View RFQ - Loudoun Water

REQUEST FOR QUALIFICATIONS 

RFQ Number: 2013-057-220A 

Potomac Water Supply Program 

Program Element Nos. 1 & 2 

Raw Water Intake & Potomac Raw Water Pumping Station – 

Phase I 

Issuance Date: June 28, 2013 

Qualifications Due Date: Wednesday, July 31, 2013 

and Time: 2:00 PM (Eastern Time) 

Delivery and Mailing Address: 

44865 Loudoun Water Way 

Ashburn, VA 20147 

Procurement Contact: Amy Bevins, Purchasing Technician 

Phone: 571.291.7719 

Fax: 571.223.2513 

E-mail: procurement@loudounwater.org 

Optional Pre-submission Conference: Tuesday, July 9, 2013 

and Time: 10:00 a.m. (Eastern Time) 

Location: 44865 Loudoun Water Way 

Ashburn, Virginia 20147 

Inquiries: Questions and inquiries are to be submitted in writing and will be accepted from any and all Proposers. The 

Procurement Department is the sole point of contact for this solicitation. Unauthorized contact with other Loudoun Water staff 

regarding the RFQ may result in the disqualification of the Proposer. Inquiries pertaining to the Request for Qualifications must give 

the RFP number, title and acceptance date. Material questions will be answered in writing with an Addendum provided, however, 

that all questions are received not later than July 12, 2013 at 2:00 pm. It is the responsibility of all Proposers to ensure that they 

have received all Addenda. Addenda can be downloaded from www.loudounwater.org. All questions regarding this RFP should be 

directed to Amy Bevins, Purchasing Technician, through e-mail at procurement@loudounwater.org. 

IF YOU NEED ANY REASONABLE ACCOMMODATION FOR ANY TYPE OF DISABILITY IN ORDER 

TO PARTICIPATE IN THIS PROCUREMENT, PLEASE CONTACT THE PROCUREMENT 

DEPARTMENT AS SOON AS POSSIBLE.

Loudoun Water 

Request for Qualifications 

RFQ# 2013-057-220A 




REQUEST FOR QUALIFICATIONS 



Raw Water Intake and Potomac Raw Water Pumping Station – Phase I 

June 28, 2013 

TABLE OF CONTENTS 

NOTICE OF REQUEST FOR QUALIFICATIONS ............................... 

DESCRIPTION AND SCOPE OF WORK .......................................... 

SELECTION PROCESS.................................................................. 

STATEMENT OF QUALIFICATIONS ............................................... 

REPRESENTATIONS AND CERTIFICATIONS .................................. 

REQUIRED SUPPLEMENTAL INFORMATION……………………………….. 

Section 

I 

II 

III 

IV 

V 

VI






for the 


I. NOTICE OF REQUEST FOR QUALIFICATIONS 

1. General 

Loudoun Water (“LW”) extends this Request for Qualifications (“RFQ”) to request 

Statement of Qualifications (“SOQ”) from interested Contractors (the 

“Proposers”) for the Raw Water Intake and Potomac Raw Water Pumping 

Station – Phase I (the “Project”). This Project is a part of Loudoun Water’s 

Potomac Water Supply Program (the “Program”), a multimillion dollar program 

aimed at withdrawing, storing, treating and distributing the Potomac River water 

to Loudoun Water customers. 

The procurement of the Project is a two step process. This is step one of the 

procurement process of the Project. The purpose of this RFQ is to request 

documentation that will enable Loudoun Water to determine which Proposers: 

(a) are qualified to successfully execute the construction of the Project; and (b) 

will be invited to submit bids in response to Loudoun Water’s Invitation for Bid 

(“IFB”) for the Project as Prequalified Bidders. Award of a Contract for the 

Project (the “Contract”) will be made in step two and award will be made to one 

of the Prequalified Bidders as determined by Loudoun Water under the criteria 

established in the IFB. 

2. Project Overview 

The Project includes: 

Construction and commissioning of a 40 million gallon per day (MGD) net 

capacity submerged raw water intake (RWI) and raw water pumping station 

(PRWPS) with all supporting facilities including a raw water transmission (RWT) 

system within the property boundaries. 

A detailed description of the scope of services is included in Section II of this 

document. 

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3. Submission of Qualification Statement. 

In order to be eligible to participate in this prequalification process, the Proposer 

must submit 8 (eight) copies of fully-completed SOQs to Loudoun Water on or 

before 2:00 p.m., on July 31, 2013, at the following address: 

LOUDOUN WATER 

44865 LOUDOUN WATER WAY 

ASHBURN, VA 20147 

ATTN: PROCUREMENT DEPARTMENT 

Each SOQ should be submitted in the manner described in Section IV of the 

Request for Qualifications. Electronic or facsimile transmissions will not be 

accepted. 

By: 

Amy Bevins 

Purchasing Agent 


Date: June 28, 2013 

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II. DESCRIPTION AND SCOPE OF WORK 

1. Project Overview and Scope 

Loudoun Water is a public body politic and corporate and an instrumentality of 

the Commonwealth of Virginia, organized under the Virginia Water and Waste 

Authorities Act, being Chapter 28, Title 15.1, Code of Virginia of 1950, as 

amended (the "Act"). Loudoun Water was created by action of the Board of 

Supervisors of Loudoun County, Virginia and was chartered by the State 

Corporation Commission on May 27, 1959. As an authority, Loudoun Water 

makes no profit and operations and finances are independent of the County’s 

tax-supported services. 

In 2008, the Loudoun Water Board of Directors moved to protect the health, the 

environment, and the quality of life in Loudoun County by addressing the critical 

need for additional water supply. This critical need will be met by the Potomac 

Water Supply Program (herein referred to as the PWSP or the Program) which 

will create a new water supply system to supply potable water to Loudoun 

Water’s Central Service Area. The facilities to be constructed under the Program 

will enable Loudoun Water to withdraw raw water from the Potomac River, 

convey it to a new water treatment plant (WTP) for processing either directly, or 

after storage in retired rock quarries, and then convey the finished water to the 

Central Service Area. These facilities are divided into six major Program Elements 

and constructed in phases: 

Program Element No. 1 - Raw Water Intake (RWI) 

Program Element No. 2 – Potomac Raw Water Pumping Station (PRWPS) 

Program Element No. 3 - Raw Water Transmission (RWT) 

Program Element No. 4 – Required Quarry Development (QRWPS) 

Program Element No. 5 - Water Treatment Plant (WTP) 

Program Element No. 6 - Finished Water Transmission (FWT) 

The term “Project” discussed herein refers to Program Elements No.1 and 2 only. 

Request For Qualifications and solicitations for other Program Elements will be 

issued separately. 

a. The work to be performed under this Project consists of the construction and 

commissioning of a 40 million gallon per day (MGD) net capacity submerged 

raw water intake (RWI) and raw water pumping station (PRWPS) with all 

supporting facilities including a raw water transmission (RWT) system within 

the property boundaries: 

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The Project site is located in Leesburg, VA adjacent to the Kenneth B. 

Rollins Water Treatment Water Plant. Work at the Project site includes, 

but is not limited to, construction and startup of a submerged raw water 

intake in the Potomac River consisting of 48” dia. half barrel screens, river 

bank vault, approximately 220’-0” long by 16’-0” tall by 16’-0” wide 

horseshoe shaped raw water tunnel, 115’-0” deep by 28’-0” deep shaft, 

pumping station, standby generation, and all supporting work such as 

electrical, instrumentation, civil, process, mechanical, HVAC, plumbing, fire 

protection, architectural, and structural. 

b. The Contractor will be required to perform a minimum of 40% of the 

construction, which is to include material and the associated labor. 

c. The Contractor will be required to comply with all Federal, State of Virginia, 

and Loudoun County laws, rules and regulations. Additionally, the Contractor 

will be required to comply with all permits and regulatory orders associated 

with the work, including those obtained by Loudoun Water. 

d. Land acquisition, temporary easements and permanent easements will be 

obtained by Loudoun Water. Details will be described in accordance with 

Contract Documents. 

2. Project Budget and Financing 

Estimated contract award amount is approximately $34 million without alternates 

and will be bid as a single prime contract. The project is included in Loudoun 

Water's approved Capital Improvements Program (CIP). 

No compensation will be provided to Proposers for submitting any materials as 

part of this procurement. 

3. Procurement and Project Schedules (Preliminary) 

PROCUREMENT SCHEDULE (Preliminary) 

Procurement Milestone 

Date 

Advertisement/RFQ Available 6/28/13 

Optional Pre-Submittal Briefing 7/9/13 

Statement of Qualifications Due 7/31/13 

Notification of Qualified Proposers 8/24/13 

Advertisement/IFB Available 9/24/13 

Price Proposals Due (IFB Due Date) 11/8/13 

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PROJECT SCHEDULE (Preliminary) 

Schedule Milestone 

Date 

Anticipated Notice of Award 12/13/13 

Anticipated Notice to Proceed 1/15/14 

Substantial Completion Milestone 7/13/16 

Final Completion Milestone 6/30/17 

Note: Procurement and Project Schedules are preliminary only and subject to change. 

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III. 

SELECTION PROCESS 

1. Step 1: Request for Qualifications. 

a. Advertisements 

The official announcement of the Project has been placed in the legal 

announcement section of newspapers serving Loudoun Water’s jurisdiction, 

specifically the Washington Post and the Loudoun Water website. 

Interested parties will be sent the full Request for Qualifications document 

(RFQ), by contacting the Procurement Department, Loudoun Water, 44865 

Loudoun Water Way, Ashburn, VA 20147. The RFQ will also be made 

available from Loudoun Water's website, www.loudounwater.org. 

b. Briefings 

A Pre-submittal Briefing will be scheduled for July 9, 2013. The briefing will 

allow Loudoun Water’s staff to answer potential Proposers’ questions in 

person and will be followed by written addenda, if needed. 

c. Communications 

Communications to the Proposers, outside of the briefing and the interview, 

shall be in writing, and shall be distributed to all invitees simultaneously. All 

communications to Loudoun Water shall be directed to the Procurement 

Department and shall include the Project Title. 

d. Late Statement of Qualifications 

It is the responsibility of the firm to ensure the Procurement Department 

receives the submittal by the proposal due date and time. No submittals or 

modifications to submittals will be accepted after the requested time on the 

proposal due date. Late SOQs will be returned to the Proposer, if the 

container is properly identified with the firm's return address. 

e. Evaluation of RFQ Proposals 

Loudoun Water will determine whether Proposers are either “qualified to bid” 

or “not qualified to bid” on the Project per Loudoun Water Procurement Policy 

and the Virginia Public Procurement Act (§ 2.2-4317 of the Code of Virginia). 

Loudoun Water will notify all applicants whether or not they have been 

determined as qualified to bid within 60 days after the deadline for receipt of 

the Statement of Qualifications. 

f. Number of Finalists 

The number of Proposers that Loudoun Water selects will be based solely on 

the qualifications of the Proposers. The Loudoun Water Evaluation 

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Committee will make the final decision on the firms determined to be 

qualified. 

g. Notifications 

The Proposers will be notified of the Evaluation Committee’s decision in 

writing. 

h. Honoraria 

No honorarium will be given to prospective Proposers submitting Statement 

of Qualifications. 

2. Step 2: Invitation for Bid. 

a. Allowable Bidders for the IFB 

Only Proposers accepted in Step 1 of the procurement process will be allowed 

to submit bids for Step 2 of the procurement process. Pre-qualified Bidders 

will be asked to submit a price proposal for the Project IFB. 

b. Briefing 

Loudoun Water will conduct a briefing for all of the pre-qualified bidders. The 

briefing will include an explanation of the Invitation for Bid (IFB) and an 

overview of the Project and may include a tour of the site. The briefing will 

include an opportunity for questions and answers, with publication and 

distribution of the attendance list and the Q&A’s to all pre-qualified bidders. 

c. Evaluation of IFB 

The evaluation criteria for the IFB will be based solely on the low bid as 

defined in the IFB. 

d. Honoraria 

No honorarium will be given as part of the IFB. 

3. General Provisions 

a. Loudoun Water's Right to Change Schedule and/or Terminate 

Procurement 

Termination and/or a change of schedule of a selection process can occur, 

and Loudoun Water reserves the right to do so, when necessary. No 

compensation will be provided to Proposers if the RFQ / IFB schedule is 

altered or terminated by Loudoun Water. 

b. Request for Copies 

Copies of the RFQ may be obtained by calling Loudoun Water Procurement 

Department between the hours of 9:00 a.m. and 4:00 p.m., Monday through 

Friday or forwarding an email request to procurement@loudounwater.org. 

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c. Inquiries 

Questions regarding this solicitation must be received in writing prior to the 

date and time indicated on the cover. Inquiries must identify the RFQ by title 

and due date. Loudoun Water will issue written addenda to any inquiries that 

alter the scope of the RFQ. All other contacts with Loudoun Water personnel 

concerning this solicitation are discouraged. Submit inquiries via email at 

procurement@loudounwater.org or by mail to: 

Procurement Department 



Attn: Amy Bevins 

d. Employees Not to Benefit 

As a prerequisite for payment pursuant to the terms of the contract, there 

shall be furnished to Loudoun Water a statement that no employee of 

Loudoun Water has received or has been promised, directly or indirectly, any 

financial benefit, by way of fee, commission, finder's fee or in any other 

manner, remuneration arising from or directly or indirectly related to this 

contract. (see Representations and Certifications in Section V). 

e. ADA Reasonable Accommodation Clause 

If there is a need for any reasonable accommodation for any type of disability 

in order to participate in this procurement, please contact the Procurement 

Department to make arrangements. 

f. Statement of Qualifications become Property of Loudoun Water 

All submitted material becomes the property of Loudoun Water, and all 

submitted material may be published and/or displayed. Requests for 

confidentiality of proprietary information will be reviewed and confirmed by 

the Evaluation Committee. 

g. Proprietary Information 

SOQ sections containing trade secrets or proprietary information submitted by 

a Proposer in connection with a procurement transaction shall not be subject 

to public disclosure under the Virginia Freedom of Information Act; however, 

Proposer must invoke protection of this section prior to or upon submission of 

the data or other materials, and must identify the data or other materials to 

be protected and state reasons why protection is necessary. 

h. Non-conformance of Statement of Qualifications 

Statement of Qualifications submittals that fail to conform to the 

requirements of the RFQ may be considered non-responsive and the Proposer 

determined to be “not qualified to bid”. Loudoun Water reserves the sole 

right to request the submission of additional information or conduct 

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interviews to assist in the evaluation contained in a SOQ. Loudoun Water 

reserves the right to waive any irregularity or informality in the SOQs. 

Loudoun Water may, but is not required to, consider SOQs taking exception 

to the terms and conditions included in the RFQ; however, preference will be 

given to Proposers that do not take exceptions. 

i. Notice Required if Substantial Change from SOQ 

If a prequalified Applicant experiences a substantial change in its financial 

condition, ownership, corporate structure, personnel or specified 

subcontractors after the Statement of Qualifications has been submitted and 

prior to the completion of the Step 2 Invitation for Bid process, the Applicant 

shall notify Loudoun Water in writing of the change at the time the change 

occurs or as soon as practical thereafter. Loudoun Water reserves the right 

to determine if the change by Applicant results in a change of qualification. 

Failure to notify Loudoun Water of a substantial change prior to the bid 

submission may constitute grounds for rejection of a bid. 

j. Execution of Agreement 

In the event the selected firm does not execute an agreement within thirty 

(30) days of the notice of award, Loudoun Water may give notice to such firm 

of its intent to award work to the next most qualified firm, or firms, or to 

conduct a new proposal process and proceed accordingly. 

k. Compensation 

Proposers will not be compensated for the cost of proposal preparation 

whether or not an award is consummated. 

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IV. STATEMENT OF QUALIFICATIONS 

1. Requirements of Submission 

The submission requirements for consideration for prequalification must include 

the following information in the order indicated: 

a. Letter of Transmittal 

This letter must contain the name, mailing address and telephone number of 

the primary representative of the Applicant to whom all correspondence is to 

be addressed. 

b. Representations and Certifications 

Applicants shall complete the Representations and Certifications forms as 

indicated in Section V by typing or clearly printing in ink the requested 

information. All information shall be provided. Applicants shall indicate if the 

appropriate response is “none” or “not applicable”. Specified attachments 

shall clearly indicate as to the corresponding part of Section V and 

information presented therein shall be straight-forward and concise. 

c. Supplemental Information 

This item includes any additional information requested in this RFQ, including 

but not limited to, information requested in Section VI. Information shall be 

organized, straight-forward and concise. 

2. Required Format of Statement of Qualifications 

In order to determine eligibility, and to make quick and accurate comparisons 

between competing applicant teams, Loudoun Water will limit the number of 

pages to 60. 

3. Number of Copies 

Provide 8 (eight) hard copies and one electronic copy in PDF format of the 

Statement of Qualifications. 

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V. REPRESENTATIONS AND CERTIFICATIONS 




REPRESENTATIONS AND CERTIFICATIONS 

By submitting this Statement of Qualifications, Applicant acknowledges and agrees that 

Loudoun Water has the right to conduct such research and verification with regard to 

the information set forth herein as it deems reasonably necessary and appropriate 

under the circumstances, including contacting project owners and other involved parties 

for references with respect to Applicant's prior performance. 

Applicant must provide all information requested herein. Any doubt on the part of 

Applicant with respect to the necessity of disclosing information should be resolved in 

favor of disclosure. 

Please type or print clearly in black ink. Applicant should number additional pages 

consecutively, referencing applicable sections of this form. 

PART A. 

GENERAL INFORMATION 

1. Firm Name _______________________________________________________ 

Street Address ____________________________________________________ 

City, State, Zip Code ________________________________________________ 

Telephone No. ____________________ 

Fax No. ______________________ 

Email Address ____________________________________________________ 

2. Mailing Address (If Different) _________________________________________ 

City, County, State Zip Code _________________________________________ 

3. Identify two contact persons for the Applicant and provide the telephone number 

and email address for each. (First named individual will be the primary contact.) 

(a) _____________________________________________________________ 

Name Title Telephone Email Address 

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(b) _____________________________________________________________ 

Name Title Telephone Email Address 

4. Type of Entity: 

Corporation (If Corporation: 

spaces below) 

provide date and state of incorporation in 

Partnership (If Partnership: indicate type of partnership, provide names of all 

partners, general and limited, state of organization, and date of formation of 

partnership in spaces below) 

Individual Owner (If Individual Owner: provide name of owner and date of 

commencement of business in spaces below) 

Joint Venture (If Joint Venture: provide name and organizational information 

for each joint venture partner and date of formation of joint venture in spaces 

below) 

Limited Liability Company (If LLC: provide names for all members, and date 

and state of organization in spaces below) 

________________________________________________________________ 

________________________________________________________________ 

________________________________________________________________ 

________________________________________________________________ 

________________________________________________________________ 

________________________________________________________________ 

________________________________________________________________ 

5. Federal Employer Identification Number and Date of Issuance: 

FEIN No.: _________________ 

Date of Issuance: ______________ 

6. How many years has the Applicant been in business as a contractor under the 

business name by which it now requests to be pre-qualified 

_______ years. 

Has the Applicant ever operated under a name that is different from that set 

forth above 

Yes _____ No _____ 

If yes, provide other name(s) and number of years in business under that 

name(s): 

________________________________________________________________ 

________________________________________________________________ 

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________________________________________________________________ 

________________________________________________________________ 

7. Virginia Class A Contractor's License #: _________________ dated __________ 

Note: Proof of Virginia Class A Contractor’s License shall be included as 

Attachment A. If the Applicant does not currently hold a Virginia Class A 

Contractor's License, insert the phrase "Not licensed in Virginia" under 

Question 7 and include a detailed description as Attachment A indicating how 

the Applicant will obtain the required license prior to the Notice of Award. 

8. In the space below, each Applicant that is organized or authorized to transact 

business in the Commonwealth of Virginia pursuant to Title 13.1 or Title 50 of 

the Virginia Code must provide the identification number issued to it by the 

Virginia State Corporation Commission (the "VSCC"). Any Applicant that is not 

required to be authorized to transact business under Title 13.1, Title 50, or any 

other law, must provide a statement indicating why it is not required to be so 

authorized. 

Applicant's VSCC Identification #: _____________________________________ 

Note: If the Applicant is not required to be authorized to transact business 

under the above-referenced provisions of the Virginia Code, provide a 

statement as Attachment A indicating why VSCC authorization is not 

required. 

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PART B. 

FINANCIAL ABILITY 

1. Name and address of Surety Company: 

________________________________________________________________ 

________________________________________________________________ 

________________________________________________________________ 

2. Is the Surety Company included on the United States Treasury List of acceptable 

surety corporations 

Yes _____ No _____ 

Note: Provide a letter from the Surety Company as Attachment B indicating 

among other matters that, if the Applicant is awarded a contract for the 

Work described in this RFQ, the Surety Company will issue payment and 

performance bonds in the full amount of the resulting contract. A sample 

letter is provided at the end of this Section. 

PART C. 

JUDGMENTS AND LITIGATION 

1. Has the Applicant or any officer, director, or owner of the Applicant had one or 

more judgments entered against it, him, or her within the past 10 years for the 

breach of contract for construction In responding, the Applicant should also 

include contracts for construction management and design-build services. 

Yes _____ No _____ 

2. Has the Applicant filed or caused to be filed on its behalf, or had filed against it, 

any lawsuits or arbitration requests or claims with regard to any construction 

contract within the last five years 

Yes _____ No _____ 

3. Is the Applicant a party to any claim, lawsuit, arbitration proceeding, or other 

legal proceeding that is pending or outstanding and that relates to a construction 

contract with a public body 

Yes _____ No _____ 

4. On any construction contract with a public body, does Applicant have any 

unsettled: 

(a) Delay claims Yes _____ No _____ 

(b) Schedule impact claims Yes _____ No. _____ 

(c) 

Other claims which, individually or in the aggregate, equal or exceed 

$100,000 on any single contract or project Yes _____ No _____ 

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5. Has the Applicant been adjudicated or otherwise finally determined to have been 

in noncompliance with any applicable federal, state, or local law, rule, ordinance, 

or regulation (an "Applicable Law", including any Applicable Law related to 

construction or to occupational safety 

Yes _____ No _____ 

Note: If the Applicant has answered yes to any question in the Part C, the 

Applicant must submit full details with regard to each such matter on 

separate sheets attached as Attachment C to this RFQ. For each affirmative 

response that relates to a judicial or administrative proceeding, the Applicant 

should provide, as applicable, the date, the project description, the style of 

the proceedings, the court, the jurisdiction, the case number, and a brief 

description of the claim or claims. 

PART D. 

CONTRACT COMPLIANCE 

1. Has the Applicant been found to be in substantial non-compliance with the terms 

and conditions of a construction contract with a public body without good cause 

Yes _____ No _____ 

2. Has the Applicant ever failed to enter into a contract with a public body when the 

Applicant was the low bidder 

Yes _____ No _____ 

3. Has the Applicant ever been party to a construction contract that was terminated 

by the public body for cause 

Yes _____ No _____ 

4. Has the Applicant ever been declared to be in default or partial default on a 

construction contract with a public body 

Yes _____ No _____ 

5. Has the Applicant ever been the subject of a stop work order on any construction 

contract with a public body 

Yes _____ No _____ 

6. Has the Applicant ever had work removed or omitted from a construction 

contract or project, other than by mutually-agreed upon change order 

Yes _____ No _____ 

7. Has the Applicant ever failed to complete any work awarded to it by a public 

body 

Yes _____ No _____ 

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Note: If the Applicant has answered yes to any of the questions set forth in 

this Part D, submit full details on separate sheets attached as Attachment D 

to this RFQ. 

PART E. 

CRIMINAL CONVICTION OR DEBARMENT 

1. During the last 10 years, has the Applicant or any officer, director, owner, project 

manager, or chief financial officer of the Applicant been convicted in any 

jurisdiction of any of the following: 

(a) 

(b) 

(c) 

A crime related to construction contracting or to contracting in general 

Yes _____ No _____ 

A violation related to conflicts of interest or to ethics in public contracting 

Yes _____ No _____ 

A crime related to governmental fraud, bid rigging, or bribery 

Yes _____ No _____ 

2. Is the Applicant or any officer, director, or owner of the Applicant currently 

debarred from bidding or contracting by any local, state, or federal agency or 

other public body 

Yes _____ No _____ 

Note: If the Applicant has answered yes to any of the questions set forth in 

this Part E, submit full details on separate sheets as Attachment E to this 

RFQ. Applicant's response on Attachment E should in each instance identify 

the name of the person or entity who was the subject of the conviction or 

debarment, and should include a description of the project involved, an 

explanation of the circumstances that gave rise to the conviction or 

debarment, and the names and telephone numbers of individuals who may 

be contacted for additional information. 

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PART F. 

EXPERIENCE 

1. Provide the Applicant's EMR (Experience Modification Rate) for each of the 3 

most recent calendar years: 

Year: 

2012 

2011 

2010 

Applicant's EMR 

Applicant's average EMR for calendar years 2010 through 2012: _____________ 

Note: If the Applicant’s average EMR for the requested period exceeds 1.0, 

submit full details on separate sheets as Attachment F to this RFQ. An 

average EMR in excess of 1.0 may result in a denial of prequalification. 

2. Has the Applicant received any OSHA citations within the last three years 

Yes _____ No _____ 

3. If the answer to the preceding question is yes, how many of each of the 

following types of citations have been received by Applicant 

Willful________ Imminent Danger_________ Serious_________ 

Non-Serious____________ 

De minimus____________ 

Note: If the Applicant has received any OSHA citations, provide a brief 

description of the nature of any citation(s) or attach a copy of the citation(s) 

as separate sheets as Attachment F to this RFQ. 

4. Has the Applicant's contractor license in any jurisdiction (including Virginia) ever 

been revoked or suspended 

Yes _____ No _____ 

5. In the event that the Applicant previously operated under a different name or 

business structure, indicate whether the Applicant (under such other name or business 

structure) had its contractor's license revoked or suspended at any time 

Yes _____ No _____ Not Applicable _____ 

Note: If the Applicant has answered yes to either question 4 or 5 as set forth 

in this Part F, submit full details on separate sheets as Attachment F to this 

RFQ. 

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PART G. 

PROPRIETARY INFORMATION 

Under the VPPA, the Applicant may elect to designate portions of its SOQ as trade 

secrets or proprietary information. In order to obtain protection from mandatory public 

disclosure laws, an Applicant must complete the chart below by identifying with 

specificity each item of information for which protection is sought and providing an 

explanation as to why protection from disclosure is necessary. In order to be effective, 

an Applicant must identify any trade secrets or proprietary information set forth herein 

at or prior to submission of this SOQ. 

SECTION: DESCRIPTION OF INFORMATION JUSTIFICATION 

Note: If this Part G is left blank, the Applicant's SOQ will be deemed not to 

contain any trade secrets or proprietary information. 

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PART H. 

SIGNATURE PAGE 

The undersigned hereby certifies under oath that he or she is duly authorized to submit 

this Statement of Qualification on behalf of the Applicant and that the information set 

forth herein, including any information submitted as an attachment, is true, correct, and 

complete in all respects. 

_____________________________________ 

Name of Applicant 

_____________________________________ 

Signature of Authorized Representative 

_____________________________________ 

Name of Representative 

_____________________________________ 

Title 

_____________________________________ 

Date 

[Notary Acknowledgements on Following Pages] 

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NOTARY ACKNOWLEDGEMENTS FOR STATEMENT OF QUALIFICATION 

(FOR A CORPORATION) 

State of 

County of 

__________________ 

__________________ 

The foregoing Statement of Qualification was acknowledged before me this _____ day 

of ______________, 20___, by ____________________________________________, 

(Name of Applicant's Authorized Representative) 

the duly authorized representative of ________________________________________, 

(Name of Applicant) 

a ______________________ corporation, on behalf of the corporation. 

(State of Incorporation) 

My commission expires: ____________________ 

__________________________________ 

Notary Public 

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(FOR A PARTNERSHIP OR JOINT VENTURE) 

State of 

County of 

__________________ 

__________________ 


of ______________, 20___, by ____________________________________________, 

(Name of acknowledging partner or agent) 

the duly authorized Partner or Venturer of ____________________________________, 

(Name of partnership or joint venture) 

a partnership or joint venture. 


__________________________________ 

Notary Public 

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(FOR AN INDIVIDUAL) 

State of 

County of 

__________________ 

__________________ 


of ______________, 20___, by __________________________________, as Applicant. 

(Name of Individual) 


__________________________________ 

Notary Public 

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(FOR LIMITED LIABILITY COMPANY) 

State of 

County of 

__________________ 

__________________ 


of ______________, 20___, by ____________________________________________, 

(Name of Manager) 

the duly authorized representative of ________________________________________, 

(Name of Limited Liability Company) 

a limited liability company. 


__________________________________ 

Notary Public 

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Attachment B (Sample Surety Letter) 

[DATE] 

[SURETY COMPANY LETTERHEAD] 

Procurement Department 




Re: 

[CONTRACTOR] 

RFQ ______ 

Raw Water Intake and Potomac Raw Water Pumping Station 

To Whom It May Concern: 

[SURETY COMPANY] has provided surety bonds on behalf of [CONTRACTOR] for 

[NUMBER] years, during which time we have issued performance and payment bonds 

for contracts valued in the range of [DOLLAR AMOUNT]. At the present time, 

[SURETY COMPANY] provides a [DOLLAR AMOUNT] single project / [DOLLAR 

AMOUNT] aggregate surety program to [CONTRACTOR]. 

[SURETY COMPANY] is prepared to provide payment and performance bonds on 

behalf of [CONTRACTOR] for the full value of the contract contemplated by RFQ 

_____, provided that [SURETY COMPANY] reserves the right to perform standard 

underwriting at the time of any bond request, including, without limitation, prior review 

and approval of relevant contract documents and bond forms. We assume no liability 

to Loudoun Water if for any reason we do not execute such bonds. 

[SURETY COMPANY] is listed on the U.S. Treasury Department's Listing of Approved 

Sureties (2005 Department Circular 570), and is rated [GRADE] ([FINANCIAL SIZE 

CATEGORY]) by A.M. Best Company. 

Please feel free to contact the undersigned at [TELEPHONE NUMBER] if you have 

questions. 

Very truly yours, 

[SURETY COMPANY] 

By: _______________________________ 

[Name], Attorney-in-Fact 

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VI. REQUIRED SUPPLEMENTAL INFORMATION 

Applicant shall provide additional information that demonstrates proof that Applicant 

has the capability and capacity to perform the Work for the Project. 

1. Proposer’s Financial Capacity 

Indicate the Proposer’s form of business, e.g., corporation, partnership, jointventure, 

or sole proprietor. Provide a copy of the Proposer’s latest financial 

statements, Standard and Poor Rating, and quarterly updates, if available. If the 

Proposer is a joint-venture, provide similar information for each member of the 

joint-venture. Disclose any unpaid judgments. Disclose any disputed or 

unadjudicated claims. 

If the Proposer is not a public company, this financial information will be held in 

confidence if requested as proprietary information. 

The Proposer (and joint-venture partners) shall provide anticipated gross 

monthly billings for the next twelve months for uncompleted work presently 

under contract, and monthly gross billings for design and construction over the 

past 24 months. 

2. Bonding Capacity 

Provide evidence that the Proposer’s current bonding capacity is at least as large 

as the estimated project budget amount and the Proposer’s current workload. 

This evidence may be in the form of a certification letter from a licensed bonding 

company (surety), or from an agent normally representing such a company. 

A representation of what will be required in the IFB is described below: 

a.) 

At the time of the IFB, each prequalified contractor must furnish with his 

Bid, a Bid Guarantee in an amount not less than five percent of the amount 

of his Bid. 

The Bid Guarantee shall be in the form of a firm commitment, such as a 

certified check, bank money order, or bid bond. Bid Bonds shall be 

executed on Loudoun Water's recommended Bid Bond Form, by the 

Contractor and a corporate bonding company licensed to transact such 

business in the Commonwealth of Virginia and named on the current list of 

“Surety Companies Acceptable on Federal Bonds” as published in the 

Treasury Department Circular Number 570. 

Loudoun Water may hold as many of the Bid Guarantees as it may deem 

advisable until the execution and delivery of the Contract and Contract 

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Bonds, whereupon all Bid Guarantees will be returned. All other Bid 

Guarantees will be returned within seven days after Bid opening. 

b.) 

The selected Contractor shall within the time specified in the Invitation for 

Bid furnish the Commission with a Labor and Materials Bond and a 

Performance Bond and Letter of Intent to issue Maintenance Bond in penal 

sum equal to 100 percent of the amount of the Contract price. Bonds shall 

be conditioned upon the performance by the Contractor of all undertakings, 

covenants, terms, conditions and agreements of the Contract Documents, 

and upon the prompt payment by the Contractor to all persons supplying 

labor, materials services in the prosecution of the Work provided by the 

Contract Documents. 

Such Bonds shall be executed by the Contractor and a corporate bonding 

company licensed to transact such business in the Commonwealth of 

Virginia and named on the current list of “Surety Companies Acceptable on 

Federal Bonds” as published in the Treasury Department Circular Number 

570. The expense of these Bonds shall be borne by the Contractor. If at 

any time a Surety on any such Bond is declared bankrupt or loses its right 

to do business in the Commonwealth of Virginia or is removed from the list 

of Surety Companies accepted on Federal Bonds, the Contractor shall within 

ten days after notice from Loudoun Water to do so, substitute an 

acceptable Bond, or Bonds, in such form and sum and signed by such other 

surety or sureties as may be satisfactory to Loudoun Water. The premiums 

on such Bond shall be paid by the Contractor. No further payments shall 

be deemed due nor shall be made until the new surety or sureties shall 

have furnished an acceptable Bond to Loudoun Water. 

c.) 

Should the Contract Price be increased by 25 percent or more before Final 

Acceptances, the amount of the Maintenance Bond shall be increased 

accordingly. 

3. Insurance Capacity 

The intent of this section is to make Proposers aware of Loudoun Water’s 

insurance requirements that will be more defined at the IFB stage. Proposer shall 

provide proof in the SOQ that minimum coverages are available. Upon award, 

the selected Contractor shall instruct his insurance agent or carrier to furnish to 

Loudoun Water certificates of insurance attesting to the issuance of insurance 

policies affording coverages as indicated in the Project’s Contract Documents. 

The successful Proposer shall provide and maintain the following minimum limits 

of insurance coverage during the period of performance required under a 

contract resulting from this IFB: 

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i) Comprehensive General Liability 

(1) $1,000,000 Bodily Injury per occurrence and aggregate 

(2) $1,000,000 Property Damage per occurrence and aggregate 

(3) Comprehensive General Form 

(4) Extended Business Liability Endorsement 

(5) Independent Contractors Coverage 

(6) Products/Completed Operations 

(7) Broad Form Contractual Liability 

(8) Personal and Advertising Injury Liability 

ii) 

iii) 

iv) 

Comprehensive Automobile Liability 

(1) $1,000,000 Combined Single Limits 

(2) Statutory Uninsured Motorist Coverage 

(3) Hired, Owned, Used and Non-Owned Coverage 

(4) Motor Carrier Act Endorsement 

Worker's Compensation and Employer's Liability 

(1) Statutory Coverage for Virginia 

(2) $1,000,000 Employer's Liability 

(3) Broad Form All States Endorsement 

Umbrella / Excess Liability – Additional $ 1,000,000 liability coverage over 

the primary limits for Comprehensive General Liability, Comprehensive 

Automobile Liability, and the Employer's Liability 

v) Professional Liability – Additional $1,000,000 liability coverage over the 

primary limits for Comprehensive General Liability, Comprehensive 

Automobile Liability, and the Employer’s Liability 

vi) 

Coverage Provisions 

(1) All deductibles shall appear on the certificate(s). 

(2) Loudoun Water, its' officers/ officials, employees, agents and 

volunteers shall be added as "additional insured" as their interests 

may appear. This provision does not apply to Professional Liability 

or Workers' Compensation/Employers' Liability. 

(3) The Proposer's insurance shall be primary over any applicable 

insurance or self-insurance maintained by Loudoun Water. 

(4) Shall provide forty-five (45) days written notice to Loudoun Water 

before any cancellation, suspension, or void of coverage in whole 

or part, where such provision is reasonable. 

(5) All coverage’s for subcontractors of the Proposer shall be subject to 

all of the requirements stated herein. 

(6) All deductibles or self-insured retention shall appear on the 

certificate(s) and shall be subject to approval by Loudoun Water. 

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At the option of Loudoun Water, either; the insurer shall reduce or 

eliminate such deductible or self-insured retention; or the Proposer 

shall be required to procure a bond guaranteeing payment of losses 

and related claims expenses. 

(7) Failure to comply with any reporting provisions of the policy(s) shall 

not affect coverage provided Loudoun Water, its' officers/officials, 

agents, employees and volunteers. 

(8) The insurer shall agree to waive all rights of subrogation against 

Loudoun Water, its' officers/officials, agents, employees or 

volunteers for any act, omission or condition of premises which the 

parties may be held liable by reason of negligence. 

(9) The Proposer shall furnish Loudoun Water Certificates of Insurance 

including endorsements affecting coverage. The certificates are to 

be signed by a person authorized by the insurance company(s) to 

bind coverage on its' behalf, if executed by a broker, notarized 

copy of authorization to bind, or certify coverage must be attached. 

(10) All insurance shall be placed with insurers maintaining an A.M. Best 

rating of no less than an A:VII. If A.M. Best rating is less than 

A:VII, approval must be received from Loudoun Water’s Manager of 

Procurement and Risk. 

(11) All coverage’s designated herein shall be as broad as the Insurance 

Services Office (ISO) forms filed for use with the Commonwealth of 

Virginia. 

(12) The contractor and/or subcontractor employees provided shall be 

employed by the contractor and/or subcontractor. The contractor 

and/or subcontractor shall be responsible for all payroll taxes, 

worker’s compensation, payroll reports, and other employer Federal 

and State requirements for assigned employees. 

4. Demonstrated Personnel Experience 

The Applicant must demonstrate the requisite experience noted in Section 5 

below for key personnel in constructing similar projects as the Project. Applicant 

must provide an organizational chart including project manager, site 

superintendent, and other key supervisory and technical personnel who would be 

expected to work on the Project. For each such individual, Applicant is to 

provide name, title, total years of construction experience, total number of years 

in proposed position, brief description of their experience in work of similar 

nature as the Project, and personal reference for each individual. 

5. Demonstrated Project Experience 

The Applicant must demonstrate the requisite experience in constructing similar 

projects as the Project. Applicant must include specific project information that 

demonstrates the requisite experience requested, including but not limited to, 

owner’s reference, Engineer / Architect reference, technical requirements of the 

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project, key personnel and subcontractors, percentage and type(s) of work 

performed by Applicant for the project, percentage and type(s) of work 

performed by Applicant’s subcontractors, Original and Final Contract Price, 

Original and Final Contract Time and claim information. 

Where indicated, Applicant may elect to demonstrate the required project 

experience by Applicants’ proposed subcontractor. If certain types of work are 

to be performed by Applicants’ proposed subcontractor, then one or more 

subcontractors’ demonstrated experience must be submitted with Applicants’ 

SOQ. If deemed qualified for the Project, Applicant is required to provide Notice 

prior to bid if there a change in Applicants’ subcontractor(s) submitted in 

response to this RFQ. 

Specified project experience that must be demonstrated includes: 

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a. Prospective Applicants shall demonstrate that they have completed at 

least 1 similar construction project of a raw water intake with a capacity of 

at least 10 MGD in the continental U.S. within the last 10 years. 

Additionally, the prospective Applicants shall demonstrate the completion 

of at least 3 similar construction projects of pumping stations of at least 

20 MGD (firm capacity) each in the continental U.S. within the last 10 

years. The project experience shall include electrical distribution systems 

using 4160V power. The projects should demonstrate similar experience 

regarding performance requirements, including material and associated 

labor. 

b. Prospective Applicants or prospective Applicants’ subcontractors shall 

demonstrate that they have successfully completed construction of 3 

tunnels and deep shafts within the last 10 years. Minimum tunnel length 

shall be no less than 100 feet and minimum diameter shall be no less than 

10 feet. Minimum deep shaft depth shall be no less than 50 feet and 

minimum diameter shall be no less than 20 feet. 

c. Prospective Applicants or prospective Applicants’ subcontractors shall 

demonstrate they have successfully completed construction of 3 coffer 

dam projects within the past 10 years. 

d. Prospective Applicants or prospective Applicants’ subcontractors shall 

demonstrate that they have successfully completed 3 projects within the 

last 10 years installing at least 500 linear feet of water main of 36-inch 

diameter or greater per project. 

e. Prospective Applicants or prospective Applicants’ subcontractors shall 

demonstrate total project experience of at least 1,000 linear feet of 

completed tunnel(s) through hard rock with minimum rock strength of 25 

ksi (~170 MPa) using blasting as the method of rock excavation. 

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