INFORMAL BIDDING APPLICATION FOR REGISTRATION November 2015 October 2016

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1 INFORMAL BIDDING APPLICATION FOR REGISTRATION General Instructions: Bidders must complete the entire Application. If the requested information does not apply please indicate by N/A. If there is not enough room in the Application for a complete response attach additional pages as needed. Do not abbreviate company or contact names. Applicants should submit a completed application in a sealed envelope marked UCCAP APPLICATION to SBCCD, Attn: Kelly Goodrich at 114 S. Del Rosa Dr., San Bernardino, CA 92408, or their application with attachments to kgoodric@sbccd.cc.ca.us. 1.0 BIDDER INFORMATION Street Address (physical location): City, State and Zip: Mailing Address (if different than above.): City, State and Zip: Address: Federal Tax ID # : Union Affiliation: Certifications: SBE MBE WBE VOBE DVBE Other: Principal Contacts

2 2.0 TRADE CATEGORIES Check boxes of the trade categories for which Informal Bidding qualification are requested and provide the license numbers and dates. California Contractors License License Number Date of Issuance Date of Expiration A General Engineering B General Building C-2 Insulation and Acoustical C-6 Cabinet, Millwork, Finish Carpentry C-7 Low Voltage Electrical C-8 Concrete C-9 Drywall C-10 Electrical C-12 Earthwork and Paving C-13 Fencing C-15 Floor and Flooring C-16 Fire Protection C-17 Glazing C-20 Warm-Air Heating and Air Conditioning C-21 Building Moving/Demolition C-27 Landscaping C-28 Lock and Security Equipment C-32 Parking and Highway Improvement C-33 Painting and Decorating C-36 Plumbing C-39 Roofing C-45 Electrical Sign C-54 Tile ASB Asbestos Abatement Certification Other 2

3 3.0 BONDING AND INSURANCE INFORMATION 3.1 Bonds and Insurance What is your current bond premium charge (expressed as a percentage value of the project)? (Attach a letter of bondability from your surety company showing bondability limits.) % Calculate percentage based on a project valued at $100,000. What is your current bonding capacity? $ Surety Company: Surety Broker: 3.2 Commercial General Liability Insurance (Attach a certificate of insurance from your insurance carrier.) General Liability Insurer: Policy No.: Current Policy Limits: Per Occurrence: $ /General Aggregate: $ General Liability Broker: 3

4 3.3 Workers Compensation Insurance (Attach a certificate of insurance from your insurance carrier.) Workers Comp Insurer: Policy No.: Workers Comp Broker: 4.0 REFERENCES LIST THREE REFERENCES FOR EACH TYPE Material Supplier Company Name City Contact Phone # Public Agency Owner (California school projects preferred) Agency Name City Contact Phone # 4

5 5.0 PRE-QUALIFICATION RATING QUESTIONNAIRE 5.1 Essential Requirements A Bidder will not qualify if the answer to any of the following questions through in this section is No Bidder possesses a valid and current California contractors license for the trades for which Bidder is prequalifying under the name presented on this application Bidder maintains a commercial general liability insurance policy with a coverage amount of at least $1,000,000 per occurrence and $2,000,000 in general aggregate Bidder has a current workers compensation insurance policy as required by the Labor Code or is legally self-insured pursuant to Labor Code 3700.* Surety must be California-Admitted, or satisfactory to the Owner. A letter from Bidder s admitted surety, authorized to issue bonds in the State of California, is attached and states the Bidder s current bonding rate and available bonding capacity At the time of submitting this Application for Qualification, is your organization eligible to bid or be awarded a public works contract, or perform as a subcontractor on a public works contract, pursuant to Labor Code ? * If exempt from this requirement because bidder has no employees, bidder will be required to show evidence of exemption issued by the Contractors State License Board. 6.0 ACCURACY AND AUTHENTICITY The undersigned is duly authorized to execute this informal Bidding Qualification Application under penalty of perjury on behalf of the above-identified Bidder. The undersigned warrants and represents that he/she has personal knowledge of each of the responses to this Informal Bidding Qualification Application and/or that he/she has conducted all necessary and appropriate inquiries to determine the truth, completeness and accuracy or responses to this Informal Bidding Qualification Application. The undersigned declares and certifies that the responses to this Informal Bidding Qualification Application are complete and accurate; there are no omissions of material fact or information that render any response to be false or misleading and there are no misstatements of fact in any of the responses. The above-identified Bidder acknowledge and agree that if the District determines that any response herein is false or misleading or contains misstatements of fact, the Bidder will not be deemed qualified to participate in the District s Informal Bidding Procedures. Executed this day of, 20 at. (City and State) I declare under penalty of perjury under California law that the forgoing is true and correct. (Signature) (Typed or Written Name) A Note about Senate Bill 854: In accordance with Senate Bill 854, which became law June 20, 2014, the District will only use registered contractors and subcontractors for public works projects awarded on or after April 1, All contractors should make sure that they are in compliance. See the Department of Industrial Relations website ( for more information. 5

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