RD2.6 PREQUALIFICATION EVALUATION, PASS/FAIL
(see [I]:4.3.2)

FOR UNIVERSITY USE ONLY
Do Not Issue to Contractor

{PROJECT NAME}

Project Number: { }

________________________________________________________________
(Contractor Name)

Prequalification Summary:

Prequalified: _____

Not Prequalified:_____

If not prequalified, list prequalification questionnaire item numbers upon which decision is based:

____________________________________________________________

____________________________________________________________

Signature of Evaluators:

1. ____________________________________________________________

2. ____________________________________________________________

3. ____________________________________________________________

Instructions: Complete this Prequalification Evaluation in conjunction with the Prequalification Questionnaire. Circle "NOT PREQUALIFIED" where applicable.

  1. License

      a. Current and in good standing?

      If answer is NO. . . NOT PREQUALIFIED

      b. Suspended or revoked?

      If answer is YES . . .NOT PREQUALIFIED

  2. Construction Experience

    1. {NUMBER}, {TYPE} projects greater than ${ }?
      If answer is NO. . .NOT PREQUALIFIED

  3. Financial Data
    1. ${ } credit available?

      If answer is NO. . . NOT PREQUALIFIED

      If answer is YES, but verifying letters are not submitted
      or are not for the required amount. . . NOT PREQUALIFIED

  4. Safety

    1. EMF rate lower than { }?

      If answer is NO. . . NOT PREQUALIFIED

      If answer is YES, but verification is not submitted or is
      greater than UC-determined factor . . . NOT PREQUALIFIED

    2. Has written IIPP that complies with Title 8?

      If answer is NO. . . NOT PREQUALIFIED

      If answer is YES, but a copy of the written program is not submitted . . . NOT PREQUALIFIED

    3. Safety personnel to be assigned?

      If answer is NO. . .NOT PREQUALIFIED

  5. Claims History

    1. For each project. If ratio of asserted claims (5a[6])
      to successful claims (5a[7]) is more than {RATIO} . . . NOT PREQUALIFIED

      For sum of all projects. If ratio of the sum of asserted
      claims (5a[6]) to the sum of successful claims (5a[7])
      is more than {RATIO} . . . NOT PREQUALIFIED

  6. Surety

    1. Contracts taken over by surety?
      If surety took over any construction contracts for contractor . . . NOT PREQUALIFIED

    2. Name of surety:
      If not provided . . .NOT PREQUALIFIED

    3. Able to obtain bonding?
      If answer is NO. . . NOT PREQUALIFIED

      If answer is YES, but a notarized declaration is not submitted or does not meet the required bonding amount . . . NOT PREQUALIFIED

  7. Insurance

    1. Firm able to obtain insurance?

      If answer is NO. . . NOT PREQUALIFIED

      If answer is YES, but notarized declarations are not submitted . . . NOT PREQUALIFIED

      If answer is YES, but a written program is not submitted . . . NOT PREQUALIFIED

  8. Staff Experience

    1. This category is for information only. The firm should commit a person now and should not recruit someone later.

  9. Quality Assurance

    1. Has written program?

      If answer is NO. . . NOT PREQUALIFIED

      If answer is YES, but a written program is not submitted . . . NOT PREQUALIFIED

  10. Prior Disqualification

    1. If formal disqualification by UC is still active . . . NOT PREQUALIFIED

    2. If formal disqualification by another contracting entity is still active . . . NOT PREQUALIFIED

  11. Contractor's Comments

    Review as required.

Back to Table of Contents

Back to Index of Models