SWC OWR - Inc. 3-4 Prequalification


IMPORTANT NOTE TO PROSPECTIVE BIDDERS: Please first read through this webform and gather the requested information/documentation PRIOR to filling-in/completing this webform. (IT IS VERY DIFFICULT TO MAKE CHANGES ONCE THIS FORM IS SUBMITTED, PLEASE DO NOT CLICK "SUBMIT" UNLESS ALL INFORMATION IS 100% ACCURATE & ALL REQUESTED DOCUMENTS HAVE BEEN UPLOADED)


To download the required forms, please click the following link: https://bbcus.egnyte.com/fl/ynHUjEpiEl. All forms must be filled out completely prior to the commencement of this webform.

  • Attachment "A-2" - Self-Scoring Sheet
  • Attachment "A-4" - Certification under Penalty of Perjury (including Notarization)
  • Form "Question 2 History of Your Firm"
  • Form "Question 3 Project List and References"
  • Question 8 - Evidence of EMR from Insurance Carrier
  • Any additional explanations to applicable questions


If you have any questions about this process, please submit them here: https://app.smartsheet.com/b/form/6abb7637311e459683a59e6faca41a11

1) Background Information

You can select multiple packages (if applicable) but you will have to qualify for the largest package amount.

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ex.) John Doe - Project Manager

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The CBA document can be found at https://bbcus.egnyte.com/dl/fQQI2MTaOb

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2) History of Your Firm

Please select your score based upon how long ago your firm was established

(1 point per year up to maximum of 6 pts.)

If multiple packages were selected, scoring must be based on the largest package. (2 pts per project up to a maximum of 30 points; select number of projects below. Attach completed form(s) at the end of this survey)

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3) Project List and References

Utilizing the form "Question 3 Project List and References" within the prequalification package, please provide a list of the last ten (10) largest projects your firm has completed within the last five (5) years. District reserves the right to contact and verify references. Un-verified references may be cause for dismissal of project in point total. Of the projects listed, the original contract amounts of the projects will need to be averaged and scored on the following basis:


If multiple packages were selected, scoring must be based on the largest package


1. Average is equal to or greater than the anticipated contract value noted on Exhibit "A-1" = (25 pts.)

2. Average is between 50% and 100% of the anticipated contract value noted on Exhibit "A-1" = (20 pts.)

3. Average is between 25% and 50% of the anticipated contract value noted on Exhibit "A-1" = (10 pts.)

4. Less than 25% of the anticipated contract value noted on Exhibit "A-1" = (Zero)

Select your score based on the above criteria*

4) OSHA Violations

Has Federal or CAL OSHA cited and assessed penalties against your firm for any "willful," or "repeat" violations of its safety or health regulations in the last five (5) years: (If answer is "Yes," Contractor is automatically disqualified.) Any “serious” violation in the past five (5) years must be accompanied by an explanation and mitigation efforts, but may be grounds for disqualification.*

5) Labor Code and Apprenticeship Violations

At the time of submitting this pre-qualification form, is your firm ineligible to bid on or be awarded a Public Works contract, or perform as a subcontractor on a Public works contract, pursuant to either Labor Code Section 1777.1 or Labor Code Section 1777.7? (If answer is "Yes", Contractor s automatically disqualified.)*

Note: Contractor must meet the requirements of SB 854 and register with the CA Department of Industrial Relations as a Public Works Contractor.

Has there been any occasion during the last five (5) years on which your firm was required to pay either back wages or penalties for your own firm's failure to comply with the state or federal (Davis-Bacon) prevailing wage laws/requirements?*

If your firm's average gross revenues for the last three years was less than $50 million, the scoring is as follows:

  • 5 points for either "No" or ("Yes" indicating either 1 or 2 such instances);
  • 3 points for "Yes" indicating 3 such instances;
  • 0 points for "Yes" with more than 3 such instances.·

If your firm's average gross revenues for the last three years was more than $50 million, scoring is as follows:

  • 5 points for either "No" or ("Yes" indicating no more than 4 such instances);
  • 3 points for 'yes" indicating either 5 or 6 such instances;
  • 0 points for 'yes" with more than 6 such instances.
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6) Claim History

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7) Surety Company Information

At any time during the past five (5) years, has any surety company made any payments on your firm's behalf as a result of a default or to satisfy any claims made against a payment bond issued on your firm's behalf? (8 points for "No"; 4 points for "Yes" indicating no more than 1 such claim; 0 points for 2 or more claims).*
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(8 points if the rate is no more than 1.0 percent; 4 points if the rate was no higher than 1.10 percent; 0 points for any other answer.)

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8) Insurance/Worker's Compensation Experience Modification Rate

In the last five (5) years, has any insurance carrier, for any form of insurance, refused to renew the insurance policy for your firm? (5 points for "No", 3 points for "Yes' indicating up to 2 such instances; 0 points for "Yes" or if more than 2 such instances.)*
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What is your firm's current worker's compensation experience modification rate? (Less than 1.00 (5 pts); between 1.01 & 1.25 (2 pts); If > 1.25 Contractor may be disqualified (without providing sufficient evidence of why rate is above 1.25.) Please upload evidence from your insurance carrier of this modification rate at the end of this form.*

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9) Licensing

Has your Contractor's license, or those of its responsible managing Employee, Responsible Managing Officer, any Owners, Officers, or Partners been revoked or suspended at any time in the last five (5) years?*

(If any such license has been revoked or suspended, attach a sheet explaining the circumstances which the Owner may consider. The Owner reserves the right to disqualify contractor after review of the explanation).


  • Attachment "A-2" - Self-Scoring Sheet
  • Attachment "A-4" - Certification under Penalty of Perjury (including Notarization)
  • Form "Question 2 History of Your Firm"
  • Form "Question 3 Project List and References"
  • Question 8 - Evidence of EMR from Insurance Carrier
  • Any additional explanations to applicable questions
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