QUALIFICATIONS BASED SELECTION FOR PROFESSIONAL SERVICES GUIDELINES FOR QUALIFICATION STATEMENTS INDEPENDENCE, OHIO JANUARY 2014 PREPARED BY:

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QUALIFICATIONS BASED SELECTION FOR PROFESSIONAL SERVICES GUIDELINES FOR QUALIFICATION STATEMENTS INDEPENDENCE, OHIO JANUARY 2014 PREPARED BY: DONALD J. RAMM, P.E. CITY ENGINEER

QUALIFICATION STATEMENT The City of Independence requests professional design firms interested in providing professional services for Independence projects to submit a statement of qualifications pursuant to Section 153.65 to 153.71 of the Ohio Revised Code. Notice of this request will be published in the Plain Dealer newspaper and will be sent directly to firms known to have a direct interest in providing such services. The qualification statements submitted will be kept on file and evaluated for design requirements when the City of Independence is planning to contract for professional design services. Qualification statements will be accepted at any time from any professional design firm or person legally engaged in rendering professional engineering and surveying services. The City Engineer will send out bi-annual request to update qualification statements which are on file. Qualification statements will contain information requested on the copies of the attached Qualification-Based Selection Statement Criteria Sheet. Two (2) Qualification statements shall be submitted. Any Qualification Statements, submitted without all requested information or not updated upon request will be reason to deem a firm or individual unqualified.

CITY OF INDEPENDENCE QUALIFICATIONS-BASED SELECTION STATEMENT CRITERIA 1. Provide a brief history of the firm. Include year established, type of organization and information pertaining to major areas of expertise. 2. Provide resumes for key personnel of the firm and list the number of employees by classification. Identify the primary key person in your firm to be contacted regarding qualification-based selection. 3. List clients and representative projects worked on during the last five years with an emphasis on municipal work. Provide a brief description and relative size of each project. 4. Provide a copy of a current ODOT technical pre-qualification letter. If not pre-qualified with ODOT, so indicate on the statement. 5. Provide information regarding insurance carried by the firm. 6. Provide information regarding the type of computer hardware and software. 7. Complete and include the Statement of Qualifications for Professional Services Summary Sheet. 8. Sign and include the Anti-Terrorism form in accordance with ORC section 2909.33 and the Ohio Division of Homeland Security. 9. Sign and include Conflict of Interest form in accordance with ORC section 3517. 10. Provide any further information which may be helpful for the City of Independence to determine the qualifications of the firm. 11. Limit Qualification statements to 30 pages including three summary sheets.

City of Independence Engineering Department Statement of Qualifications for Professional Services Summary Sheet Name of Firm: Date: Contact Person and Title: Address: City: State: Zip: Telephone: Email: Fax: Web Page: Please check all the services that your firm can provide and check the appropriate box if your firm is ODOT pre-qualified to provide such services. Engineering Categories Service ODOT Non-complex Roadway Design Complex Roadway Design Safety Studies Right-of-Way Plan Development Level 1 Bridge Design Level 2 Bridge Design Level 3 Bridge Design Elements Minor Bridge Inspection Major Bridge Inspection Underwater Bridge Inspection Geotechnical Engineering Services Geotechnical Testing Laboratory Basic Traffic Signal Design Traffic Signal System Design

Engineering Categories Service ODOT Limited Lighting Design Complex Lighting Design Environmental Document Preparation EA/EIS Environmental Document Preparation CE Environmental Document Preparation 4(f) Aquatic Ecology Survey Terrestrial Ecology Survey Wetland Delineation Wetland Mitigation Waterway Permits Air Quality Analyses Noise Analyses and Abatement Design Archaeological Investigations History/Architectural Investigations Environmental Site Assessment Screening Phase I Environmental Site Assessment Phase II Environmental Site Assessment Environmental Site Assessment Remedial Design Right-of-Way Categories Service ODOT Project Management Title Search Value Analysis Appraisal Appraisal Review

Right-of-Way Categories Service ODOT Negotiation Closing Relocation Relocation Review Construction Categories Service ODOT Construction Inspection Construction Materials Testing Construction Administration Miscellaneous Design, Inspection, and Survey Service ODOT Categories Roundabouts Storm Water Management Pavement Condition Assessment Field Surveying Bridge Load Rating Other (list as necessary)