Prequalified Vendor Application

Contracts & Purchasing

Contact Info
Email(s) where all correspondence and requests for bids will be sent.
Organization Info
Specify which categories of work you are requesting prequalification for:

(Note: Three representative projects, over $500K must be submitted for each category requested)

Utility
(Water & Sewer, manholes...etc)
(Specialty Rehab Work)
(Specialty Rehab Work)
Transportation
Park and Landscape
Previous Projects
Current Projects

Upload a list of all major construction projects the Respondent currently has under contract in Colorado on this date. Include the following information for each project listed:

  • Project Name
  • Owner Name & Phone Number
  • Architect/Engineer Name & Phone Number
  • Contract Amount, Date, Percent Complete, Original Scheduled Completion Date, Change Order Amount, and Current Scheduled Completion Date
Completed Projects

Upload a list of major construction projects (for each category) that the Respondent has completed in Colorado in the past (5) years. Must include projects with a contract value equal to or exceeding, five hundred thousand dollars ($500,000). Respondent must have a significant, recent, similar, experience to be considered qualified as described in Section 1. Include the following for each project listed:

  • Project Name
  • Owner name & phone number
  • Architect/Enginer name & phone number
  • Orginal contract amount, final contract amount, and number of change orders
  • Contract date, original completion date, and actual completion date
  • Dollar value of work broken out by this category
  • Description of the work performed under the category of work

Note: Representative projects must demonstrate work under the requested category, and demonstrate the following:

  • Respondent is the prime contractor
  • Work performed under the requested category exceeds $500K
  • Three representative projects for each category requested
  • Representative projects must demonstrate that the work performed on the project is the same as the work in the requested category

Three (3) representative Projects must be submitted for each category of work you are requesting prequalification for:

Capacity and Capability to Perform the Work Resources:
  1. Total number of current employees in the following positions:
Safety Record

Provide the Respondent's incidence rate of non-fatal occupational injuries and illnesses per one hundred (100) full time workers (Total Recordable Incident Rates or TRIR rate) as defined by the Bureau of Labor Statistics Table 1 over the prior three (3) year period, and the three (3) year average rate. Refer to https://www.bls.gov/iif/home.htm (If you do not have complete numbers for the previous year yet, use the most current three year period that you have):


Provide the Respondent's Worker's Compensation Experience Modification Rate Factor (EMRF) for the prior three (3) years, by year, and the three (3) year average, from the National Council on Compensation Insurance, Inc. (NCCI, www.ncci.com).



Indicate your company's Days Away Restrited Time (DART) rate for the last three (3) year period, and the three (3) year average.

Bank References
Bonding Company
Insurance Company

Provide the name of the Respondent's insurance carriers.

Shown in Appendix D
Legal Info

Provide the following in a file labeled with the Project name and number, the Respondent's name, the date submitted, and marked "CONFIDENTIAL - CLAIM AND LITIGATION RECORD"

  1. A list of the projects, along with address and telephone number of the owner, to which the Respondent or any of the Respondent's directors, partners, or officers were party in their role as director, partner, or officer of the Respondent, during the previous ten (10) years if such projects were the subject of formal arbitration or litigation of any type. If the dispute resulted in a confidential settlement agreement, the names of the parties involved may be redacted, but the project must be listed.
  2. Indicate if any judgments have been entered against the Respondent or against any of the Respondent's directors, partners, or officers within the last five (5) years. If so, provide a list of Judgment Creditors, where docketed and date, and amount, for each. Indiciate if any of the judgments included an award of attorneys' fees as a sanction. If yes, explain why.
  3. A list of current lawsuits that are pending at this time against the Respondent, or against any of the directors, partners, or officers of the Respondent. Indicate the Parties and summarize the nature of the dispute.
Workforce Info

Provide information on the following:

  1. Submit a description and/or documentation of your work force development and training policy/plan
  2. Submit a description and/or documentation of your staffing plan and personnel procurement policy/plan

Provide the information which demonstrates that the following areas of emphases are within the normal and acceptable range for the industry and the local community:

  1. Respondent's employee benefits

    Indicate which benefits the Respondent currently provides to your employees

  2. Respondent's hourly rates of pay

    Indicate if your company currently pays equal to or greater than the following employee hourly rate benchmark

If Not, please provide the following hourly rates of pay (do not include fringe benefits):

Foreman:

At the lead level, assists in supervising and coordinating activites of construction workers engaged in various phases of construction

$
Heavy Equipment Operator:

Includes: Trackhoes, loaders, backhoes, etc.

$
Small Equipment Operator

Includes: Rubber tire backhoes, skidsteers, etc.

$
Truck Driver:

Includes: Lowboys, tractor trailer, dump trucks, etc.

$
General Laborer:

Includes: General unskilled labor, etc.

$
Signature

By inputting your name below and clicking “Submit Application”, you certify that:

1. The information provided is, to the best your knowledge and belief, is true and accurate as of the date and time of the submittal.

2. The individual submitting this information has been duly authorized by the Contractor to submit and bind the Contractor in the terms and conditions of this SOQ submission.

3. The Contractor will take full responsibility to monitor the City of Thornton webpage for construction projects as they are released for bid. In doing so, Respondent hereby agrees to hold Thornton harmless for any failure to notify the Respondent of any bid postings, any missed bidding opportunities, and any and all other issues related to bid notifications.

4. No City Council member, member of a board or commission, Municipal Judge, City Manager, City Attorney, or employee of the City of Thornton, or any such person's family member, domestic partner, or person assuming a relationship being the substantial equivalent of the above, has an existing or pending, direct or indirect, financial, pecuniary or personal interest in the Respondent.

5. Thornton is authorized to obtain reference information concerning the Respondent with the provided information. Respondent further agrees to release and hold Thornton and the firm or agency providing reference information harmless from all liability resulting from providing the requested reference information to Thornton about the Respondent.

Please type in your Full LEGAL Name