King Street Pump Station Improvements (Volume I) & ASR Lime System Improvements (Volume II)

Team Member

Company Name

Proposed Role

Worked with
in the Past

Prime Contractor

Key Subcontractor #1

Yes No

Key Subcontractor #2

Yes No

Key Subcontractor #3

Yes No

Key Subcontractor #4

Yes No

Key Subcontractor #5

Yes No

Team Member

Proposed Key
Personnel Role

Name of Key
Personnel

Included in Org
Chart?

Prime Contractor

Project Manager

Yes No

Superintendent

Yes No

QC Manager

Yes No

Other:

Yes No

Key Subcontractor #1

Project Manager

Yes No

Superintendent

Yes No

Other:

Yes No

Key Subcontractor #2

Project Manager

Yes No

Superintendent

Yes No

Other:

Yes No

Key Subcontractor #3

Project Manager

Yes No

Superintendent

Yes No

Other:

Yes No

Key Subcontractor #4

Project Manager

Yes No

Superintendent

Yes No

Other:

Yes No

Key Subcontractor #5

Project Manager

Yes No

Superintendent

Yes No

Other:

Yes No

Project Name:

Utility/Owner name:

Utility/Owner Project Manager’s name and contact information to include a valid, recently verified email and telephone number:

Proposed Contractor’s Key Personnel who participated on this project:

Key Personnel’s role on this project:

Project is within the last fifteen (15) years:

Yes No

Project has similar size, scope, and complexity to the work described in the Contract Documents:

Yes No

Detailed project description and explanation for why it is comparable to the size, scope and/or complexity for this item:

(Note: please include sufficient project details so similarity and applicability of project reference can be determined. Include details like facility footprint, greenfield or rehabilitation, capacity of pump station in mgd, number of pumps, type of pumps, capacity of each pump (gpm or mgd), materials of construction for yard piping and pipe diameter, # of well pumps and motors replaced, number and size of buildings built, shutdown duration, and other specific project details.)

Original bid/price and final construction in place costs:

Total costs for all change orders, as well as an explanation regarding the reason for specific change orders:

Construction Contract Notice to Proceed (NTP) Date:

Identify whether the project was completed on-time and within budget:

On-time: Yes No

Within budget: Yes No

Original Contract Time (specify Calendar Days or Working Days):

Original Contract Substantial Completion Date and Actual Substantial Completion Date:

Original Contract Completion Date and Actual Completion Date:

Actual number of days beyond the original contract:

Actual number of days added through change orders. If Contract time extensions were added to the contract as a result of Prime Contractor’s responsibilities, provide a short explanation of each.

The recovery schedule/plan and implementation of such, if it was required. If a recovery/plan schedule was implemented, describe whether the project was successfully brought back on schedule. Please discuss, as necessary and deemed appropriate.

Project Name:

Utility/Owner name:

Utility/Owner Project Manager’s name and contact information to include a valid, recently verified email and telephone number:

Proposed Contractor’s Key Personnel who participated on this project:

Key Personnel’s role on this project:

Project is within the last fifteen (15) years:

Yes No

Project has similar size, scope, and complexity to the work described in the Contract Documents:

Yes No

Detailed project description and explanation for why it is comparable to the size, scope and/or complexity for this item:

(Note: please include sufficient project details so similarity and applicability of project reference can be determined. Include details like facility footprint, greenfield or rehabilitation, capacity of pump station in mgd, number of pumps, type of pumps, capacity of each pump (gpm or mgd), materials of construction for yard piping and pipe diameter, # of well pumps and motors replaced, number and size of buildings built, shutdown duration, and other specific project details.)

Original bid/price and final construction in place costs:

Total costs for all change orders, as well as an explanation regarding the reason for specific change orders:

Construction Contract Notice to Proceed (NTP) Date:

Identify whether the project was completed on-time and within budget:

On-time: Yes No

Within budget: Yes No

Original Contract Time (specify Calendar Days or Working Days):

Original Contract Substantial Completion Date and Actual Substantial Completion Date:

Original Contract Completion Date and Actual Completion Date:

Actual number of days beyond the original contract:

Actual number of days added through change orders. If Contract time extensions were added to the contract as a result of Prime Contractor’s responsibilities, provide a short explanation of each.

The recovery schedule/plan and implementation of such, if it was required. If a recovery/plan schedule was implemented, describe whether the project was successfully brought back on schedule. Please discuss, as necessary and deemed appropriate.

Project Name:

Utility/Owner name:

Utility/Owner Project Manager’s name and contact information to include a valid, recently verified email and telephone number:

Proposed Contractor’s Key Personnel who participated on this project:

Key Personnel’s role on this project:

Project is within the last fifteen (15) years:

Yes No

Project has similar size, scope, and complexity to the work described in the Contract Documents:

Yes No

Detailed project description and explanation for why it is comparable to the size, scope and/or complexity for this item:

(Note: please include sufficient project details so similarity and applicability of project reference can be determined. Include details like facility footprint, greenfield or rehabilitation, capacity of pump station in mgd, number of pumps, type of pumps, capacity of each pump (gpm or mgd), materials of construction for yard piping and pipe diameter, # of well pumps and motors replaced, number and size of buildings built, shutdown duration, and other specific project details.)

Original bid/price and final construction in place costs:

Total costs for all change orders, as well as an explanation regarding the reason for specific change orders:

Construction Contract Notice to Proceed (NTP) Date:

Identify whether the project was completed on-time and within budget:

On-time: Yes No

Within budget: Yes No

Original Contract Time (specify Calendar Days or Working Days):

Original Contract Substantial Completion Date and Actual Substantial Completion Date:

Original Contract Completion Date and Actual Completion Date:

Actual number of days beyond the original contract:

Actual number of days added through change orders. If Contract time extensions were added to the contract as a result of Prime Contractor’s responsibilities, provide a short explanation of each.

The recovery schedule/plan and implementation of such, if it was required. If a recovery/plan schedule was implemented, describe whether the project was successfully brought back on schedule. Please discuss, as necessary and deemed appropriate.

Project Name:

Utility / Owner Name:

Date of Notice to Proceed:

Original Contract Time (calendar days or working days):

Original Contract Completion Date:

Actual Contract Completion Date (if not complete, provide % complete based on Contract Time):

Original Bid Price / Price Proposal:

Final Construction In-place Cost (if not complete, provide percent (%) complete based on Contract Value and most recent application for payment):

Was the project completed on-time?

Yes No

Was the project completed within budget?

Yes No

Key Personnel
Name

Company
Affiliation

Project
Name

% Time
Allocated

Project
Completion
Date

Project Name:

Identify if the Project was performed by Sub-Contractor or if Prime Contractor Self-Performed

Utility/Owner name:

Utility/Owner Project Manager’s name: and contact information to include a valid, recently verified email and telephone number:

Proposed Key Subcontractor’s Key Personnel who participated on this project:

Key Personnel’s role on this project:

Project is within the last ten (10) years:

Yes No

Key Sub-Contractor’s Key Personnel involved in this Project were identified on the organizational chart:

Yes No

Project has similar size, scope, and complexity to the work described in the Contract Documents:

Yes No

Detailed project description and explanation for why it is comparable to proposed Key Subcontractor’s role on the Project:

Original bid/price and final construction in place costs:

Total costs for all change orders, as well as an explanation regarding the reason for specific change orders:

Construction Contract Notice to Proceed (NTP) Date:

Identify whether the Project was completed on-time and within budget:

On time: Yes No

Within budget: Yes No

Original Contract Time (specify Calendar Days or Working Days):

Original Contract Substantial Completion Date and Actual Substantial Completion Date:

Original Contract Completion Date and Actual Completion Date:

Actual number of days beyond the original contract:

Actual number of days added through change orders. If Contract time extensions were added to the contract as a result of Key Sub-Contractor’s responsibilities, provide a short explanation of each.

The recovery schedule/plan and implementation of such, if it was required. If a recovery/plan schedule was implemented, describe whether the project was successfully brought back on schedule. Please discuss, as necessary and deemed appropriate.

Project Name:

Identify if the Project was performed by Sub-Contractor or if Prime Contractor Self-Performed

Utility/Owner name:

Utility/Owner Project Manager’s name: and contact information to include a valid, recently verified email and telephone number:

Proposed Key Subcontractor’s Key Personnel who participated on this project:

Key Personnel’s role on this project:

Project is within the last ten (10) years:

Yes No

Key Sub-Contractor’s Key Personnel involved in this Project were identified on the organizational chart:

Yes No

Project has similar size, scope, and complexity to the work described in the Contract Documents:

Yes No

Detailed project description and explanation for why it is comparable to proposed Key Subcontractor’s role on the Project:

Original bid/price and final construction in place costs:

Total costs for all change orders, as well as an explanation regarding the reason for specific change orders:

Construction Contract Notice to Proceed (NTP) Date:

Identify whether the Project was completed on-time and within budget:

On time: Yes No

Within budget: Yes No

Original Contract Time (specify Calendar Days or Working Days):

Original Contract Substantial Completion Date and Actual Substantial Completion Date:

Original Contract Completion Date and Actual Completion Date:

Actual number of days beyond the original contract:

Actual number of days added through change orders. If Contract time extensions were added to the contract as a result of Key Sub-Contractor’s responsibilities, provide a short explanation of each.

The recovery schedule/plan and implementation of such, if it was required. If a recovery/plan schedule was implemented, describe whether the project was successfully brought back on schedule. Please discuss, as necessary and deemed appropriate.

Project Name:

Identify if the Project was performed by Sub-Contractor or if Prime Contractor Self-Performed

Utility/Owner name: