HomeMy WebLinkAboutAgenda 02-03-2026; 8-h - Approval of Prequalification Assessment Tool for the Crisis Diversion Facility 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: February 3, 2026
Action Agenda
Item No. 8-h
SUBJECT: Approval of Prequalification Assessment Tool for the Crisis Diversion Facility
DEPARTMENT: Asset Management Services
(AMS)
ATTACHMENT(S): INFORMATION CONTACT:
1.) Prequalification Policy Alan Dorman, AMS Director, 919-245-
2.) Proposed Prequalification 2627
Assessment Tool
PURPOSE: To review and approve the Prequalification Assessment Tool for the purpose of
prequalifying bidders for the construction of the Crisis Diversion Facility.
BACKGROUND: At its April 15, 2025 Business meeting, the Board of County Commissioners
approved a contract with Gilbane Building Company to serve as the Construction Manager-At-
Risk ("CMAR") for Crisis Diversion Facility. One of the advantages of using a CMAR for the
construction process is that it enables competitive bidding for project components, including the
ability to pre-qualify bidders. North Carolina General Statute 143-135.8 requires the County to
adopt a pre-qualification policy before advertising for bids and approve a project-specific
assessment tool and criteria.
A Prequalification Policy was previously adopted by the Board at the March 19, 2019 Business
meeting for use during the bidding process for the construction of the Northern Campus buildings
and remains in effect (Attachment 1).
Attachment 2 is the proposed Prequalification Assessment Tool and criteria that Gilbane would
use to pre-qualify bidders.
The bidding process will allow the CMAR to establish a guaranteed maximum price ("GMP") from
subcontractors. Once the GMP has been approved by the Board, the construction manager must
manage and control construction costs to ensure they do not exceed the GMP. Any costs that
exceed the GMP that are not changed orders directed by the owner are the final liability of the
CMAR.
FINANCIAL IMPACT: There is no direct financial impact with this item. The approval of this
assessment tool will allow the CMAR to initiate the bidding process for the Crisis Diversion Facility
by pre-qualifying bidders. Upon completion of the bidding process, the CMAR will establish and
submit the GMP to the Board as the final step in approving the construction of the Crisis Diversion
Facility.
ALIGNMENT WITH STRATEGIC PLAN: This item supports:
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• GOAL 2: HEALTHY COMMUNITY
OBJECTIVE 1: Improve harm reduction, prevention, and support services for adults and
children experiencing behavioral health issues, substance use disorder, and intellectual or
developmental disability.
RECOMMENDATION(S): The Manager recommends that the Board approve the Prequalification
Assessment Tool for the purpose of prequalifying bidders for the construction of the Crisis
Diversion Facility.
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Attachment 1
ORANGE COUNTY
PREQUALIFICATION POLICY
A. Governing Law (Session Law 2014-42)
This policy is in effect for all prequalifications on Orange County work, including single prime
project delivery and construction manager at risk first-tier subcontractors. G.S. 143-135.8(b)(2)
requires the governmental entity to "adopt an objective prequalification policy applicable to all
construction or repair work prior to the advertisement of the contract for which the
governmental entity intends to prequalify bidders."
B. Requirements for Prequalification Criteria Form and Assessment
1. Uniform, consistent, and transparent in its application to all bidders.
2. All bidders who meet the prequalification criteria to be prequalified are allowed to
bid on the construction or repair work project.
3. Criteria must be rationally related to construction or repair work.
4. The bidder is not required to have been previously awarded a construction or repair
project by the governmental entity.
5. Bidders are permitted to submit history or experience with projects of similar size,
scope, or complexity
6. Assessment process of prequalification is stated in this policy.
7. A process for a denied bidder to protest is stated below in this policy.
8. A process for notifying a denied prequalified bidder is stated below in this policy.
C. Review of Application
1. Prequalification Committee — The County and/or construction manager shall agree
upon the members of the prequalification committee. The County Finance Officer shall
be the Prequalification Official. The Prequalification Official shall not be on the
prequalification committee. The prequalification committee will review prequalification
applications submitted by the firms and will determine each firm's prequalification
eligibility for the project.
2. Review of Application — The prequalification committee shall use the objective
assessment process form as adopted by the Orange County Asset Management Services
Department. The prequalification committee shall approve or deny the applications in
accordance with the prequalification criteria and scoring system based upon the
applicants' initial response to the County's solicitation for qualified bidders. With the
possible protests and appeals on prequalification and the times associated with
responses, the County and/or construction manager should have the advertisement for
prequalification out to potential applicants approximately two (2) months prior to actual
bid date.
3. Notice of Decision — All firms that submitted applications for prequalification shall be
promptly notified of the prequalification committee's decision, including the reason for
denial, via e-mail. Notice shall be provided prior to the opening of bids for the project
and with sufficient time for the firm to appeal the denial of prequalification.
4. Informal Meeting - Upon denial, the applicant may request an informal meeting with
the County's representative and/or construction manager to receive feedback and
4
suggestions for improvement. The County's representative and/or construction manager
shall hold a feedback session for the applicants who do not appeal the decision within 2
weeks of the request.
5. Firms wishing to appeal the decision shall follow the appeals process described below.
D. Appeals Procedure
1. The firm may appeal the denial of Prequalification as noted below.
a. Initial Protest — A firm denied prequalification may protest the prequalification
committee's decision by filing a written appeal via hand-delivery or e-mail to the
applicable prequalification committee within three (3) business days of emailed
notice that the firm has been denied prequalification. The written appeal shall
clearly articulate the reasons why the firm is contesting the denial (i.e., explains
how the firm satisfied all required criteria for prequalification in the government's
solicitation in their initial response) and attach all documents supporting the
firm's position. The prequalification committee may contact the firm regarding
the information provided prior to ruling on the protest. The Prequalification
Committee should review the written protest within five (5) business days. If the
prequalification committee is satisfied that the firm should be prequalified, the
firm shall be notified that it is prequalified to bid on the project and allowed to
participate in the bid process. If the prequalification committee upholds its denial,
the firm shall be notified in writing via e-mail.
b. Appeal — Within three (3) business days of the County's emailed notice of the
Prequalification Committee's written protest decision, the denied prequalified
firm may appeal the prequalification committee's decision, in writing, via hand-
delivery or e-mail, to the Prequalification Official (see C.1 above). The
Prequalification Official should review the appeal within five (5) business days.
In the event the Prequalification Official is unable to review in a timely manner,
he/she may designate a representative that is not a member of the prequalification
committee to handle the appeal.
C. Decision on Appeal — The decision of the Prequalification Official or
Representative on the appeal shall be final, and the firm shall be promptly
notified of the decision.
d. General Rules for Protests and Appeals — Firms submitting prequalification
applications shall be provided an e-mail address for the communication with the
County and/or construction manager during the protest and appeal process. The
firm shall provide at least two e-mail addresses for use by the County and/or
construction manager in communicating with the firm. In the event the
Prequalification Official or Representative is unable to render a decision on either
the initial protest or the appeal prior to the bid date, the firm shall be allowed to
submit a bid on the project subject to a final decision on the protest or appeal. If
the firm's bid is opened prior to a final decision on the protest or appeal and the
bid is not the lowest monetary bid for the project, the appeal shall be terminated
and rendered moot. Bids received from firms who have been ruled disqualified to
bid shall not be opened. A firm's failure to comply with any requirements of the
protest and appeals procedures of this section shall result in the firm's protest or
appeal being terminated and rendered moot.
{M45#5991I9oul Page 2 of 2
Gilbane Building Company 5
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
G=
Pursuant to the NC Statute GS143-128.1, 143-135.8 and Prequalification requirements for Bidders for Construction
Projects, this form gathers information about the Subcontractor seeking to qualify for the work and provides a
general format for the prequalification criteria. Completing this questionnaire does not guarantee
prequalification. Evaluation of the submittal shall be performed by the Prequalification Committee in accordance
with the statutes and policies. A minimum score of 80 points must be achieved to be prequalified for this project.
Prequalification for Bid Packages
Due Date and Time: Open Through Friday February 27, 2026 @ 5:00 PM
Submitted To: Ksenia Turner& Lauren Morris
Gilbane Building Company—Construction Manager at Risk
150 Fayetteville St. Suite 1100, Raleigh, NC 27601
P: 919-425-1274& 704-501-0962
kturner@gilbaneco.com; Imorris@gilbaneco.com
Project: Name: Orange County Crisis Diversion Facility
Owner: Orange County
Location: Waterstone Drive, Hillsborough, NC 27278
Architect: CPL
Civil Designer:Timmons Group
Structural Engineer: CPL
MEP Engineer: CPL
Phase 2 Construction: +/- 16 Months
Advertisement to Bid: March 27, 2026
Bid Due Date: April 21,2026, will be included in the Advertisement to Bid
*Subject to change based on Construction Drawings release.
Project Description:
• Ground Up Construction of an approximately 20,000 SF, Single-Story Crisis Diversion Facility in
Hillsborough, NC on a 5-Acre Site.The building consists of Patient Rooms, Observation Rooms, Offices,
Conference Rooms, Exam Rooms, Break Rooms, Warming Kitchen, Multipurpose and Group Activity Spaces,
Intake and Triage Areas, Consult/Sensory Rooms and Back of House Spaces. Construction consists of a Steel
Frame with Concrete Foundations, Flat Roof Membrane, and an Exterior Envelope with Fiber Cement
Panels, Stacked Stone Veneer, and Aluminum Storefront Systems.
Instructions to Prequalify:
• For questions about this form contact Ksenia Turner(kturner@gilbaneco.com, 804-727-2667) or Lauren
Morris (Imorris@gilbaneco.com , 919-425-1333).
• Forms may be submitted electronically via email, mail, or hand delivery. Please make sure, if submitting
hand written form,that all information is clearly printed. Gilbane will request illegible information be
resubmitted and this may delay the prequalification process.
• The following forms are provided for reference only and are not required to be submitted with
prequalification form:
o Sample Prequalification Ratings Matrix
o Prequalification Schedule and Procedures
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Gilbane Building Company 6
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
COMPANY NAME:
Date Form Received by Gilbane: (To be completed by Gilbane)
Bid Packages:
If your firm is interested in prequalifying for this project, please check the box for your trade(s). If multiple bid packages are
selected, please make sure that project experiences and references are provided to allow Prequalification Committee to
evaluate your firm for EACH bid package selected.
This is a preliminary list of Bid Packages and may change based on response and qualified bidders.
Check Box if Bid Package Scope of Work General Scope Details Approximate Value
Prequalifying ($)
0 TBD TBD TBD TBD
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0
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u
n
u
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n
u
n
u
n
u
u
0
u
0
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0
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0
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Gilbane Building Company 7
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
SECTION 1. GENERAL COMPANY INFORMATION
1.1. Office Location
Legal Company Name:
Physical Address:
Mailing Address:
City/State/Zip:
Federal Tax ID#:
Website Address:
Phone: Fax:
Primary Contact: Email address:
(Contact person for Prequalification Committee.)
Bidding Contact: Email address:
(Person to receive bid documents, addenda, clarifications and other bid notices.)
Must attached a copy of your current (2022) W-9 =W-9 Attached
Owners/Officers/Partners (Individuals who are authorized to represent or conduct business for and sign legal
documents for the firm)
Full Legal Name:
Title:
Phone:
Email:
Year company founded or number of years in business:
1.2. Business Type
Business Type (check box)
=Corporation =Partnership =LLC =Sole Proprietor I=Joint Venture
HUB Certification - Indicate your NC Statewide Uniform Certification: (check box)
=Black =Hispanic =Asian-American (=American Indian (=Female =None
=Socially and Economically Disadvantage =Disabled-Owned =Disabled Business Enterprise
See website link for more information: http://www.doa.nc.gov/hub/swuc-htm
Is your firm registered with the State of North Carolina to do business? =Yes =No
Is your firm owned or controlled by a parent or any other organization? =Yes =No
If yes, describe Ownership (include Parent Company Name, Federal Tax ID#,full address):
List all other names your firm has operated as for the past (S)years:
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Gilbane Building Company 8
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
1.3. Licensing Information
Please provide all North Carolina professional licenses and license limit/level required for you to perform your
services on this project.
Has any license ever been denied or revoked? IAYes I]No
If yes, please describe:
1.4.Type of Work Self Performed on a Regular Basis
Primary Scope of Work:
Secondary Scope of Work:
Other Scope of Work:
D-U-N-S Number(Dun &Bradstreet):
Number of employees?
Has your company participated in a CMAR project before? IAYes EANo
Does your company have BIM (Building Information Modeling) capabilities? DYes ONo
(Prequalification Ratings Matrix: If completely filled in give 1 point. If not,give 0 points.)
1.5. Bonding-Surety Letter
Attach letter, dated within the last 30 days, from your surety company, signed by their Attorney in Fact,verifying
their willingness to issue sufficient payment and performance bonds for this project, on behalf of your firm and the
dollar limits of that bond commitment, both single and aggregate. Surety company bond rating shall be rated A-
/VII or better under the A.M. BEST Requirements AND listed under the United States treasury dept.
Have you attached a surety letter? IAYes ONo
Gilbane reserves the right to request a Performance& Payment Bond at our discretion.
(Prequalification Ratings Matrix: If surety letter attached give 4 points. If not,give 0 points.)
1.6. Bonding—Funds Expended by Surety Company
Have any funds been expended by a Surety Company on your firm's behalf? DYes ONo
If yes, explain:
(Prequalification Ratings Matrix: if no funds expended by Surety Company, give 4 points. If yes, give 0 points.)
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Gilbane Building Company 9
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
1.7. Insurance
The minimum requirement of insurance coverage is listed below. Firms must indicate that they can provide
evidence of insurance coverage, should they be the successful bidder by attaching a copy of their current insurance
certificate.
Have you attached a copy of your insurance certificate? I IYes I INo
• Insurance Carriers—All insurance carriers must have an AM Best Rating of"A"or better
• General Liability with a required limit of no less than $1,000,000 each occurrence, $2,000,000 general
aggregate per project.
• Worker's Compensation per statue and Employer Liability with the required limit of no less than
$1,000,000 each accident, $1,000,000 Disease policy limit, $1,000,000 Disease each employee
• Automobile Liability—Requirement of no less than $1,000,000 combined single limit for Any Auto.
• Additional Insured—Gilbane Building Company and Forsyth County and the Forsyth County Board of
Education. (Required upon contract award)
• Excess Liability(Umbrella) policy with the required limit of no less than $5,000,000 each occurrence,
$5,000,000 aggregate (limits will increase if the firm will be providing any crane usage).
• Waiver of subrogation— In favor of Gilbane Building Company and Orange County. (Required upon
contract award)
(Prequalification Ratings Matrix: If insurance certificate attached give 1 point. If limits meet or exceed the
required limits indicated above give additional 3 points. If insurance certificate not attached give 0 points.)
1.8. Financials
Attach latest fiscal year-end CPA Prepared (audited, reviewed or compiled) Financial Statements (current within the
past 12-month period). A financial statement includes the CPA opinion letter, balance sheet, income statement,
cashflow, additional schedules/addendums, notes section, etc. If CPA prepared financial statements are not
available,then an internally prepared (unaudited) balance sheet and income statement may be submitted by the
firm, with confirmation from an officer of the company as to the validity of the statements. If there is a situation
where the CPA statement isn't available because it has not been completed by the CPA,then the previous year's
CPA report should be submitted along with an internally prepared (unaudited) balance sheet and income
statement for the recent fiscal year end.
Financial information may be submitted in the following ways:
1. Submission as an attachment to this Prequalification form. (Firm must submit financial data and may clearly
indicate a request for confidentiality to avoid this item from becoming part of public record.)
OR
2. Gilbane's Prequalification database, www.compass-app.com. If this option has been used, please indicate
below
OR
3. Individual review with Gilbane Controller, Matt McGarry, at mmcgarry@gilbaneco.com or 617 478-3368,
via email, mail, live online review or in person review at Gilbane's office in Charlotte, NC.
Have you attached financial statements? EAYes EANo
Have you submitted through www.compass-app.com (optional)? EAYes EANo
Have you held a private review with Gilbane Controller(optional)? EAYes EANo
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Gilbane Building Company 10
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
Financials (Continued):
This section 1.8 will be completed by Gilbane Building Company. Financial Statements will be analyzed by Gilbane
and scored in accordance with the table below. Discounting of the firm's assets will apply including items such as
"goodwill", related party receivables, intangibles, etc. This section includes six(6) financial ratio formulas. The firm
can receive a maximum score of 2 for each ratio formula. The firm can receive a maximum score of 12 for all of
section 1.8.
Financial Contractor Contractor
Ratio Ratio Formula Ratio Points Received Score
1.)Current Current Assets <1.2 = Opts
Debt Ratio Current Liabilities 1.2 to 1.5=1 pts
>1.5 = 2 pts
2.) Liquidity (Cash+Cash Equivalents+Accounts Receivable) <1.0=0 pts
Ratio Current Liabilities 1.0 to 1.3=1 pts
>1.3=2pts
3.) Revenue Last Year's Revenues <1.0=0 pts
to Scope Bid Package Value x 3 1.0 to 1.5 =1 pts
Ratio >1.5 =2 pts
4.)Capital (Current Assets-Current Liabilities)x 5 <1.0=0 pts
to Scope Bid Package Value 1.0 to 1.5=1 pts
Ratio >1.5=2 pts
5.)Equity to (Total Assets-Total Liabilities)x 5 <1.0=0 pts
Scope Ratio Bid Package Value 1.0 to 1.5=1 pts
>1.5=2 pts
6.) Debt to (Total Liabilities) >2.5=0 pts
Equity Ratio (Total Equity) 2.5 to 1.5=1 pts
<1.5=2 pts
(Prequalification Ratings Matrix: For each financial ratio above,a maximum of 2 points per financial ratio for a maximum of
12 points from the Construction Manager/General Contractor.)
Prequalification Ratings Matrix: Submission of financial information is a REQUIREMENT for prequalification submission)
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Gilbane Building Company 11
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
SECTION 2. GENERAL REQUIREMENTS
2.1. Number of Construction Protects Under Contract
How many projects do you CURRENTLY have under contract or in progress and what is their total dollar value?
A: Number of Projects Under Contract:
B: Current Projects Contract Amount: $
C: Current Amount Remaining to Bill: $
(Prequalification Ratings Matrix: If section completed give 1 point. If not,give 0 points.)
2.2. Largest Job Completed
What was your largest job COMPLETED within the last three years? _
A: Dollar Amount: $
B: Location:
C: Year Completed:
(Prequalification Ratings Matrix: Take dollar amount of largest job completed within the last three years and multiply by
1.25. If the result is larger than the estimated budget for this bid package give 4 points. If the result is smaller,give 0
points.)
2.3. Office Location
Will this project be managed and directed from an office in NC? An office in NC is defined as "The principal place
from which the trade or business of the bidder is directed or managed," per GS143-59(c).
=Yes I=No
(Prequalification Ratings Matrix. If office location is managed and directed from NC office give 1 point. If not,give 0 points.)
2.4. Litigation/Claims Last 5 Years
Has your company been involved in any judgments, claims, arbitrations, mediation proceedings, or suits within the
last five years,whether resolved or still pending resolutions? =Yes =No
If yes, state the project name(s),year(s), case number and reason why:
(Prequalification Ratings Matrix: If company has been involved in any litigation indicated above without adequate
explanation,give 0 points.If no,or if adequate explanation provided,give 3 points.)
2.5. Litigation/Claims Currently Outstanding
Are there currently any judgments, claims, arbitration or mediation proceedings or suits pending or outstanding
against your company, its officers, owners or agents? DYes =No
If yes, state the project name(s),year(s), case number and reason why:
(Prequalification Ratings Matrix: If there are currently any litigation indicated above against your company without
adequate explanation,give 0 points.If no,or if adequate explanation provided,give 3 points.)
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Gilbane Building Company 12
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
2.6. Failure to Complete,Supplementation or Breach of Construction Contract
Has your company failed to complete work awarded to it within the last 15 years? =Yes =No
If yes, state the project name(s),year(s), and reason why:
Has your company asked to be relieved of or refused to sign a contract awarded to it within the last 15 years?
=Yes I=No
If yes, state the project name(s),year(s), and reason why:
Has your company been denied an award of a contract based upon a finding by a public agency that your
organization was not a responsible bidder within the last 15 years? =Yes I=No
If yes, state the project name(s),year(s), and reason why:
Has your company been declared in default of a construction contract within the last 15 years? =Yes =No
If yes, state the project name(s),year(s), and reason why:
Has your company been declared in breach of a construction contract within the last 10 years? DYes I=No
If yes, state the project name(s),year(s), and reason why:
Has your company been supplemented by another entity in performance of a construction contract within the last
10 years? DYes =No
If yes, state the project name(s),year(s), and reason why:
Has your company failed to complete a construction contract within the authorized schedule within the last 10
years? =Yes =No
If yes, state the project name(s),year(s), and reason why:
(Prequalification Ratings Matrix: If yes without sufficient explanation,give 0 points. If no, or if adequate explanation
provided,give 10 points.)
2.7. Liquidated Damages
Have you paid liquidated, actual or consequential damages on any project within the last 15 years? DYes =No
If yes, state the project name(s),year(s), and reason why:
(Prequalification Ratings Matrix: If yes without sufficient explanation,give 0 points. If no, or if adequate explanation
provided,give 5 points.)
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Gilbane Building Company 13
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
2.8. Convicted of Conflicts of Interest/Bribery/Bid-Rigging
Has your present company, its officers,owners, or agents ever been convicted of charges relating to conflicts of
interest, bribery, or bid rigging? =Yes =No
If yes, state the project name(s),year(s), and reason why:
(Prequalification Ratings Matrix: If yes,give 0 points. If no,give 3 points.)
2.9.113arred From Public Work in NC
Has your present company, its officers,owners, or agents ever been barred from bidding public work in North
Carolina? =Yes =No
If yes, state the project name(s),year(s), and reason why:
(Prequalification Ratings Matrix: If yes,give 0 points. If no,give 3 points.)
2.10a Safety- EMR Rating
List your company's Experience Modification Rate (EMR)for the past three years.
Present Rate: Previous Rate: Year Before Rate:
If EMR is greater than 1.00 for any given year attach OSHA 300 Log and 300A Summaries for previous 5 years.
Attached? =Yes =No
(Prequalification Ratings Matrix: Submission of Safety Records is a REQUIREMENT for prequalification submission. If EMR
is 1.0 or less give 2 points. If no,give 0 points.)
If these rates reflect corporate performances over a number of locations, please explain,to the extent possible,the
performance experience of the location serving this project:
2.10b Safety-OSHA citations
Has your company been issued any OSHA citations/penalties, NC Department of Labor citations/penalties or had
any jobsite fatalities in the past 3 years? =Yes =No
If yes, please provide specific explanation:
(Prequalification Ratings Matrix: If yes without sufficient explanation,give 0 points. If no or sufficient explanation
provided,give 3 points.
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Gilbane Building Company 14
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
2.10c Safety—Written Plan,Training, Inspections
Does your company have a written Safety/Health Program and required Drug Testing Program? IAYes =No
Does your company provide weekly safety and health training to your on-site employees? IAYes ONo
Does your company perform weekly safety and health inspections of the workplace? DYes =No
(Prequalification Ratings Matrix. Give 3 points for each yes response above,for a maximum of 9 points.)
2.11. Documented HUB Plan
Does this company currently have a documented plan for engaging subcontractor participation from Historically
Underutilized Businesses? DYes ONo If yes, company HUB Plan may be requested by Gilbane.
(Prequalification Ratings Matrix: if company has a current,documented HUB plan give 4 points. If no,give 0 points.)
SECTION 3. Project Specific Staff
3.1. Superintendent Resume
The assigned project superintendent for this project shall be:
Include a resume. Have you included a resume? DYes =No
(Prequalification Ratings Matrix: If resume included,give 2 points. If no,give 0 points.)
3.2. Superintendent Experience
The years of experience this superintendent has on this specific project type is_<1 _1-2 _3-4 _5 or more
(Prequalification Ratings Matrix: If<1 give 0 points,if 1-2,give 0.5 point,3-4 give 1 point,if 5 or more give 2 points.)
3.3. Project Manager Resume
The assigned project manager for this project shall be:
Include a resume. Have you included a resume? DYes =No
(Prequalification Ratings Matrix: If resume included,give 2 points. If no,give 0 points.)
3.4. Project Manager Experience
The years of experience the project manager has on this specific project type is_<1 _1-2 _3-4 _5 or more
(Prequalification Ratings Matrix: If<1 give 0 points,if 1-2,give 0.5 point,3-4 give 1 point,if 5 or more give 2 points.)
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Gilbane Building Company 15
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
3.5. Current and Similar Project Experience
IF YOUR COMPANY HAS WORKED ON ANY PROJECT WITHIN THE LAST 5 YEARS WITH GILBANE,YOU MUST LIST
THAT PROJECT BELOW. IF YOU HAVE PROVIDED A GILBANE REFERENCE, NO ADDITIONAL REFERENCES ARE
REQUIRED.
IF YOUR COMPANY HAS NOT WORKED WITH GILBANE IN THE LAST 5 YEARS,YOU MUST LIST 2 CURRENT PROJECT
REFERENCES AND 1 SIMILAR PROJECT REFERENCE WITHIN THE LAST 5 YEARS. Failure to provide current contact
information for references will impact points given by Prequalification Committee.
1.GILBANE or Current Project
Owner Name/Representative
Owner Phone Number/Email
Designer Name/Representative
Designer Phone Number/Email
CM/GC Name/Representative
CM/GC Phone Number/Email
Contract Dollar Amount
Scope of Work
Percentage Complete
Anticipated Completion Date
2.Current Project Name
Owner Name/Representative
Owner Phone Number/Email
Designer Name/Representative
Designer Phone Number/Email
CM/GC Name/Representative
CM/GC Phone Number/Email
Contract Dollar Amount
Scope of Work
Percentage Complete
Anticipated Completion Date
3.Similar Project Name:
Owner Name/Representative
Owner Phone Number/Email
Designer Name/Representative
Designer Phone Number/Email
CM/GC Name/Representative
CM/GC Phone Number/Email
Contract Dollar Amount
Scope of Work
Percentage Complete
Anticipated Completion Date
(Prequalification Ratings Matrix: For projects above,give up to 15 points per Gilbane reference for a maximum of 15 points.
If Gilbane reference is not provided,give up to 5 points per 1 positive current and similar reference for a maximum of 15
points from the Construction Manager/General Contractor. If company contracted directly with the Owner, Gilbane will
contact Owner for reference information.)
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Gilbane Building Company 16
Prequalification Form for First-Tier Subcontractors under CM at Risk
Orange County Crisis Diversion Facility
SECTION 4. Signature
By signing this document,you are acknowledging that all answers are true to the best of your knowledge.
Any answers found to be falsified will bar you from being prequalified on this project.
Company Name:
Dated this day of:
Submitted by: (signature)
(print)
(title)
(phone)
(email)
Notary Certification:
North Carolina, County
I, a Notary Public of the County and State aforesaid, certify that
personally appeared before me this day and acknowledged the execution of the foregoing instrument.
Witness my hand and official seal,this the _day of , 20_.
Signature of Notary Public
My commission expires , 20_
(Prequalification Ratings Matrix: If signature page fully executed give 1 point. If not, give 0 points.)
SECTIONS. Prequalification Committee
a. CM at Risk Prequalification Committee:
o Project Executive—David Repnyek
o Preconstruction Executive— Phill Herrell
o Purchasing Director—Jennifer Quinn
o Controller— Matt McGarry
o Prequal Management—Daniel Buser
b. Appeals Hearing Designee (Orange County Prequalification Official)
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