request for bid services commodities 201505111339223470[1]

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560_Request for Bid - Services & Commodities.doc Rev: 1/21/15 Page 1 of 6 REQUEST FOR BID QUESTIONNAIRE (For Services and Commodities) DATE: TO: , Procurement Services Department FROM: , Project Manager, Phone Number 1. Project Title: 2. Requisition Number: Printing EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4) Printing POETA Funding Source: Project (9) Organization Expenditure Type Task (4) Award (8) Postal EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4) Postal POETA Funding Source: Project (9) Organization Expenditure Type Task (4) Award (8) Advertising EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4) Advertising POETA Funding Source: Project (9) Organization Expenditure Type Task (4) Award (8) 3. Estimated Cost: $ 4. FUNDING/BUDGET SOURCE: Operating Enterprise (check all that apply) Capital Grant* Other: *If Grant funded in whole or in part, who is the Granting Agency: Special Conditions/Grant Requirements included in Special Conditions. Grant expiration date:

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Page 1: Request for Bid Services Commodities 201505111339223470[1]

560_Request for Bid - Services & Commodities.docRev: 1/21/15

Page 1 of 6

REQUEST FOR BIDQUESTIONNAIRE

(For Services and Commodities)

DATE:

TO: , Procurement Services Department

FROM: , Project Manager, Phone Number

1. Project Title:

2. Requisition Number:Printing EBS Oracle Funding SourceFund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Printing POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

Postal EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Postal POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

Advertising EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Advertising POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

3. Estimated Cost: $

4. FUNDING/BUDGET SOURCE: Operating Enterprise

(check all that apply) Capital Grant*

Other:

*If Grant funded in whole or in part, who is the Granting Agency:

Special Conditions/Grant Requirements included in Special Conditions.

Grant expiration date:

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5. Provide a sentence that addresses the funding source for this procurement that is appropriate for the Recommendation/Staff Recommended Motion section of the Agenda Item at the time of award (per A.D. 04):

6. Delivery and/or Contract Completion Time: calendar days from the Award Date, Notice to Proceed, or Release Order Date.

o Describe any special delivery or completion requirements:

o Delivery location(s):

7. Previous PO/BPO Number:

8. Insurance Requirements coordinated with Risk Management:

Yes, Documentation from Risk Management should be attached

No, Insurance not required

9. Minority Business Enterprise and Small Business Enterprise (MBE/SBE) considerations coordinated with the Economic Development Department for possible Small Business Set Aside:

Yes, Documentation from Economic Development Department must be attached

10. Does the project involve computer hardware, software or data/telephone connection? Contact the Information and Technology Services Department (ITS) at (813) 272-5464 for more information.

Yes, Documentation from ITS should be attached

No

11. License Requirements has been coordinated with The Center for Development:

No License RequiredGeneral ContractorBuilding ContractorElectricalPaintingUnderground UtilitiesMechanicalPlumbingOther (Specify):

12. Pursuant to A.D. 25, all new contracts for direct public services shall include customer satisfaction surveys as part of the contractor’s requirements. Did you include requirements?

Yes, Requirement(s)/Provision(s) included

No

13. Certain information is exempt from Florida Public Records Law if it pertains to security related matters. Does this bid contain security sensitive information?

Yes, Explain:

No

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14. When the specifications are out of the ordinary or unique, the Requesting Department should have their Department Attorney review the specifications. Have the specifications been reviewed by the Requesting Department’s Attorney?

Yes, Name of Attorney: , date reviewed:

No

15. Are there any business decisions regarding this procurement that may limit competition?

Yes, Explain:

No

16. Suggested vendor list to contact. Include business name, fax number, and email address

Company Fax Number Email Address

17. Award will be based on:

Invitation to Bid (ITB) Cost Alone: Answer question 18.

Request for Proposal (RFP) Other factors including cost: Answer question 19.

18. ITB Special Instructions, Terms, and Conditions:

a. Bidders’ minimum qualifications and experience

b. Are there any other special features (such as a Site Visit or Pre-bid Conference [NOTE: Mandatory Site Visit and/or Mandatory Pre-Bid require a Memo of Justification signed by your Director] Special Bid Submittals, Special Exhibits, etc.)?

Yes, Special Feature(s): No

c. Recommended Contract Term:

d. Recommended Renewal Periods:

e. Bid Bond Requirements:

f. Additional contract provisions:

g. Specifications and/or Scope of Services (Provide in .txt or .xml format. Do not use hyphen (-), ampersand (&) or less than/greater than (<, >).):o Introduction to the project

o A clear statement of the intended use; essential characteristics necessary

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o Appropriate type of specification (Brand Name, Qualified Products List, Design, Performance, Design/Performance)

o Background information. Attach exhibits if necessary

o Provide detailed specifications and/or scope of services that define the deliverables

o Deliverables with quantities (Actual or Estimated)

o Liquidated Damages: (Backup computation should be attached)Yes $ per calendar day of delayNo

o Invoicing or Payment requirements

o Contract transition requirements from one contractor to another

o Performance Bond Requirements

19. RFP Special Instructions, Terms, and Conditions:

a. Proposers’ minimum qualifications and experience:

b. Are there any other special features such as a Site Visit or Pre-Proposal Conference [NOTE: Mandatory Site Visit and/or Mandatory Pre-Bid require a Memo of Justification signed by yourDirector] Special Bid Submittals, Special Exhibits, etc.)?

Yes, Special Feature(s):

No

c. Recommended Contract Term:

d. Recommended Renewal Periods:

e. Proposal Bond Requirements:

f. Evaluation Criteria:

o Cost 50 Points

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o Qualifications Points

o Experience Points

o Technical Approach Points

g. RFP Questionnaire – Provide questions by evaluation criteria that proposers should respond to.

h. Indicate Evaluation Committee Members that do not report or indirectly report to one another:

o Chairperson: , Department

o Member: , Department

o Member: , Department

o Optional Member: , Department

o Optional Member: , Department

i. Additional contract provisions:

j. Specifications and/or Scope of Services:

o Introduction to the projectA clear statement of the intended use; essential characteristics necessary

o Appropriate type of specification (Brand Name, Qualified Products List, Design, Performance, Design/Performance)

o Background information. Attach exhibits if necessary

o Provide detailed specifications and/or scope of services that define the deliverables

o Deliverables with quantities: Actual or Estimated

o Liquidated Damages: Backup computation should be attached

Yes $ per calendar day of delay

No

o Invoicing or Payment requirements

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o Contract transition requirements from one contractor to another

o Performance Bond Requirements

20. Request For Bid Questionnaire Attachment Checklist:

Completed Request For Bid Questionnaire

Insurance Requirements

MBE/SBE Review

ITS Review

Licensing Requirements

Specifications

Suggested Vendor List

Mandatory Conference and/or Site Visits Justification, if applicable

Liquidated Damages Computation, if applicable

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REQUEST FOR PROFESSIONAL SERVICES QUESTIONNAIREUNDER F.S. 287.055, CONSULTANTS COMPETITIVE NEGOTIATION ACT (CCNA)

DATE:

TO: , Supervisor, Procurement Services Department

THROUGH:(If Applicable)

FROM: , Project Manager, Phone No:

1. This request is to initiate a procurement for Professional Services under the subject procedures:

Project Title:

C.I.P. NO: Requisition (RQ) number: .

2. Estimated Project Cost:

3. Contract Required by Date:

4. Certification for this project is required in:

Architecture

Engineering

Landscape Architecture

Surveying and Mapping

5. FUNDING/BUDGET SOURCE: Operating Enterprise(check all that apply) Capital Grant*

Other:

*If Grant funded in whole or in part, who is the Granting Agency:Grant Name:Grant Expiration Date:

Special Language, Clause and/or Requirements must be attached.Grant Expiration Date:

6. Provide a sentence that addresses the funding source for this procurement that is appropriate for the Recommendation/Staff Recommended Motion section of Agenda Item at the time of awards (per A.D. 04):

Printing EBS Oracle Funding SourceFund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Printing POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

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Postal EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Postal POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

Advertising EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Advertising POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

7. There are sufficient funds in the Department to accommodate award of the contract.

8. This procurement is is not related to one or more of the Board’s Strategic goals. If so, which

9. Pursuant to A.D. 25, all new contracts for direct public services shall include customer satisfaction surveys as part of the contractor’s requirements.

Yes, Requirement/Provision Included

No, Not Applicable

10. Certain information is exempt from Florida Public Records Law if it pertains to security related matters. Does this bid contain security sensitive information?

Yes

No

11. Number of firms to be selected to provide the required services:

Stand Alone/Single Contract

Miscellaneous Work Order Contracts (Enter number of firms to receive a contract)

12. Number of firms to be shortlisted: (Minimum of three firms)

13. CONSULTANT INTERVIEWS (Check One)Oral Presentations are requested

Telephone discussions requested

14. Small Business Set-Aside

Yes (Attach coordination with Economic Development)

No

15. Name of User Agency (if applicable):

16. Estimated Cost of Construction (if applicable):

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17. From the time negotiations are authorized, how long do you expect it to take to complete negotiations?

Indicate number of weeks

18. The documents listed below are attached to this Request and an electronic copy has been emailed to the Sr. Procurement Analyst:

Scope of Services, including a proposed project/design schedule indicating month/year design itto be complete, if applicable. (Provide in .txt or .xml format)

Brief Description for Legal Advertisement

Evaluation Criteria Form

Rating Guide

Page Limitations

Insurance Requirements for Project

Evaluation Committee Selection Memo

19. Does the project involve computer hardware, software or data/telephone connection? Contact ITS at (813) 272-5464 for more information.

Yes (Attach documentation that ITS has reviewed and approved)

No

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BRIEF DESCRIPTION OF SCOPE OF SERVICESFOR

LEGAL ADVERTISEMENT

PURSUANT TO SECTION 287.055, FLORIDA STATUTES, HILLSBOROUGH COUNTY INVITES QUALIFIED FIRMS TO SUBMIT RESPONSES ON THE FOLLOWING PROJECT.

SCOPE OF WORK:

NOTE: If this request is for miscellaneous term contracts with options to renew, the initial term, dollar cap and the unilateral renewal option term(s) must be stated in the legal ad.

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EVALUATION CRITERIA FORM

PROJECT TITLE:

THE PROJECT MANAGER (PM) SHALL ASSIGN A MAXIMUM POINT VALUE (MPV) FOR EACH EVALUATION CRITERION LISTED BELOW. THE MORE IMPORTANT THE CRITERIA, THE HIGHER THE MPV WILL BE. THE PM MUST SELECT ONE OF THE CRITERIA AS THE HIGHEST VALUED. IN THE EVENT OF A TIE, FOR THE SECOND TIEBREAKER THE FIRM RECEIVING THE HIGHEST POINTS ON THE HIGHEST VALUED CRITERIA WILL BE CONSIDERED THE HIGHER-RANKED FIRM. THE TOTAL MPV MUST EQUAL THE SUM OF 100 POINTS.

EVALUATION CRITERIA MAX POINT VALUE

1. Ability of the firm and its professional personnel

2. Firm’s experience with projects of similar type and size

3. Firm’s willingness and ability to meet schedule and budget requirements

4. Effect of firm’s recent, current and projected workload

5. Effect of project team location

Total:

(Must equal 100)

The attached rating guide has been completed using the MPVs listed above.

Reviewed By: Date:

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PROFESSIONAL CONSULTANT SELECTION RATING GUIDE

INSTRUCTIONS FOR COMPLETING THIS GUIDE:

1. AT THE END OF EACH EVALUATION CRITERION TITLE, INSERT THE MPV FROM THE PREVIOUS PAGE.

2. ESTABLISH A RANGE UNDER EACH CRITERION TO DISTRIBUTE THE MPV TO THE CORRESPONDING DEFINITIONS. NEGATIVE SCORES SHALL NOT BE USED.

3. EVALUATORS WILL SCORE EACH RESPONSE USING THIS RATING GUIDE.

4. THIS RATING GUIDE WILL BE INCLUDED IN THE RPS DOCUMENT FOR FIRMS TO REVIEW.

EVALUATION CRITERIA NO. 1: ABILITY OF FIRM AND ITS PROFESSIONAL PERSONNEL

Project team personnel do not have appropriate level of qualifications and experience. -Project team does not contain all critical disciplines. Organization of project team is inappropriate. Prime firm lacks adequate professional resources to properly provide services. Proposed project manager is not appropriate.

Some project team personnel have adequate level of qualifications and experience. Project team lacks minor disciplines. Organization of project team is marginal. Prime firm’s professional resources to properly provide services are marginal. Proposed project manager’s qualifications are marginal.

Project team personnel have adequate level of experience. Project team contains all necessary disciplines. Organization of project team is adequate to the project. Prime firm has adequate professional resources to properly provide services. Proposed project manager’s qualifications are adequate.

Project team personnel have above average level of experience and the project manager is uniquely qualified. Project team contains all necessary disciplines. Organization of project team is adequate to the project. Prime firm has superior professional resources to properly provide services.

Project team personnel have exceptional level of experience and several are uniquely qualified. Project team contains all necessary disciplines. Organization of project team is superior. Prime firm has exceptional professional resources to properly provide services. Proposed project manager is uniquely qualified.

EVALUATION CRITERIA NO. 2: FIRM’S EXPERIENCE WITH PROJECTS OF A SIMILAR SIZE AND TYPE

Prime firm has marginal experience with projects of a similar size and type.

Prime firm has minor successful experience with projects of a similar size and type. Scope of services provided for representative projects vary from RPS Scope.

Prime firm has adequate successful, recent (within past five years) experience with projects of a similar size and type. Scope of services provided for representative projects are similar to RPS scope.

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Prime firm has more than adequate successful, recent (within past 5 years) experience with projects of a similar size and type. Scope of services provided for representative projects are similar to RPS scope.

Prime firm has superior past and recent successful experience with projects of a similar size and type. Scope of services provided for representative projects are similar to RPS scope.

EVALUATION CRITERIA NO. 3: FIRM’S WILLINGNESS AND ABILITY TO MEET SCHEDULE AND BUDGET REQUIREMENTS

Submittal does not address either the schedule or budget.

Submittal shows inadequate understanding of schedule and budget requirements.

Submittal shows adequate schedule approach and understanding of budget control. Project budget and schedule can be met or modified to meet project intent.

Submittal shows good understanding of and approach to schedule and budget. Project budget and schedule can be met.

Submittal shows superior understanding of and approach to schedule and budget with potential improvements for project delivery and cost savings.

EVALUATION CRITERIA NO. 4: EFFECT OF FIRM’S RECENT, CURRENT AND PROJECTED WORKLOAD

Submittal shows that consultant does not have sufficient available personnel to complete services on schedule.

Submittal shows that consultant’s workload commitments will impact its ability to complete services on schedule

Submittal shows that while consultant has adequate time and available personnel, prior workload commitments may impact its ability to complete services on schedule.

Submittal shows that consultant’s project team has adequate time and available personnel to complete services on schedule.

Submittal shows that consultant’s project team has adequate staffing available to complete services on schedule. Submittal indicates backup staffing capability in the event of unforeseen circumstances.

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FOR EVALUATION CRITERIA NO. 5 THERE ARE TWO VERSIONS IN THIS MEMO. THE FIRST ONE LISTED BELOW IS FOR ENGINEERING CONSULTANTS AND THE SECOND ONE IS FOR ARCHITECTURE CONSULTANTS. THERE MAY BE A NEED TO CHANGE THE WORDING IN THE RATING GUIDE ON WORK ORDER BASED CONTRACTS OR FOR SURVEYING AND MAPPING PROJECTS. IF YOU ARE REQUESTING LANGUAGE DIFFERENT FROM THAT STATED IN THIS DOCUMENT, YOU MUST COORDINATE IT WITH THE SR. PROCUREMENT ANALYST. ALSO NOTE, ANY CHANGES TO THIS AREA MAY IMPACT THE PAGE LIMITATION SECTION.

ENGINEERING

EVALUATION CRITERIA NO. 5: EFFECT OF PROJECT TEAM LOCATION ON PROJECTScored by Evaluation Committee Chairperson ONLY

Note: “Local” is any county within the Tampa Bay Regional Partnership area, i.e. Hillsborough, Pinellas, Pasco, Polk, Manatee, Sarasota and Hernando Counties.

Non-local location of most of project team, including the prime firm and Project Manager, may adversely affect work quality and schedule.

Non-local location of some of project team, although prime firm and project manager may be local, may adversely affect work quality and schedule.

One or two key elements of project teams are non-local and may adversely affect work quality and schedule. All major sub-consultants (Civil, Structural, Mechanical, Electrical, Plumbing) are local.

Only minor elements of project team are non-local and probably will not affect work quality or schedule.

All of the project team is local.

ARCHITECTURE

EVALUATION CRITERIA NO. 5: EFFECT OF PROJECT TEAM LOCATION ON PROJECTScored by Evaluation Committee Chairperson ONLY

Note: “Local” is any county within the Tampa Bay Regional Partnership area, i.e. Hillsborough, Pinellas, Pasco, Polk, Manatee, Sarasota and Hernando Counties.

Non-local location of most of project team including the prime firm, project manager, and civil engineer may adversely affect work quality and schedule.

Non-local location of some of project team, although prime firm, project manager and civil engineer may be local, may adversely affect work quality and schedule.

One or two key elements of project teams (e.g., MEP Engineer) are non-local and may adversely affect work quality and schedule.

Only minor elements of project team are non-local and probably will not affect work quality or schedule. All major sub-consultants (Civil, Structural, Mechanical, Electrical, Plumbing) are local.

All of the project team is local.

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PAGE LIMITATIONS

PROJECT TITLE:

INSTRUCTIONS:

1. Indicate your choice of page limits in the spaces provided for each of the five (5) evaluation criteria.

2. If you have suggested changes to the items listed under any of the evaluation criteria for this project, please advise. All changes must be coordinated with the Sr. Procurement Analyst prior to development of the RPS.

3. Responses to the evaluation criteria should include, but not necessarily be limited to, the information included with each of the criteria below:

Ability of the firm and its professional personnel

Responses limited to pages maximum, plus resumes for key personnel

Attach resumes only for key personnel of the Project Team, detailing past experience as it relates to projects of a similar size and type.

Submit separate organizational charts delineating personnel assigned to both construction anddesign services, if applicable.

Firm’s experience with projects of similar type and size

MAXIMUM NUMBER OF PROJECTS TO BE INCLUDED:

Responses limited to one (1) page maximum per project

List a maximum of recent projects, preferably during the past years, to indicate proficiency in similar work.

Firm’s willingness and ability to meet schedule and budget requirements

Response limited to pages maximum

Provide a short narrative outlining how you propose to manage the project in order to meet schedule and budget requirements.

Indicate the controls to be utilized to maintain both schedule and budget for this project.

Describe how personnel will be assigned, and tasks effectively handled, in order to provide the most efficient service on the project (during both the design and the construction phases, if applicable).

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Effect of firm’s recent, current and projected workload

Responses limited to pages maximum, including a one page graphic representation.

Describe the current workload and your daily ability to handle the scope of services.

Provide a graphic representation of your current commitment over the next one year period for key members of the project team.

Effect of project team location

Response is limited to a page maximum.

Define where elements of the work will be performed (city/state), whether performed by prime or subconsultant firms, and who in the Proposer's organizational chart will oversee performance of that work.

Specify the members of the project team and office location for each.

A firm shall be considered local if it is within the Tampa Bay Regional Partnership area, made up of Hillsborough, Pinellas, Pasco, Polk, Manatee, Sarasota and Hernando Counties.

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M E M O R A N D U M

DATE:

TO: Michael J. McNabb, Risk Management

FROM:

SUBJECT: INSURANCE REQUIREMENTS FOR PROFESSIONAL CONSULTANT SELECTION

Please provide the insurance requirements and limits of liability for:

PROJECT:

Attached is a brief Scope of Work for the project (total sheets).

A. Worker’s Compensation and Employer’s Liability Insurance:

Employer’s Liability: $ Limit Each Accident$ Limit Disease Aggregate$ Limit Disease Each Employee

B. Commercial General Liability Insurance*:General Aggregate $Products - Completed Operations Aggregate $Personal and Advertising Injury $Each Occurrence $Fire damage (Any One Fire) $Specific Contract Aggregate Limits $

C. Business Automobile Liability Insurance*:Bodily Injury & Property Damage Liability:

$ Combined Single Limit Each Accident

D. Professional Liability Insurance Each claim and aggregate $

E. Aircraft Liability Insurance* $

F. Pollution Liability Insurance $

*General Liability, Auto Liability, Garage Keepers, and Aircraft Insurance must include “Hillsborough County, a political subdivision of the State of Florida” as an Additional Insured.

Risk Management:

BY:Signature

Title Date

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MEMORANDUM

DATE:

TO: Supervisor, Procurement Services Department

FROM: , Director, Department

SUBJECT: Project Title:

Evaluation Committee Selection for Consultant’s Competitive Negotiation Act (CCNA)

In accordance with the procurement manual procedures established for the CCNA Professional Consultant Selection process, the representatives listed below will comprise the Evaluation Committee for the subject project. No committee member listed is a direct or indirect report to any other committee member. The County Attorney and Procurement Services Department representatives serve in an advisory capacity to the committee.

EVALUATION COMMITTEE:

1. Project Manager (CHAIR): Phone:2. Member: Phone: 3. Member: Phone: 4. Member: Phone: 5. Member: Phone:

SCORING METHOD TO BE USED:Consensus (Recommended scoring method)

Individual (Provide explanation why the consensus scoring method should not be used)

NOTE 1: The Committee may be extended to up to five (5) members. At the discretion of the Procurement Services Department, the Committee may be expanded to include a representative of a local Professional Association to serve in an advisory capacity only.

NOTE 2: Committee members shall refrain from discussing the responses with other committee members and are prohibited from discussing any matters related to this project with respondents or anyone except authorized advisors until negotiations with the top-ranked firm(s) have been authorized. Additionally, evaluations shall be based on only the information provided in the consultant’s written response, presentations, and reference checks.

cc: Evaluation Committee Members

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CONSTRUCTION SERVICES QUESTIONNAIRE

DATE:

TO: John Benson, Procurement Operations Coordinator, Procurement Services Department

THROUGH:(If Applicable)

FROM: , Project Manager, Phone No:

Please prepare contract documents for the following project according to the information given below:

1. Requisition Number (RQ)

Project Title:

Scope of Work (for use in Advertisement:

C.I.P. No.

Estimated Base Cost for the Project:

2. Solicitation Event:

Invitation to Bid

Request for Proposal, Contract Manager at Risk

Request for Proposal, Design/Build

Indicate Evaluation Committee Members (for RFPs only):

1. Chairperson: , Phone 2. Member: , Phone 3. Member: , Phone 4. Member: , Phone 5. Member: , Phone

3. Contract Completion Time: calendar days from the Notice to Proceed, or by

4. Retainage:

a. Standard (Recommended): 10%, then 5% after 50% Completion.

b. Other: %, then after 50% Completion

c. None

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5. Liquidated Damages (Memorandum of computation must be attached):

a. If interim milestones: See attached schedule b. See Special Conditionsc. Maximum LD's shall not exceed: per calendar day of delayd. If no interim milestones: per calendar day of delay

6. Term (WORCS) Contract:

Yes

No

If Yes, Contract shall be in effect for Year(s)

Number of Renewals:

Number of Years for Each Renewal:

Cost Escalation? Describe:

Specify the amount the award will be capped if other than the total calculated bid amount:

If requesting award be made to more than one contractor, include justification for needing multiple awards and how work orders will be assigned to the contractors. (i.e., rotational, 2nd awardee would be for emergencies only, etc.)

7. Allowance(s)d. Permitse. Non-Priced Items (NPI)f. Other: g. Other:

8. Design Firm #1:

Address:

Design Contact Person: Phone Fax

Design Firm #2:

Address:

Design Contact Person: Phone Fax

12. Projects under $500,000 must have been submitted to SBE Committee prior to submitting Request for Bids. Projects $500,000 and greater must have been submitted to MBE Committee prior to submitting Request for Bids. Has this project been reviewed by the appropriate committee, and is a copy of the results attached?

Yes

No

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13. FUNDING/BUDGET SOURCE: Operating Enterprise(check all that apply) Capital Grant*

Other:

*If Grant funded in whole or in part, who is the Granting Agency:Special Conditions/grant requirements included in Special Conditions.

Name of Grant:Grant Expiration Date:

14. Provide a sentence that addresses the funding source for this procurement that is appropriate for the Recommendation/Staff Recommended motion section of the Agenda Item at the time of award (per A.D. 04):

Advertising EBS Oracle Funding Source Fund (5) Center (6) Account (6) Subaccount (4) Activity (4)

Advertising POETA Funding Source:Project (9) Organization Expenditure Type Task (4) Award (8)

15. Pursuant to A.D. 25, all new contracts for direct public services shall include customer satisfaction surveys as part of the contractor’s requirements.

Yes, Requirement/Provision Included

No, Not Applicable

16. Certain information is exempt from Florida Public Records Law if it pertains to security related matters. Does this bid contain security sensitive information?

Yes

No

17. “Proposed Equals” be reviewed:After Bid Closing (Recommended)

Prior to Bid Closing

18. Is the Trench Safety Act applicable? Yes

No

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19. Does this project require the Contractor to the requirements of the Jessica Lundsford Act?Yes

No

20. Do the Special Conditions indicate all Hillsborough County permits that must be obtained by the Contractor, and the cost for each (as required by State statute)?

Yes

None required

21. If the project is estimated under $200,000, are Performance/Payment Bonds recommended?

Yes

No

22. Insurance requirements (coordinated with Risk Management):

Yes (copy attached or forwarded with specifications)

No Insurance Required

23. Does the project involve computer hardware, software or data/telephone connection? (Contact ITS at (813) 272-5464 for more information)

Yes (Attach documentation that the Information Technology Services Department has reviewed and approved)

No

24. Are Alternates included? (If yes, provide cost estimate for each alternate and how the selection of alternates will be made)

Yes indicate the Special Conditions or Division 1-16 page where they are addressed:

No

25. Is a Mandatory Site Visit, Mandatory Pre-bid Conference required?

Yes Attach Memo of Justification, signed by Director.

No

26. Will the Contractor perform any work on CSX (railroad) right-of-way?YesNo

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27. License Requirements, (coordinated with The Center for Development):General ContractorBuilding ContractorElectricalPaintingUnderground UtilitiesMechanicalPlumbingOther (Specify)No License Required

Indicate the Special Conditions page where licensing is addressed:

28. ATTACHMENTS CHECKLIST:e. Attach files to the Oracle requisition.f. No single file can be more than 30MB in size.

Liquidated Damages Justification Memorandum

Mandatory Pre Bid/Site Visit Justification Memorandum

Special Conditions (Provide in Word format)

Division 1-16 Sections for use in bid (as applicable) (Provide in Word format)

RFQ Line Item Template for Construction (Provide in Excel format)

Insurance Requirements, approved by Risk Management

MBE or SBE Committee review results Memorandum – REQUIRED. (Not required, if LAP)

Technical Specifications

Plan Sheets/Drawings (.pdf format)

29. SPECIAL INSTRUCTIONS: