Register. The surety will be contacted to confirm willingness to bond this particular project. It is suggested that the contractor include a letter of bondability from the surety indicating their support levels for the project in question. 5. Submission of Completed Statements: Completed statements are to be submitted with the contractor's bid per the instructions as stated in Notice Inviting Bids. The statement must be in an envelope marked "Confidential." 6. Please refer any questions to Stephen Garcia at DISTRICT Facilities Construction Office or telephone (760) extension 2250.

3 SECTION B - GENERAL INFORMATION CONTRACTOR: (as name appears on license) 1. Check one: Corporation Partnership Sole Proprietorship Joint Venture ADDRESS, CITY, STATE, ZIP PHONE NUMBER LICENSE NUMBER FAX NUMBER LICENSE CLASS EXPIRATION DATE RMO/RME - RESPONSIBLE MANAGEMENT OFFICER/EMPLOYEE AS REPORTED TO CONTRACTORS STATE LICENSE BOARD TAX ID NUMBER DATE BUSINESS FORMED DATE OF INCORPORATION 2. If a corporation, under the laws of what state was the corporation organized: 3. Has there been any recent change in control of company? YES NO If yes, explain on separate signed pages. 4. Is the company or its owners connected with other companies as a subsidiary, parent, holding, or affiliate? YES NO If yes, explain on a separate signed page. 5. List corporate officers, partners, proprietor, owners, and/or key personnel: NAME YEARS WITH FIRM POSITION % OF OWNERSHIP SOCIAL SECURITY NUMBER

4 6. Has the company or the officers or principals of this firm ever been licensed under a different name or different license number? YES NO If yes, list all name(s) and license number(s) 7. Have officers or principals of firm ever had their contractor's licenses suspended or revoked? YES NO If yes, explain on separate signed sheet. 8. In what type of construction do you specialize: 9. What was the largest total amount of work completed in one year: $ Number of jobs in this total Year 10. Largest job $ 11. List annual gross and net income for last five (5) years: Annual Gross Income Annual Net $ YEAR $ YEAR 12. Comment on your experience in state construction work with the Division of the State Architect. * * * *

5 SECTION C - INSURANCE 1. Do you currently have a minimum of $1,000,000 combined comprehensive single limit and $2,000,000 aggregate annual liability insurance? Please provide a Certificate of Insurance as verification. YES NO AMOUNT OF INSURANCE $ 2. Insurance Company: Address: City, State, Zip Phone Number Contact Person How long have you been with this insurance company? 3. If less than two years, please list prior insurance companies below. * * * * NOTE: If you should be awarded a contract, you will be required to provide a certificate of insurance with DISTRICT listed as an additional insured. SECTION D - SURETY 1. Provide a statement listing names of all surety companies, not agencies, utilized by bidder in the last five (5) years. State whether the surety or sureties bonding bidder's jobs have been required or requested to complete any part of bidder's work during the last five (5) years. Please provide a letter stating bondability for this project from surety company. SURETY COMPANY AND CONTACT PERSON ADDRESS AND TELEPHONE NUMBER LARGEST BOND LIST YEARS USED SECURITY REQUESTED TO COMPLETE ANY PART OF WORK? 2. Has your company ever been unable to obtain a bond or been denied a bond for a contract? YES NO If yes, explain on a separate signed page.

6 3. For how many projects is your firm currently bonded? 4. Has company (or any owner) ever defaulted on a contract forcing a surety to suffer a loss? YES NO If yes, explain on a separate signed page. 5. Has your company ever failed to complete a contract under the California contractor's license number(s) listed in Section B-1? YES NO If yes, explain on a separate signed page. 6. In the last seven years, has your company ever failed to complete a contract within the authorized contract time under the contractor's license number(s) listed in Section B-1? YES NO If yes, explain on a separate signed page giving owner and details. 7. Has your company been assessed liquidated damages for any project under the California contractor's license number(s) listed in Section B-1 in the past five years? YES NO If yes, please explain on a separate signed page giving owner and details. 8. Has your company had any arbitration on a contract? YES NO If yes, explain on a separate signed page. 9. Has your firm had any Stop Notice(s) or Department of Labor Notices filed against you under the California license(s) listed in Section B-1 in the past five years that were not resolved before a lawsuit was filed? YES NO If yes, please explain (using the following format) on a separate signed page. DATE BY WHOM/WHICH PROJECT WHY FILED HOW RESOLVES 10. At this time, are there any outstanding liens/stop notices/department of Labor notices for labor and/or material filed against your firm under the California contractor's license numbers listed in Section B-1, on any contracts which have been done or are being done by your company? YES NO If yes, explain on a separate signed page. 11. What has been the frequency of Workers' Compensation claims over the past three (3) years? Please explain on a separate signed page. 12. What has been the severity of your Workers' Compensation claims over the past three (3) years? Please explain on a separate signed page.

7 13. List the number of CONTRACTOR GENERATED change orders and their total value filed on projects completed under the California contractor's license(s) listed in Section B-1 on your last three projects: TOTAL NUMBER OF CONTRACTOR GENERATED CHANGE ORDERS PERCENTAGE OF TOTAL CONTRACT DISPUTED? Yes/No PROJECT AND OWNER 14. Has this company, an affiliated company, or any owner ever declared bankruptcy? YES NO Been in receivership? YES NO If yes, explain on a separate signed page. IF AN EXPLANATION IS REQUIRED FOR ANY OF THE ABOVE ANSWERS, PLEASE PROVIDE COMMENTS WITH DATES OF OCCURRENCES ON ATTACHED ADDITIONAL SIGNED PAGES. * * * * SECTION E - PERFORMANCE 1. What was the largest amount of work your company completed in one year: $ Number of jobs: Year: Largest job: $

8 2. List five (5) of the largest asbestos abatement contracts completed in the past five (5) years. OWNER, PERSON TO CONTACT TELEPHONE NUMBER KIND OF WORK CONTRACT PRICE YEAR 3. List all asbestos abatement projects in progress or completed for school districts, including community college districts, in the last five years. SCHOOL DISTRICT PERSON TO CONTACT TELEPHONE NUMBER KIND OF WORK CONTRACT PRICE YEAR 4. How many years experience do you have as a contractor (a) in public works projects in California ; (b) on school or community college construction projects in California under the license classification listed in Section B. 5. List three principal suppliers of equipment, supplies, and materials: NAME MATERIAL/SERVICES PROVIDED STREET ADDRESS, CITY, AND ZIP TELEPHONE NUMBER (WITH AREA CODE) 6. List experience record of principal individuals of your present organization include Responsible Managing Officer/Employee (RMO/RME) as reported to the California State License Board. NAME PRESENT POSITION YEARS WITH FIRM YEARS OF ASBESTOS ABATEMENT EXPERIENCE MAGNITUDE AND TYPE OF PROJECTS

9 7. Explain how this project would be staffed (positions, lines of communication, authority/responsibility). Provide the names and experience of the proposed construction superintendent and project manager and include their experience with comparable school or community college projects constructed in California. SECTION F - FINANCIAL ACCOUNTING Name of Accounting firm: Address: Telephone: 1. How many years has this firm prepared financial statements for you? Tax returns: 2. Fiscal year end: 3. Are taxes (both company and person) current? YES NO BANK Name of Bank Account Manager Phone Address Account numbers Amount of credit line $ Amount in use $ How secured Expiration date Attach letter from bank confirming line of credit and/or relationship/credit/banking history. Signed this day of 20. Signature Printed Name and Title

10 AFFIDAVIT OF AN INDIVIDUAL FOR A SOLE PROPRIETORSHIP I, an individual, doing business as This day of,, city of County of State of Signature of Applicant PARTNERSHIP AFFIDAVIT I, a partner of (name of firm) This day of,, city of County of State of Signature of Applicant CORPORATION AFFIDAVIT I, the (Title of corporation officer) of (use full corporate name) This day of,, city of County of State of Signature of Applicant The submitter of the foregoing statement of experience and financial condition has read the same and it is true to the best of his/her knowledge. The statement is for the purpose of determining bidder's qualification to undertake work bid. Attached is a certified copy of the minutes of the corporation indicating that the person whose signature appears below has authority to bind the corporation. For other types of organizations, provide evidence in a form and substance acceptable to the district (such as Power of Attorney) that the person whose signature appears below has authority to bind the contractor.

11 By signing the proper affidavit, the submitter certified and declares under penalty of perjury that the foregoing is true and correct. If a corporation, answer this: Capital paid in cash, $ When incorporated: In which state: If a partnership, answer this: Date of organization State whether partnership is general, limited, or association In which state: Name and address of each partner President: Vice President: Secretary: Treasurer: Provide copy of most recent certificate from the Secretary of State indicating the standing of the corporation.

12 CONTRACTOR'S FINANCIAL STATEMENT ASSETS DETAIL TOTAL 1. Free and unrestricted, Cash on hand 2. Notes receivable 3. Accounts receivable from completed contracts 4. Accts. receivable, sums billed on incomplete contract 5. Other account(s) receivable 6. Advances to construction joint ventures 7. Material in stock not included in item 4 8. Negotiable securities 9. Other current assets SUBTOTAL OF CURRENT ASSETS $ FIXED AND OTHER ASSETS 10. Real Estate 11. Construction Plant and equipment 12. Furniture and fixtures 13. Investments of a noncurrent nature 14. Other noncurrent assets SUBTOTAL OF FIXED AND OTHER ASSETS TOTAL ASSETS $ $ LIABILITIES AND CAPITAL CURRENT LIABILITIES 15. Current portion of notes payable, exclusive of equipment obligations and real estate encumbrances 16. Accounts Payable 17. Other current liabilities SUBTOTAL OF CURRENT LIABILITIES OTHER LIABILITIES 18. Real Estate encumbrances 19. Equipment obligations secured by equipment 20. Other noncurrent liabilities and non-current notes payable 21. Reserves SUBTOTAL OF OTHER LIABILITIES CAPITAL AND SURPLUS 22. Capital stock, paid up 23. Retained earnings SUBTOTAL OF CAPITAL AND RETAINED EARNINGS TOTAL OF LIABILITIES AND CAPITAL CONTINGENT LIABILITIES 24. Liability on notes receivable, discounted or sold 25. Liability on accounts receivable, pledged, assigned, or sold 26. Liability as a bondsman 27. Liability as guarantor on contracts or on accounts of others 28. Other contingent liabilities TOTAL OF CONTINGENT LIABILITY $ $ $ $ $

13 SUPPORTING SCHEDULES TO BALANCE SHEET ASSETS List any and all items of the following categories as listed on page 11 that exceed 10% of the subject line total or any item that exceeds $50,000. DUE FROM DATE DUE SECURITY AMOUNT LINE 2 NOTES RECEIVABLE LINE 3 ACCOUNTS RECEIVABLE FROM COMPLETED CONTRACTS EXCLUSIVE OF CLAIMS NOT APPROVED FOR PAYMENT LINE 4 SUMS EARNED ON INCOMPLETE CONTRACTS LINE 5 OTHER ACCOUNTS RECEIVABLE LINE 6 ADVANCES TO CONSTRUCTION JOINT VENTURES SUPPORTING SCHEDULES TO BALANCE SHEET LIABILITIES List any and all items of the following categories as listed on page 11 that exceed 10% of the subject line total or any item that exceeds $50,000. DUE FROM DATE DUE SECURITY AMOUNT PERIODIC PAYMENT LINE 15 NOTES PAYABLE EXCLUSIVE OF EQUIPMENT OR REAL ESTATE LINE 16 ACCOUNTS PAYABLE LINE 17 OTHER CURRENT LIABILITIES

14 LINE 18 REAL ESTATE ENCUMBRANCES LINE 19 EQUIPMENT OBLIGATIONS SECURED BY EQUIPMENT