REQUEST FOR PROPOSALS Engineering and Construction Services For Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Fort Knox Sanitary Sewer System Hardin County Water District No. 1 January 2012 REQUEST FOR PROPOSALS Hardin County Water District No. 1 (“District") is soliciting proposals to provide Engineering and Construction services for a Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Project (“Project”) to significantly reduce infiltration and inflow (I/I) in the Fort Knox Sanitary Sewer Utility. The successful “Team” will provide professional engineering services in addition to pipeline and manhole inspection and construction to repair defects. A minimum of five percent (5%) of contracted work must be directed to select small business categories. Request for Proposal (RFP) documents are available on the District website under the “Bid Information” tab, at www.HCWD.com. Interested parties may also request that an RFP be emailed by contacting Mr. Preston Pendley at 270-351-3222, ext 224, or email to ppendley@hcwd.com. A Pre-Proposal meeting will be held at the Fort Knox Wastewater Treatment Plant on South Carolina Street at 10 am on Monday, January 23, 2012. Proposals must be submitted no later than 2pm on Friday, February 10, 2012. The District reserves the right to award or reject any and all proposals or to waive technical defects, informalities, irregularities and omissions, if in its judgment, is in the best interests of the District. Final contract award is subject to approval by the District’s Board of Commissioners. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 2 REQUEST FOR PROPOSAL Design/Build for Sanitary Sewer Evaluation Study Rehabilitation and Replacement of Manholes and Sewer Mains Project for Fort Knox Sanitary Sewer System Hardin County Water District No. 1 1) INTRODUCTION: Hardin County Water District No. 1 (“District") owns and operates four (4) distinct utility systems. These include the original water utility (urban and rural) founded in 1952, the Fort Knox sanitary and storm sewer systems, and the Radcliff sanitary sewer utility. The Fort Knox sanitary and storm systems were privatized by the U.S. Government in 2005 and awarded to the District. The Fort Knox sanitary system service area includes approximately 83 miles of sanitary sewer and 2,540 manholes. District mapping subdivides the system into ten (10) basins. This Project will focus to varying degrees on Basins 2, 3, 5, 6, 7, 8, and 10. The District is interested in selecting and contracting with a qualified Team that will work together for the best interest of the District. The District assumes that the Team will also provide oversight of subcontractors, manufacturers and other agents during the completion of Sanitary Sewer Evaluation Study Services (SSES) and Rehabilitation and Replacement of Manholes and Gravity Sewer Mains Project “Project”. The Fort Knox Wastewater Treatment Plant (WWTP) is designed for average daily flow of 6 mgd and peak flow of 14 MGD. In recent years, the average daily flow has been 1.0 to 1.5 MGD, with peak flows during rain events regularly exceeding 12 MGD. The only measure of success for the Project is significant reduction of peak flows due to inflow and infiltration (I/I) to the WWTP from the selected sub-basins. The Project is being funded through the 2012 Capital Plan for the Fort Knox Sanitary Sewer Utility. 2) PROJECT PHASES AND SCHEDULE: a) Pre-Proposal meeting at Fort Knox WWTP Jan 23, 2012 at 10 am b) Submittals due (there will be no public opening of submittals) Feb 10, 2012 at 2 pm c) Anticipated authorization to award contract at Board meeting Feb 21, 2012 d) Execute Agreement and begin preliminary meetings Feb 24, 2012 e) Flow Monitoring i) Establish baseline average and peak flow rates in the study areas Mar-May 2012 and sub-branches of the study areas ii) Measure average and peak flow rates after project completion f) Sanitary Sewer Evaluation Study (SSES) - Identify, evaluate, and quantify Mar-May 2013 Mar-Aug 2012 sources of I/I in the study areas, using appropriate tools and techniques g) Rehabilitation and Replacement gravity sewers and manholes i) May-Dec 2012 Identify and prioritize recommendations, with appropriate Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 3 and cost-effective solutions and with submittal of technical specifications to the District. ii) Complete the approved repairs and replacements. iii) All Rehabilitation and Replacement work shall be completed by December 31, 2012. 3) SANITARY SEWER EVALUATION SURVEY DESCRIPTION: The Fort Knox Sanitary Sewer is a system that largely flows by gravity to the WWTP. There are over 2,500 manholes in the system, and almost 1,900 manholes are in the WWTP Basin. Two of the sub-basins, No. 2 and No. 10, comprise areas that drain to large lift stations. Basins 2 and 10 are included in this Project, along with Basins 3, 5, 6, 7, and 8, which are primarily sub-areas of the WWTP Basin. The SSES work, along with overall project/construction management of the rehab/replacement efforts, will be reviewed as a single lump sum price in the proposal. Following is a summary of the quantities in each sub-basin: Sub-Basin # No. Manholes LF of Gravity Mains (approx.) Sub-Basin 2: 134 30,000 Sub-Basin 3: 293 52,500 Sub-Basin 5: 277 51,500 Sub-Basin 6: 241 50,600 Sub-Basin 7: 187 48,800 Sub-Basin 8: 146 31,000 Sub-Basin 10: 138 38,900 a) Review of Existing Data The Distict has performed, through its operations contract with Veolia Water North America, “Veolia”, significant CCTV work in the system, resulting in PACP ratings for inspected mains. Additionally, summary reporting on previous inspection work from 2005-06 by a third party consultant is available for review. The Team shall review the existing data to help prioritize SSES work under this contract. Additionally, the District has storm water GIS data that is available to help prioritize areas for assessment in terms of direct cross connections. The Team shall incorporate this information into review of existing data. b) Flow Monitoring The Team will install a minimum of five flow monitors per sub-basin, for twelve (12) weeks. The monitors shall be capable of determining totalized flow (even under surcharged conditions) and instantaneous flow rate measured a minimum of every 15 minutes. Data must be compatible for review on FLOWLINK® software. Electronic versions of the raw data shall become property of the District. A written technical memorandum evaluating the data will also be required. Additionally, the Team will install up to six (6) other flow monitors in other sub-basins, as directed by the District. Results from these flow monitors will help to prioritize future work in other sub-basins. Additionally, the Team will provide ten (10) surcharge level indicators, Cretex Companies Inc. or equal, to be used on the project. These indicators will be placed in the field as part of the flow monitoring phase, with sites selected in coordination with the District personnel. Surcharge level indicators will become the property of the District after Team removes from field on this project. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 4 The Team shall review the GIS mapping and also field verify manhole conditions to determine the best placement of the flow monitors, in coordination with District staff. Data shall be downloaded weekly at a minimum, and field-reviewed for problems that may require adjustments to the monitors. The Team will review the flow monitoring results and incorporate into the overall rehab/replacement plan of recommendations. Monitoring of the same manholes using the same types of monitors will be required March through May 2013, for approximately twelve (12) weeks. Results of the two monitoring seasons will be compared, with an assessment of the rehab/replacement efforts from this contract. c) CCTV Inspection A minimum of 75,000-LF of the gravity mains shall be inspected using CCTV equipment. Mains shall be rated using the Pipeline Assessment Certification Program (PACP) methodology, and results will be incorporated into the overall rehab/replacement plan of recommendations. CCTV inspection of storm water assets should be included to follow up on specific defects. Inspection results will be provided electronically in a format that can be imported or merged into existing GIS mapping to populate our attributes. Inspection results will be summarized in a technical memorandum with graphical exhibits. d) Manhole Inspection A minimum of 1,000 manholes shall be inspected. Inspection from the surface will be the primary method, but it is expected that the Team shall make a full descent into a small sampling of manholes for inspection due to depth or to confirm severity or other inspection details. Manholes shall be rated using Manhole Assessment and Certification Program (MACP) methodology. Analysis of results and will place particular emphasis on defects that are allowing I/I. Results will be incorporated into the overall rehab/replacement plan of recommendations. The Team will be provided the District’s GIS mapping, both electronic and hard copy, to be utilized in the field. The District is very confident in the overall horizontal accuracy of the sanitary sewer mapping. The Team will be expected to provide notes/feedback to correct or amend the District-provided mapping in order to increase its accuracy. Inspection results will be provided electronically in a format that can be imported or merged into the District’s existing GIS mapping to populate the appropriate attributes. Inspection results will be summarized in a technical memorandum with graphical exhibits. e) Dye Water Flooding The Team’s Plan Approach shall include use of dye-water flooding of up to 40 sites to follow up on direct connections through sanitary main defects from the surface or through the storm water system. Dye used shall be certified as compliant under NSF/ANSI Standard 60. Inspection results will be summarized in a technical memorandum with graphical exhibits. f) Dual Blower Smoke Testing A minimum of 100,000-LF of the gravity mains shall be inspected using dual blower smoke testing. Special emphasis will be placed on coordination with the Fort Knox Directorate of Public Works, Fort Knox Emergency Services, and the Knox Hills personnel. The Team’s Plan Approach shall indicate how dye water flooding and CCTV inspection will be used to support smoke testing results and rehab/replacement plan of recommendations. Results will be incorporated into the overall rehab/replacement plan of recommendations. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 5 Inspection results will be summarized in a technical memorandum with graphical exhibits. 4) REHABILITATION AND REPLACEMENT PLAN OF RECOMMENDATIONS The SSES work will be summarized in a report that includes a plan of recommendations for rehabilitation and replacement. The plan will be summarized by sub-basin and by priority in order to provide best value for reduction of I/I. Some severe defects may be corrected during the course of the SSES work, but the Team shall communicate these activities with the District on a week-to-week basis. It is the intent of this RFP and this project that most of the construction activity occurs after the plan of recommendations is well-developed in order to maximize the impact to reduce I/I of the construction investment. Examples of severe defects include: i. Severe direct connections to storm water system ii. Observed and documented severe I/I of manhole or pipe iii. Collapsed pipes iv. Other defects resulting in excessive and severe I/I Moreover, this is a Design-Build project, the plan is understood to be a dynamic living document subject to change. Conclusions can be reached in areas of the target sub-basins, with rehab/replacement recommendations approved by the District, even as the SSES work continues through the summer of 2012. As noted in Section 2, Phases and Schedule, it is expected that the Construction phase will overlap with the SSES phase. It is the primary responsibility of the Team, coordinating with the District through regular deliverables and progress meetings, to seek the best balance of progress on SSES work, rehab/replacement activity, and value of the dollars invested by the District. The Team will provide a full set of detailed technical specifications, to include the materials and procedures utilized for each type of rehab/repair method, for review and approval prior to the significant phase of rehabilitation and replacement activity. 5) REHABILITATION AND REPLACEMENT ACTIVITIES The Team will include capabilities to perform various types of rehabilitation and replacement for gravity mains and manholes. The Plan Approach in the Proposal shall include descriptions of methods most likely to be utilized in this project with an assessment of how and when those methods would likely be recommended. The Plan Approach should detail experience with these methods by the Team’s engineer, contractor, and any significant subcontractors that will be part of the Team. 6) PROJECT MANAGEMENT The Team shall designate primary and secondary Points-of-Contact to the District for all communications, from the engineer and from the contractor. It is expected that the primary POCs shall attend all or most of the meetings and be responsible for all written deliverables. a) Progress Meetings: The Team will plan and coordinate a preliminary workshop meeting with the District and Veolia for the purpose of discussion of procedures, standards, objectives and goals for the project. This meeting will also establish the overall framework, work flow and standards for both the SSES project and for the Rehab/Replacement efforts. The topics may include: ii) I/I field investigation procedures Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 6 iii) Standardization of inspection reporting iv) Transfer of historical data from District and Veolia to the Team for review v) Discussion and field investigation of potential flow monitoring locations vi) Codes, Standards, Naming Conventions, Numbering Systems, and Forms vii) Coordination with Fort Knox Public Works, Fire Department, etc. viii) Source data dictionary and flow quantification ix) Program Plan/Basin Prioritization refinement x) Data management delivery xi) Work Flow coordination xii) Traffic control, rights of access xiii) Mobilization Regular progress meetings, at least monthly and possibly more often during different periods of the project, will be conducted between all parties, to include the , District, Veolia and major subcontractors. An agenda and any technical memorandums will be drafted by the Team and distributed prior to the meeting, with minutes/follow-up action lists to be distributed after each meeting. b) Work Plan A work plan shall be presented at the beginning of the project and will be used as a "living" document to guide project activities. The plan will be a flexible tool and will be modified or updated as needed. The work plan will include static and dynamic items, including: Static Deliverables i) Overall plan approach ii) A Quality Assurance and Quality Control Plan that will address how the Team will (1) Utilize the existing SSES and GIS data (2) Schedule and perform the SSES field work (3) Quantify I/I and give District best value for the invested dollars for improvements (4) Coordinate SSES field work with the rehab and replacement efforts iii) Technical specifications for rehab and replacement methods/procedures. iv) Plan of Recommended work: In conjunction with the delivery of technical specifications, the Team will deliver a complete plan of recommended work that summarizes the SSES procedures, scopes and results, with graphical exhibits and delivery of electronic data. The Plan will prioritize work to be completed, with cost estimates subdivided by basin. Estimated impact of the completed work will be provided, comparing flow monitoring results from 2012 with expected/anticipated results from 2013. An additional chapter will be provided to summarize the second round of flow monitoring from the winter/spring of 2013, as identified in the scope. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 7 Dynamic Deliverables v) Detailed schedule of the various activities with dates and milestones. It will include SSES work and recommendations for the rehab and replacement work for review and approval by the District. vi) Summaries of SSES work to date vii) Overall review of defects prioritized for repair, including cost breakdowns by sub-basin, along with severe defects recommended for more immediate action viii) Monthly deliverables of electronic files of CCTV and Manhole Inspection reports, for merging and population the District GIS mapping. ix) Notes on the District-provided GIS mapping, for corrections and amendments. c) Construction Administration The Team will provide basic Construction Administration and Resident Project Representation (CA and RPR) Services, including review of monthly invoices, maintenance of as-built notes and drawings, observation and reporting of standards testing (such as manhole vacuum, main pressure, mandrel testing, and mil thickness testing of coatings), and daily reports for the work performed by the Team including Team subcontractors. The RPR shall be provided by the Team’s engineering firm, and shall be on site for all rehab and replacement activities. 7) i) Pre-construction meeting coordination ii) Provide resident project inspection services iii) Pay Request quantity verification and payment recommendation iv) Field inspection and construction administration v) Project completion certification vi) Coordination of releases of liens vii) Coordination to address any warranty items SMALL BUSINESS COMPONENT Teams that submit proposals for this “Project” must understand that 5% of the contracted work must be for small businesses registered with the U.S. Small Business Administration in one or more of the following categories according the NAICS codes applicable to the services provided by those firms: a) VOSB – Veteran Owned Small Business (A5) b) WOSB – Woman Owned Small Business (8W) c) SD-VOSB – Service Disabled – Veteran Owned Small Business (QF) d) SBA or Self-Certified HUB Zone e) SBA or Self-Certified Small Disadvantaged Business Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 8 Please note that any certifications by local municipalities or the state of Kentucky (including the Kentucky Department of Highways), do NOT constitute or substitute for the requirements listed in this section. 8) PROPOSAL The Proposal shall include the following components: a) Design Build Team – Description and background information of the primary team members and major subcontractors. Primary team members must include an engineering firm and a construction company. Include brief biographies of key team members. Attachment A is a part of this component b) Certification of Proposal – The Team members shall complete and submit Attachment B. c) Plan Approach – the Team should include items 6b (i) and (ii) in a written plan approach, and should focus on how the Team with provide best value to the District by identifying, quantifying, correcting defects, and measuring the impact i) For the engineering firm, what is your capacity to perform the work on schedule for 2012? ii) For the construction company, what is your capacity to perform the work on schedule for 2012? iii) Summarize the Team’s Kentucky-based staff resources iv) Summarize, if any, of the Team’s Hardin-County based resources or subcontractors. d) Expertise and Project Experience – i) What makes your team a leader in the field of SSES and Rehab/Replacement of assets? ii) What successful project experience from the past five years can you provide? Please keep in mind the District’s concept of measured success, as stated previously in this RFP. iii) Summarize your local Kentucky-based staffing resources. iv) Please provide references and contact information for three most recent or current clients performing similar work. e) How do you propose to meet the required small business goals for the project? 9) PROPOSAL PRICING Include the pricing with your proposal, but the pricing should be in a sealed envelope separate from the other required submittals of the proposal i) Provide a lump sum fee for the SSES and Project Management. ii) Provide a percent of construction cost to be the fee for Construction Administration and Resident Project Representation. iii) Provide unit costs for the rehab and replacement from the tables below. Methods and procedures must be widely accepted in the industry and will be subject to approval of technical specifications to be provided by the Team. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 9 Size 6-inch 8-inch 10-inch 12-inch 15-inch 18-inch 21-inch 24-inch 30-inch GRAVITY MAIN REPLACEMENT (SDR-35 or SDR-26) Description: More than 20-ft length Cost per foot Up to 15-ft deep 15-20-ft deep 20-25-ft deep GRAVITY MAIN REPLACEMENT - TRENCHLESS Description: Up to 20-ft Length Size 6-inch 8-inch 10-inch 12-inch 15-inch 18-inch 21-inch 24-inch 30-inch Pipe Bursting $/foot Cured In Place Liner $/foot Other Method A $/foot Other Method B $/foot Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 10 GRAVITY MAIN REHAB - POINT REPAIR - TRENCHLESS Description: Up to 6-ft length Size 6-inch 8-inch 10-inch 12-inch 15-inch 18-inch 21-inch 24-inch 30-inch Size 6-inch 8-inch 10-inch 12-inch 15-inch 18-inch 21-inch 24-inch 30-inch Cured In Place Patch Other Trenchless Point Repair Method A Other Trenchless Point Repair Method B $/unit $/unit $/unit GRAVITY MAIN REHAB - POINT REPAIR – EXCAVATE Description: Up to 20-ft Length Cost per Point Repair Up to 15-ft deep 15-20-ft deep 20-25-ft deep Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 11 MANHOLE REPLACEMENT or FULL REHAB Cost per MH up to Method 12-ft vertical Full Replacement with Precast Structure HDPE Liner Polyurea Liner Cementitious Liner CIP Fiberglass Other Method A (proposer to define) Other Method B (proposer to define) $/VF above 12-ft MANHOLE POINT REPAIR or REHAB Method Cost per Repair Replace lid/frame (standard) Replace lid/frame (watertight) Replace lid/frame (traffic) Install inflow insert Chimney Seal - Exterior Mechanical Chimney Seal - Interior Mechanical Chimney Seal - CIP Replace precast chimney Replace precast cone Chemical Grout Hydraulic Cement External Joint Wrap Expanded Gasket Other Method A (proposer to define) Other Method B (proposer to define) Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 12 10) EVALUATION CRITERIA: Proposals shall be evaluated utilizing the criteria listed in the table below. Submittals will be reviewed and ranked first prior to selection committee review of the fee schedules provided. Evaluation Factor 11) Percent % Written Plan Approach 10% Capacity to Perform the Work 10% Staff Qualifications and Expertise 10% Project Experience 10% Local Familiarity 5% Demonstration of a Plan to Achieve the District’s Small Business Goal of 5% of Contract Fee on the Project 5% Value to District for services provided 50% PROPOSAL FORMAT AND TIME REQUIREMENTS: a) To be considered for selection a proposal must be received at the address and time set forth on the advertisement sheet of this RFP. The District assumes no responsibility for delays in the US mail or courier systems, or delays due to weather conditions. b) Submission of a Portable Document Format (PDF) file by electronic mail does not relieve the Consultant of the responsibility of having an original, signed and single paper copy of their proposal to the District by the required time and date. c) All proposals shall be submitted in sealed, full sized envelope (9"x12" or larger). All pages, except preprinted technical inserts, must be sequentially numbered within each document submitted as part of the proposal. Proposals do not need to include photos, brochures nor other marketing media. d) Four (4) copies of each proposal shall be submitted, including one original with original signatures. Teams shall bear all costs of preparing, copying and printing the proposals. e) REFERENCES: Provide at least three (3) references for the engineer, and three (3) references for the prime contractor (client, contact name, phone number) for wastewater design projects, which was completed in last three (3) years, which projects included wastewater main (new or replacement) design and had a contract value of at least $750,000. f) DURATION OF OFFER: Proposals submitted in response to this solicitation are irrevocable for ninety (90) days following the deadline for submission of proposals. This period may be extended by written mutual agreement between a responder and the District. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 13 g) PUBLIC INFORMATION AND TRADE SECRETS; All materials submitted in response to this RFP will be considered private or nonpublic until the responses are reviewed. All other data in a responder's proposal is private or non-public data until completion of the evaluation process. After the District has completed the evaluation process, all remaining data submitted by all respondents is open to the public with the exception of trade secret data as defined or classified by Kentucky statutes. A proposal by a responder that submitted data is copyrighted or otherwise protected does not prevent public access to the data contained in the response. h) RIGHTS RESERVED BY DISTRICT: The District reserves the right to: i) Reject any and all proposals received in response to this RFP ii) Waive or modify any information, formalities, irregularities, or inconsistencies in proposals received iii) The District’s Board may select a different Team than that recommended by the staff iv) Consider and/or accept a written modification (requested by the District) of a proposal if the proposal itself was submitted on time, and the modified proposal is more favorable to the District v) May negotiate any aspect of a proposal with any Team and negotiate with more than one Team at the same time vi) If negotiations fail to result in a contract, terminate negotiations and prepare and release a new RFP or take such other action as the District deems appropriate vii) The selection of the Team shall remain the sole and final decision of the District’s Board of Commissioners 12) QUESTIONS: All questions regarding this RFP shall take the form of a formal Request for Information and be directed to Mr. Preston Pendley at 270-351-3222, ext 224 or email to ppendley@hcwd.com. No other contact with the District or Veolia shall be made without prior authorization from Mr. Pendley. District reserves the right to share any answers with any other interested parties or known proposers. Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 14 ATTACHMENT A Required Questionnaire INSTRUCTIONS: Each Team must answer all of the following questions and provide all requested information. Each proposal must include a response from minimum of two Team members which must consist of 1) Licensed Civil Engineering Firm, and 2) Prime Contractor, General Contractor with prior experience constructing commercial / industrial projects of similar size. (Type or Print Clearly) SECTION A - COMPANY CONTACT INFORMATION: Engineer Prime Contractor 1. Name of Firm / Company 2. Address 3. City, State, ZIP 4. Contact Person Name 5. Contact Person Title 6. Phone Number 7. FAX Number 8. Email Address 9. Website Address SECTION B - DESIGN BUILD TEAM BACKGROUND: 10. Has this Team previously performed Design / Build Project services for wastewater collection? 11. YES NO If YES, how many DB projects have been completed by this Team? List project names, owner: 12. Has the Prime Contractor filed for bankruptcy in last 5 years (in any company name that Team member or principal / partner of Prime Contractor was associated with or owned)? YES NO Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 15 SECTION C - SURETY / FINANCIAL INFORMATION: 13. Has either member of the proposing Team purchased a performance bond or provide surety on a DB project in last 5 years? 14. YES NO Can the Prime Contractor on the Team provide a surety / bonding capacity of $2,000,000? YES NO Name of bond / insurance company: 15. Can the Engineer provide professional errors & omission insurance in the amount of $2,000,000? $ 16. Name of insurance company: Has any surety paid out any monies on claims on the performance bond issued by a surety for the benefit of the owner arising out of the construction activities of the prospective Design/Builder Prime Contractor within the last ten (10) years? If Yes, please explain. YES NO Explain circumstances, amount paid, project name, location, owner; SECTION D - SIGNATURE & CONTACT INFORMATION: All information contained herein is accurate and complete to the best of my knowledge. Date Date Name of Prime Contractor Name of Engineering Firm Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 16 Printed Name and Title Printed Name and Title Signature Signature ATTACHMENT B Proposal Form - Certification By signing below, the undersigned does hereby agree and certify the following terms, understanding and commitments; 1. That all members of the Team, including officers, partners or principals, have thoroughly read and understood all sections of the RFP, and that any exceptions or variances requested have been submitted with their proposal. 2. That all information and answers and correct for all parties to the best of their knowledge, and that should any information be found to be materially incorrect or false, the District may terminate any contract or agreement with the parties. 3. That the Proposal fee structure from qualified Teams will be arrived at with due diligence and full understanding of the lump sum fee that would be paid for those professional services, and that the Team will endeavor to maximize the use of construction dollars to most effectively reduce infiltration and inflow in the project area. 4. By submitting a proposal, the Team agrees to release the District from any liability resulting from the District’s disclosure of such materials and the information contained in them. 5. By submitting a proposal, the Team also agrees to defend any legal or administrative action seeking release of materials the Team believes to be trade secret information and will indemnify and hold harmless the District, its agents and employees from any judgments or damages awarded against any of them in favor of any party requesting the materials, including any costs connected to that defense. If a request is made under Kentucky Statutes for release of any materials submitted by a Team that the Team deems to be trade secret information, the District will notify the Team of such a request, but the District will have no obligation to Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 17 commence or defend any action to prevent the disclosure of any materials, including materials the Team believes to be trade secret information or otherwise confidential. 6. That no member of the proposing Team (its employees, principals or partners) have given, offered to give, nor intend to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a District employee or Commissioner in connection with this proposal and offer. 7. That the undersigned have the authority and approval of their respective companies to submit this proposal and bind their corporation or organization to the terms required in the RFP, and if selected for further consideration, will in good faith negotiate with the District to provide additional pricing or cost information, and to enter into a Design / Build Agreement for professional services and construction of the Project. Prime Contractor Certification: Civil Engineer Certification: Date Date Name of Prime Contractor Name of Engineering Firm Printed Name and Title Printed Name and Title Signature Signature Witness Signature Witness Signature Hardin County Water District No. 1 Request for Proposals – Fort Knox Sanitary Sewer Project – Design/Build for Sanitary Sewer Evaluation Study and Rehabilitation and Replacement of Manholes and Sewer Mains Page 18