REQUESTS FOR PROPOSALS ARCHITECTURAL SERVICES

Transcription

1 REQUESTS FOR PROPOSALS ARCHITECTURAL SERVICES FOR Attleboro Public Library Repairs and Improvements I. GENERAL INFORMATION AND BID SUBMISSION REQUIREMENTS A. INTRODUCTION: The City of Attleboro, acting through its Municipal Building Commission, is requesting proposals for Architectural Services to provide: Building Evaluation / Feasibility Phase Services Design Phase Services Construction Phase Services A BRIEF HISTORY OF THE BUILDING: The library opened at its present site on 74 North Main Street in November of Although from its beginnings in 1885, the collections of the Attleboro Free Public Library Association had been housed in buildings near the center of the city, there had not been a dedicated library building until J.L. Sweet donated land for one. His only stipulations were that the building be complete within a three year period of time and that it cost at least $25,000. The architectural firm of MacLean and Wright won a design competition for the building, and a local contractor, Grant Brothers, was hired to build it. Construction costs were approximately $85,000, far surpassing Mr. Sweet s request. The original building was beautiful and ornate in execution but very simple in organization. One entered from front center stairs into a central foyer, which faced a small horseshoe-shaped main desk. The reading room to the left was dedicated to children s service, the one to the right was for adults. A metal selfsupporting book stack that was behind the desk and in the basement beneath it as well, held the main collection. The stone stairs that led from the entrance went to a grand gallery and meeting room on the second floor. Modifications and additions were made to the building over the years. Most important was a series of additions (constructed 1962 to 1974) that were put on the back of the building to gain office and stack space. The latest construction and renovation project (1992 to 1994) maintained the beauty and dignity of the original building but expanded the usable space and allowed for an increase of approximately 50,000 volumes in the collection. PAGE 1

2 B. ARCHITECTURAL SERVICES FOR REPAIRS AND IMPROVEMENTS TO ATTLEBORO PUBLIC LIBRARY: 1. Review existing conditions of Attleboro Public Library. 2. Perform Building Evaluation and Feasibility Study. 3. Prepare conceptual scope of work and drawings for approved scope of work based on feasibility study findings. 4. Prepare preliminary level drawings, present to City, revise as needed. 5. Prepare schematic level drawings, present to City, revise as needed. 6. Prepare design development level drawings, present to City, revise as needed. 7. Prepare Construction Documents. 8. Provide Overall Procurement Leadership and Support for Construction Phase Services. 9. Provide Construction Administration/Oversight Services. GENERAL SCOPE OF WORK: The City of Attleboro is seeking professional assistance of an A/E team to help evaluate, prioritize, design and oversee implementation of certain facility improvements at the Attleboro Public Library at 74 North Main Street Attleboro, MA. The selected designer shall be experienced in building envelopes, modern mechanical systems and controls as well as historical renovations/improvements. It is the intent of this scope of work to include in initial comprehensive Building Evaluation component followed by required Design Phase, Procurement Phase and Construction/Closeout Phase Services of selected scope of work elements. Building Evaluation /Study and Concept Phase Services in this phase include conducting a thorough physical investigation of the Exterior Envelope and Mechanical Systems with a goal of identifying issues that serve to impact adequate weather tightness, end of useful life issues, appropriate indoor environmental comfort and operational life cycle efficiencies. Scope shall include: Roofing. Owner notes that a variety of roofing applications currently exist - TPO (2017), EPDM (20+ years) and Slate (100+ years); Cornice, Corbel and Metal Trim appears deteriorated; Windows (both historic wood configurations as well as modern aluminum on addition); Brick and Stone Work to determine extent of repointing or other recommendations regarding the building facade; Air & Vapor Barriers advise cost effective solutions to address issues that exist; Water Intrusion advise solution options to observed conditions; Observe and Sample Exterior Coatings and Caulking materials to determine the presence of Asbestos, PCB s, Lead or other Hazardous Materials. Advise cost effective solutions to address as required; Other Building Envelope observations and recommendations. Mechanical Systems existing rooftop and internal equipment and controls many appear to be at or beyond their useful life; PAGE 2

3 Research the availability of potential grants, utility incentives and other financial assistance to help offset the cost of completing functional, aesthetic and energy improvements, including window replacement, to this historic structure. Deliverable shall include a comprehensive report of findings, recommendations and order of magnitude costs and a potential phasing plan as applicable. Owner intends on maintaining as much of the original character as possible with recognition that there will be a defined project budget. The target date for completed Building Evaluation /Study and Concept Phase is 60 days after award. Design Development Phase Develop a preliminary phasing plan along with a comprehensive overall project budget and master project schedule to complete all work identified in prior Building Evaluation / Study and Concept Phase; Develop designs and bid specifications related to: o Roofing Work; o Exterior Trim, Corbel/Cornice and other Exterior Moldings; o Windows and Caulking Note: the designs and specifications must meet historic, energy efficiency and code compliance while maintaining cost control. This element of the project is currently a lower priority and therefore construction would need to be scheduled based on availability of funding; o Brick and Stone Façade Repairs o Air/Vapor/Water Barriers o Replacement Mechanical Systems Identifying and obtaining all required permits and approvals with assistance of The City. Provide design drawings as required for all permit submissions. Provide two detailed cost estimates (1) at end of Design Development, and at (2) 80% completion of Construction Documents. Prepare final construction documents that will facilitate accurate and dependable final pricing by public bid process, as required. The target date for completed Design Phase is within 90 days after Owner acceptance of Building Evaluation /Study and Concept Deliverables. Construction documents for Owner selected elements of the scope of work shall be complete by April 20, 2018; Bid, Construction and Closeout Phase: Perform and manage all necessary bid phase and procurement phase services necessary to assist the Owner as they engage a general contractor. Perform Construction Administration services, including weekly and periodic site meetings and site observations by all lower tier sub-consultants. Close-Out and Warranty Phase services shall be included in the A/E s basic services. Designer shall be responsible for administering the construction contract, responding to RFI s, issuing ASI s and complete conformance to AIA A101 and A201 and the suite of AIA contract documents. Designer shall also assist in reaching an on-time and on-budget project completion. They will work directly with the Owner selected and provided Clerk of the Works, Capital Projects Administrator, Library Director and other project stakeholders. PAGE 3

4 The design team should anticipate regular communications with the Owner Team and attend/participate at up to two larger community meetings as requested. C. SUBMISSION REQUIREMENTS: The Successful Responder shall provide services in any contract awarded pursuant to this RFP as an independent contractor with the City of Attleboro. The Successful Responder and his/her/its employees shall not be entitled to receive any benefits of employment with the City of Attleboro, including, without limitation, salary, overtime, vacation pay, holiday pay, health insurance, life insurance, pension, or deferred compensation. Responders shall submit the following: Fifteen (15) copies of the Proposal in a sealed envelope(s) clearly labeled Attleboro Public Library Non Fee Architectural Services Proposal containing the Non Fee Architectural Services Proposal and one (1) sealed envelope clearly labeled Attleboro Public Library Architectural Services Fee Proposal containing the Fee Proposal. One (1) compact disc or one (1) a memory stick containing all of the Non Fee Architectural Services Proposal materials in electronic format. The City reserves the right to disregard minor discrepancies or inconsistencies contained in a Proposal. The fee for the entire Project is to be a negotiated fixed fee, not to exceed $125, The City will be responsible for the cost of: advertising the bid. The Consultant shall supply all required labor, materials, supplies, out of pocket expenses and travel time necessary, and sub consultants such as Roofing, Building Envelope Consultant, Mechanical, Electrical Plumbing, Fire Protection, Structural, and others as may be required to complete the scope of services contained in this RFP in its entirety, including reproductions. If a fixed fee cannot be negotiated for both projects to an acceptable amount with the top ranked finalist after a reasonable period of time, the Mayor, or his designee, will negotiate a fee with the next highest ranked finalist until an acceptable fee is negotiated. If an acceptable fee is not negotiated for the Project with any of the ranked finalists, the City will not award the contract and will re advertise for proposals. Each Proposal must contain information sufficient to assist the City in its evaluation of the firm s abilities according to the criteria listed below and may also provide other information it feels is relevant to fully demonstrate its capabilities: i. The Proposal shall be accompanied by a cover letter signed by a duly authorized individual who may bind the firm. If multiple firms submit the Proposal, all parties, excluding sub consultants, must sign the cover letter. ii. Architectural Team Provide the resume of all individuals who will be participating and performing work on the project (the Architectural Team ), including any sub consultants. The resumes should clearly identify the educational background, qualifications and experience of each individual. Special skills should be summarized, including recent similar projects, and relevant work. Identify the person(s) who will serve as the project manager or team leader with ultimate responsibility for the day to day work. Proposed staff with direct charge must be a registered Massachusetts Architect in the Commonwealth of Massachusetts with experience in Historic Building Renovations, Improvements as well as building design and construction. iii. A project schedule for the Requested services shall also be submitted. iv. Capabilities and Competing commitments Internal firm capabilities, competing commitments and the means by which adequate and timely attention to this agreement will be assured must be referenced in this Proposal. v. Signed Certificates To be considered complete, a Proposal must include completed and signed certificates of non collusion and tax compliance, which have been attached to the RFP as PAGE 4

5 vi. vii. Attachment 1 and Attachment 2. Non Fee Architectural Services Proposals and Fee Proposals submitted by or facsimile will not be accepted. Submit a sample Certificate of Insurance (on Acord form) containing Responder s limits for General Liability, Automobile Liability, Umbrella and Excess Liability, Workers Compensation and Errors and Omissions Coverage in compliance with Commonwealth of Massachusetts Regulations. The successful respondent shall name the City and OPM as Additional Insureds. A fully executed Certificate of Non-Collusion (Appendix A) A fully executed Certificate of Tax Compliance (M.G.L c 62C) (Appendix B A fully executed Conflict of Interest Certification. (M.G.L. c. 268A) (Appendix C) A fully executed Certificate of Corporate Responder, if applicable. (Appendix D) A fully executed Certificate of Compliance with M.G.L. c.151b (Appendix E) A fully executed Certificate of Non-Debarment. (Appendix F) A fully executed Certificate of Compliance with applicable EEO/AA/SDO provisions (Appendix G) A fully executed Designer Selection Board (DSB) Application Form (Exhibit A) D. SUBMISSION DEADLINE: Deliver the sealed Architectural Services Proposals and Fee Proposal no later than Friday December 8, 2017 at 10:00 a.m. to: Gale Clark, Capital Projects Manager Government Center 77 Park Street, 2 nd Floor Attleboro, MA Any questions concerning the RFP are to be directed to Gale Clark at ext or at capitalprojects@cityofattleboro.us. The clock in the Capital Projects Administrator s Office shall be the official time clock. The late submission of either the Architectural Services Proposal and/or the Fee Proposal will not be accepted. M.G.L. c. 7C, 44-57, which is incorporated herein by reference, shall govern all procedures. II. QUALIFICATIONS OF ARCHITECTURAL FIRMS The architectural firm must possess the following minimum qualifications: 1. Licensed to do business in the Commonwealth of Massachusetts. 2. Thorough knowledge of the MA State Building Code, Regulations of the Architectural Access Board, and Commonwealth of Massachusetts Department of Health 105 CMR Sufficient levels of staff to complete the project. 4. Previous experience in the planning, design and development of Municipal Public Buildings and specifically Libraries or similar projects. 5. The architectural firm must provide Additional Insureds status to both the City of Attleboro and its OPM with regard to general and professional liability insurance. See sample form request in Section (1.C.vii above). Policy shall include covering negligent errors, omissions, and acts of the PAGE 5

6 architectural form or any person or business entity for which the performance the architectural firm is legally liable arising out of the performance of the contract for architectural services. III. REJECTION OF PROPOSALS AND CANCELLATION OF RFP The City reserves the right to reject any and all Proposals if it is determined to be in the public interest to do so. Failure to submit the Fee Proposal in a sealed envelope separate from the Architectural Services Proposal will result in rejection of the Proposal. The City of Attleboro may cancel this RFP if the City determines that cancellation or rejection serves the best interests of the City. IV. FUNDING The award of any contract resulting from this RFP process is contingent on the availability of City funding. V. PROPOSAL EVALUATION CRITERIA 1. THE SELECTION OF THE FINALIST WILL BE BASED ON THE FOLLOWING CRITERIA: a. Prior similar experience. b. Past performance on public and private projects. c. Financial stability. d. Identity and qualifications of the consultants who work with the applicant on the project. e. Any other criteria that MBC considers relevant for the project. All Proposals will be reviewed in accordance with M.G.L. Ch. 7C, sections The Municipal Building Commission (MBC), serving as the Designer Selection Committee, will review and rank the Non Fee Proposals. All Responders are encouraged to attend a non mandatory site walkthrough on Monday, November 27, The site walkthrough will commence at 10:00 a.m. at the 74 North Main Street site. 2. MINIMUM EVALUATION CRITERIA: a. References: List a minimum of four references from similar projects that can be contacted during the RFP process. Include the customer name, contact person, title, address and telephone number. b. Completeness of Proposal: All quality requirements and forms submitted are complete and as requested in the RFP. c. Years of Related Experience: Responders must have more than five (5) years of related experience working for Massachusetts municipalities. d. Technical Approach: Responders must demonstrate understanding of the project and the City s needs. PAGE 6

7 VI. AWARD The Mayor shall award and execute a contract for the Project. The contract will be awarded to the most advantageous Responder as set forth in this RFP. A Notice of Award will be provided within fourteen (14) days of the selection of the successful Responder. A contract will be provided to the successful Responder within fourteen (14) days of the funds being appropriated. If a contract is not executed within thirty (30) days after the appropriation of funds, the City reserves the right to designate another Responder. Any and all disputes will be settled through a Court of competent jurisdiction. VII. OWNERSHIP OF INFORMATION All information, documents and materials whether draft, incomplete, or final developed by the selected architectural consultant in the performance of the tasks under this RFP shall be considered the property of the City and shall be delivered upon request. All required information, documents and material shall be delivered to the City before the City makes final payment. No information, documents or materials developed by the consultant exclusively for this project is to be used by the consultant for other purposes, or released to others, without the express written consent of the City of Attleboro. VIII. DELIVERABLES All work products generated by the selected architectural consultant in carrying out the scope of work for these projects shall become the property of the City when the task is completed. All designs, plans, and drawings through Design Development shall be prepared in a printed format and electronically, in most recent version of AutoCAD. All written documents shall be prepared in Microsoft Office along with printed copies. During this project, the selected architectural consultant shall prepare and submit the following for each project: 1. Building Evaluation and Feasibility Study 2. conceptual plan level drawings 3. preliminary plan level drawings 4. schematic plan level drawings 5. design development plan level drawings 6. elevations of building exteriors 7. functional areas along with associated square footage 8. proposed project construction schedule 9. construction cost estimates 10. final construction documents including site and project manual PAGE 7

8 APPENDIX 1 CITY OF ATTLEBORO RESPONSE FORM The undersigned hereby submits a sealed Response for the provision of Designer Services Related to the Repair and Improvement of the Attleboro Public Library. Printed Name of Responder: Address: Responder certifies as follows: A. Responder is an established business with a minimum of five (5) years of experience in providing designer services related to public projects in the Commonwealth of Massachusetts. B. Responder holds all applicable State and Federal permits, licenses and approvals. (Responder shall attach to the Response Form copies of all applicable State and Federal permits, licenses, and approvals.) C. Responder provides supervision of all workers performing under all Contracts held and pledges to provide such supervision under any Contract. D. Responder holds all applicable documentation and Insurance in accordance with this RFP. (Responder shall attach to the Response Form copies of all relevant insurance certificates hereto. Nothing in this provision, however, shall eliminate the requirement that the Responder, if chosen as the Successful Responder, shall submit to the Town an endorsement or a rider in compliance with the Contract.) E. Responder has not defaulted on any Contract within the last five (5) years. F. Responder maintains a permanent place of business. (Responder shall attach to the Response Form the address of his/her/its place of business). G. Responder has adequate personnel and equipment to perform the work expeditiously. (Responder shall attach to the Response form a statement of experience of his/her/its personnel and the proposed staffing plan it shall offer in reference to the work for which qualifications are sought. Responder shall attach to the Response Form a description of his/her/its equipment and shall explain how such equipment satisfies the requirements stated herein.) H. Responder has suitable financial status to meet obligations incident to the work. (Responder shall attach to the Response Form a financial statement that shows the Responder s present financial status. This information will not be considered a public record, pursuant to M.G.L. c. 4, 7, cl. 26 th.) I. Responder is registered with the Secretary of the Commonwealth of Massachusetts to do business in Massachusetts. (Responder shall attach to the Response Form a copy of a Letter of Good Standing from the Secretary of the Commonwealth s Office.) J. Responder has not failed to perform satisfactorily on Contracts of a similar nature. PAGE 8

9 The undersigned agrees that all specifications and Contract documents are hereto made part of any Contract executed with the Town and are binding on the Successful Responder. Authorized Signature Printed Name Printed Title Date If a Corporation: Full Legal Name Officers of Corporation and Addresses State of Incorporation Principal Place of Business Telephone Number. Qualified in Massachusetts Yes No PAGE 9

10 Principal Place of Business in Massachusetts Telephone Number Full Legal Name of Surety Company Principal Place of Business of Surety Company Telephone Number Admitted in Massachusetts Yes No Place of Business in Massachusetts Telephone Number PAGE 10

11 ATTACHMENT 1 NON-COLLUSION FORM The undersigned certifies under penalties of perjury that this bid or proposal has been made and submitted in good faith and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word person shall mean any natural person, business, partnership, corporation, union, committee club, or other organization, entity, or group or individuals. Signature: Date: Name: Title: Company: Telephone: Fax: Address: City: State: Zip: PAGE 11

12 ATTACHMENT 2 Certificate of Compliance with State Tax Laws Pursuant to M.G.L. Chapter 62C, Section 49A, and M.G.L. Chapter 151A, Section 19A, I certify under the penalty of perjury that, has complied with all laws of the Commonwealth of Massachusetts relating to taxes, reporting of employees and contractors, and withholding and remitting child support. *Signature of Individual or Corporate Officer **Social Security Number/Federal Identification # Corporate Name: (If applicable) Name and Title of Corporate Officer: (If applicable) *Approval of a contract or other agreement will not be granted unless this certification clause is signed by the applicant. For all corporations, a certified copy of the vote of the Board of Directors must be provided. **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Providers who fail to correct their non filing or delinquency will not have a contract or other agreement issued, renewed or extended. This request is made under the authority of Massachusetts General Laws, Chapter 62C, Section 49A. PAGE 12

13 Commonwealth of Massachusetts 1. Project Name/Location For Which Firm Is Filing: Standard Designer Application Form for Municipalities and Public Agencies not within DSB Jurisdiction (Updated July 2016) 2. Project # This space for use by Awarding Authority only. 3a. Firm (Or Joint-Venture) - Name and Address Of Primary Office To Perform The Work: 3. Name Of Proposed Project Manager: For Study: For Design: (if applicable) (if applicable) 3b. Date Present and Predecessor Firms Were Established: 3f. Name and Address Of Other Participating Offices Of The Prime Applicant, If Different From Item 3a Above: 3c. Federal ID #: 3g. Name and Address Of Parent Company, If Any: 3d. Name and Title Of Principal-In-Charge Of The Project (MA Registration Required): Address: Telephone No: Fax No.: 3. Check Below If Your Firm Is Either: (1) SDO Certified Minority Business Enterprise (MBE) (2) SDO Certified Woman Business Enterprise (WBE) (3) SDO Certified Minority Woman Business Enterprise (M/WBE) (4) SDO Certified Service Disabled Veteran Owned Business Enterprise (SDVOBE) (5) SDO Certified Veteran Owned Business Enterprise (VBE) 4. Personnel From Prime Firm Included In Question #3a Above By Discipline (List Each Pers on Only Once, By Primary Function -- Average Number Employed Throughout The Preceding 6 Month Period. Indicate Both The Total Number In Each Discipline And, Within Brackets, The Total Number Holding Massachusetts Registrations): Admin. Personnel ( ) Ecologists ( ) Licensed Site Profs. ( ) Other ( ) Architects ( ) Electrical Engrs. ( ) Mechanical Engrs. ( ) ( ) Acoustical Engrs. ( ) Environmental ( ) Planners: Urban./Reg. ( ) ( ) Civil Engrs. ( ) Fire Protection ( ) Specification Writers ( ) ( ) Code Specialists ( ) Geotech. Engrs. ( ) Structural Engrs. ( ) ( ) Construction Inspectors ( ) Industrial ( ) Surveyors ( ) ( ) Cost Estimators ( ) Interior Designers ( ) ( ) ( ) Drafters ( ) Landscape ( ) ( ) Total ( ) 5. Has this Joint-Venture previously worked together? Yes No Updated July 2016 Municipalities & Other Public Agencies Form Page 1

14 6. List ONLY Those Prime And Sub-Consultant Personnel Specifically Requested In The Advertisement. This Information Should Be Presented Below In The Form Of An Organizational Chart. Include Name Of Firm And Name Of The One Person In Charge Of The Discipline, With Mass. Registration Number, As Well As MBE/WBE Status, If Applicable: CITY / TOWN / AGENCY Prime Consultant Principal-In-Charge Project Manager for Study Project Manager for Design Discipline Discipline Discipline Discipline (from advertisement) (from advertisement) (from advertisement) (from advertisement) Name Of Firm Name Of Firm Name Of Firm Name Of Firm Person In Charge Of Discipline Person In Charge Of Discipline Person In Charge Of Discipline Person In Charge Of Discipline Mass. Registr. # Mass. Registr. # Mass. Registr. # Mass. Registr. # MBE/WBE Certified (If MBE/WBE Certified (If MBE/WBE Certified (If MBE/WBE Certified (If Applicable) Applicable) Applicable) Applicable) Updated July 2016 Municipalities & Other Public Agencies Form Page 2

15 7. Brief Resume of ONLY those Prime Applicant and Sub-Consultant personnel requested in the Advertisement. Include Resumes of Project Managers. Resumes should be consistent with the persons listed on the Organizational Chart in Question # 6. Additional sheets should be provided only as required for the number of Key Personnel requested in the Advertisement and they must be in the format provided. By including a Firm as a Sub-Consultant, the Prime Applicant certifies that the listed Firm has agreed to work on this Project, should the team be selected. a. Name and Title Within Firm: a. Name and Title Within Firm: b. Project Assignment: b. Project Assignment: c. Name and Address Of Office In Which Individual Identified In 7a Resides: c. Name and Address Of Office In Which Individual Identified In 7a Resides: MBE MBE WBE WBE SDVOBE SDVOBE VBE VBE d. Years Experience: With This Firm: With Other Firms: d. Years Experience: With This Firm: With Other Firms: e. Education: Degree(s) /Year/Specialization e. Education: Degree(s) /Year/Specialization f. Active Registration: Year First Registered/Discipline/Mass Registration Number f. Active Registration: Year First Registered/Discipline/Mass Registration Number g. Current Work Assignments and Availability For This Project: g. Current Work Assignments and Availability For This Project: h. Other Experience and Qualifications Relevant To The Proposed Project: (Identify Firm By Which Employed, If Not Current Firm): h. Other Experience and Qualifications Relevant To The Proposed Project: (Identify Firm By Which Employed, If Not Current Firm): Updated July 2016 Municipalities & Other Public Agencies Form Page 3

16 8a. Current and Relevant Work By Prime Applicant Or Joint-Venture Members. Include ONLY Work Which Best Illustrates Current Qualifications In The Areas Listed In The Advertisement (List Up To But Not More Than 5 Projects). a. Project Name And Location Principal-In-Charge b. Brief Description Of Project And Services (Include Reference To Relevant Experience) C. Client s Name, Address And Phone Number (Include Name Of Contact Person) d. Completion Date (Actual Or Estimated) e. Project Cost (In Thousands) (1) Construction Costs (Actual, Or Estimated If Not Completed) Fee for Work for Which Firm Was Responsible (2) (3) (4) (5) Updated July 2016 Municipalities & Other Public Agencies Form Page 4

17 8b. List Current and Relevant Work By Sub-Consultants Which Best Illustrates Current Qualifications In The Areas Listed In The Advertisement (Up To But Not More Than 5 Projects For Each Sub- Consultant). Use Additional Sheets Only As Required For The Number Of Sub-Consultants Requested In The Advertisement. Sub-Consultant Name: a. Project Name and Location Principal-In-Charge (1) b. Brief Description Of Project and Services (Include Reference To Relevant Experience c. Client s Name, Address And Phone Number. Include Name Of Contact Person d. Completion Date (Actual Or Estimated) e. Project Cost (In Thousands) Construction Fee For Work For Costs (Actual, Or Which Firm Was/Is Estimated If Not Responsible Completed) (2) (3) (4) (5) Updated July 2016 Municipalities & Other Public Agencies Form Page 5

18 9. List All Projects Within The Past 5 Years For Which Prime Applicant Has Performed, Or Has Entered Into A Contract To Perform, Any Design Services For All Public Agencies Within The Commonwealth. # of Total Projects: # of Active Projects: Role P, C, JV * Phases St., Sch., D.D., C.D.,A.C.* Project Name, Location and Principal-In-Charge 1. Total Construction Cost (In Thousands) of Active Projects (excluding studies): Awarding Authority (Include Contact Name and Phone Number) Construction Costs (In Thousands) (Actual, Or Estimated If Not Completion Date (Actual or Estimated) (R)Renovation or (N)New * P = Principal; C = Consultant; JV = Joint Venture; St. = Study; Sch. = Schematic; D.D. = Design Development; C.D. = Construction Documents; A.C. = Administration of Contract Updated July 2016 Municipalities & Other Public Agencies Form Page 6

19 10. Use This Space To Provide Any Additional Information Or Description Of Resources Supporting The Qualifications Of Your Firm And That Of Your Sub-Consultants For The Proposed Project. If Needed, Up To Three, Double-Sided 8 ½ X 11 Supplementary Sheets Will Be Accepted. APPLICANTS ARE ENCOURAGED TO RESPOND SPECIFICALLY IN THIS SECTION TO THE AREAS OF EXPERIENCE REQUESTED IN THE ADVERTISEMENT. Be Specific No Boiler Plate 11. Professional Liability Insurance: Name of Company Aggregate Amount Policy Number Expiration Date 12. Have monies been paid by you, or on your behalf, as a result of Professional Liability Claims (in any jurisdiction) occurring within the last 5 years and in excess of $50,000 per incident? Answer YES or NO. If YES, please include the name(s) of the Project(s) and Client(s), and an explanation (attach separate sheet if necessary). 13. Name Of Sole Proprietor Or Names Of All Firm Partners and Officers: Name Title MA Reg # Status/Discipline Name Title MA Reg # Status/Discipline a. d. b. e. c. f. 14. If Corporation, Provide Names Of All Members Of The Board Of Directors: Name Title MA Reg # Status/Discipline Name Title MA Reg # Status/Discipline a. d. b. e. c. f. 15. Names Of All Owners (Stocks Or Other Ownership): Name And Title % Ownership MA. Reg.# Status/Discipline Name And Title % Ownership MA. Reg.# Status/Discipline a. d. b. e. c. f. 16. I hereby certify that the undersigned is an Authorized Signatory of Firm and is a Principal or Officer of Firm. I further certify that this firm is a Designer, as that term is defined in Chapter 7C, Section 44 of the General Laws, or that the services required are limited to construction management or the preparation of master plans, studies, surveys, soil tests, cost estimates or programs. The information contained in this application is true, accurate and sworn to by the undersigned under the pains and penalties of perjury. Submitted by (Signature) Printed Name and Title Date Updated July 2016 Municipalities & Other Public Agencies Form Page 7

20 APPENDIX A CITY OF ATTLEBORO NON-PRICE PROPOSAL CERTIFICATE OF NON-COLLUSION The undersigned certifies, under penalties of perjury, that this Proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word person shall mean any natural person, business, partnership, corporation, union, committee, club or other organization, entity, or group of individuals. Name of Proposer Address of Proposer Telephone Number By: _ (Signature) Printed Name Printed Title Date

21 APPENDIX B CITY OF ATTLEBORO NON-PRICE PROPOSAL CERTIFICATE OF TAX COMPLIANCE Pursuant to Massachusetts General Laws (M.G.L.) c. 62C, 49A, I certify under the penalties of perjury that the Proposer named below has complied with all laws of the Commonwealth of Massachusetts pertaining to the payment of taxes, to the reporting of employees and contractors, and to the withholding and remitting of child support. Name of Proposer Address of Proposer Telephone Number By: _ (Signature) Printed Name Printed Title Date

22 The Proposer hereby certifies that: APPENDIX C CITY OF ATTLEBORO NON-PRICE PROPOSAL CONFLICT OF INTEREST CERTIFICATION 1. The Proposer has not given, offered, or agreed to give any gift, contribution, or offer of employment as an inducement for, or in connection with, the award of a Contract pursuant to this RFP. 2. No consultant to, or subcontractor for, the Proposer has given, offered, or agreed to give any gift, contribution, or offer of employment to the Proposer, or to any other person, corporation, or entity as an inducement for, or in connection with, the award to the consultant or subcontractor of a Contract by the Proposer. 3. No person, corporation, or other entity, other than a bona fide full time employee of the Proposer has been retained or hired to solicit for or in any way assist the Proposer in obtaining a Contract pursuant to this RFP upon an agreement or understanding that such person, corporation or entity be paid a fee or other compensation contingent upon the award of a Contract to the Proposer. 4. The Proposer understands that the Massachusetts Conflict of Interest Law, Chapter 268A of the Massachusetts General Laws (M.G.L.), applies to the Proposer and its officers, employees, agents, subcontractors, and affiliated entities with respect to the transaction outlined in the Request for Proposals. 5. The Proposer understands that the Proposer and its officers, employees, agents, subcontractors, and affiliated entities, shall not participate in any activity which constitutes a violation of the Massachusetts Conflict of Interest Law or which creates an appearance of a violation of the Massachusetts Conflict of Interest Law. Name of Proposer Address of Proposer Telephone Number By: (Signature) Printed Name Printed Title Date

23 APPENDIX D CITY OF ATTLEBORO NON-PRICE PROPOSAL CERTIFICATE OF CORPORATE PROPOSER I,, certify that I am the Clerk of the Corporation named as Proposer in the attached Proposal Form; that, who signed said Proposal on behalf of the Proposer was then of said Corporation and was duly authorized to sign said Proposal Form; and that I know his/her signature thereto is genuine. Name of Proposer Address of Proposer Telephone Number By: _ (Signature) Printed Name Printed Title Date This Certificate shall be completed where Proposer is a Corporation and shall be so completed by its Clerk. In the event that the Clerk is the person signing the Proposal on behalf of the Corporation, this certificate shall be completed by another officer of the Corporation.

24 APPENDIX E CITY OF ATTLEBORO NON-PRICE PROPOSAL CERTIFICATE OF COMPLIANCE WITH M.G.L. c. 151B The Proposer hereby certifies that it is in compliance with and shall remain in compliance with Massachusetts General Laws (M.G.L.) Chapter 151B and shall not discriminate on any prohibited basis outlined therein. The Proposer also hereby certifies that it shall comply with any and all applicable Supplier Diversity Office (SDO) thresholds that have been established in conjunction with this Request for Proposals. Name of Proposer Address of Proposer Telephone Number By: _ (Signature) Printed Name Printed Title Date

25 APPENDIX F CITY OF ATTLEBORO NON-PRICE PROPOSAL CERTIFICATE OF NON-DEBARMENT The Proposer hereby certifies that it is presently not debarred, suspended, or otherwise prohibited from practice by any federal, state, or local agency, and that, should any proceeding arise in which it is debarred, suspended, or otherwise prohibited from practice by any federal, state, or local agency, the Proposer shall inform the Town within one (1) business day of such debarment, suspension, or prohibition from practice. Name of Proposer Address of Proposer Telephone Number By: _ (Signature) Printed Name Printed Title Date

26 APPENDIX G CERTIFICATE OF COMPLIANCE WITH APPLICABLE EEO/AA/SDO PROVISIONS The Proposer hereby certifies that it shall comply with all applicable minority workforce percentage ratio and specific affirmative action steps contained in any EEO/AA/SDO provisions of this Contract, including, without limitation any imposed by the Massachusetts Supplier Diversity Office (SDO). Name of Proposer Address of Proposer Telephone Number By: _ (Signature) Printed Name Printed Title Date