Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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REQUEST FOR QUALIFICATIONS (RFQ) FOR:
P
LANNING & DESIGN SERVICES FOR HYDROGEN
INFRASTRUCTURE & FACILITY MASTER PLAN
RFQ NO. 12502218
SCHEDULED DEADLINE:
MONDAY, JUNE 16, 2025
POINT OF CONTACT: ORIE RUBALCAVA
[email protected]
(559) 621-1 573
Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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TABLE OF CONTENTS
P age #
DIVISION I – INTRODUCTION ...............................................................................i Notice Inviting Proposals .......................................................................................ii Instructions to Proposers .......................................................................................iv D
IVISION II – BIDDING AND CONTRACT DOCUMENTS .....................................1 Business License Information ...............................................................................4 Proposer’s Qualification Questionnaire .................................................................5 References ............................................................................................................7 Acceptance of Indemnification & Insurance Requirements ...................................8 DBE Listing ...........................................................................................................9 Debarment & Suspension Certification ..................................................................11 Nonlobbying Certification ......................................................................................12 Federal Tax Liability & Felony Conviction Certification ..........................................13 Disclosure of Conflict of Interests ..........................................................................14 DOE Certification Form .........................................................................................15 Sample Service Contract .......................................................................................16 Cost Proposal Instructions ....................................................................................18 D
IVISION III – GENERAL CONDITIONS ................................................................20 AP
PENDICES
Appendix A – Special Conditions
Appendix B – Insurance Requirements
Appendix C – Federal Conditions
Appendix D – Statement of Work
AT
TACHMENT
Attachment A – Sample Cost Proposal
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DIVISION I – INTRODUCTION
Summary:
Division I introduces the proposer to a brief description of the work to be accomplished and instructions on how proposals are to be submitted to the City.
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N
OTICE INVITING PROPOSALS
S
ealed proposals or electronic proposals via Planet Bids will be received at the office of the Projects Administrator of the City of Fresno, 2223 G Street, Fresno, CA 93706, all in accordance with the Specifications for:
RE
QUEST FOR QUALIFICATIONS FOR
COMPREHENSIVE PLANNING SERVICES FOR HYDROGEN INFRASTRUCTURE &
FACILITY MASTER PLAN
REQUEST FOR QUALIFICATIONS NO. 12502218
T
he City of Fresno Department of Transportation/FAX (hereinafter (“FAX”) is soliciting proposals from qualified contractors for Planning Services.
T
he RFQ forms and specifications may be obtained from the Office of th e Projects Administrator (phone 559- 621-1537) via the City’s website: www.fresno.gov, click on “Business” (at the top of the screen), then “Bid Opportunities” under the “Doing Business” section.
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roposals may be submitted electronically via Planet Bids or by paper only.
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roposals are to be submitted to the Projects Administrator of the City of Fresno, 2223 G Street, Fresno, CA 937 06 or electronically using Planet Bids prior to the deadline at 3 p.m. on Monday, June 16, 2025.
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re-Proposal Conference
A
pre-proposal conference will be held at 2223 G Street, Fresno, CA 93706 and virtually on May 14, 2025 at 1:00 PM. The meeting will be held virtually at Join the meeting now Meeting ID 271 591 038 616 4. Participants can also dial in at +1 323- 676- 6164,,243742495#. Prospective Proposers are encouraged to attend. City Staff will be present to answer any questions regarding the Specifications and provide a tour of the job site.
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ll proposals must be made on the proposal forms provided by FAX.
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he City of Fresno hereby notifies all Proposers that no person shall be excluded from participation in, denied any benefits of, or otherwise discriminated against in connection with the award and performance of any contract on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation or on any other basis prohibited by law.
T
his contract is funded in part by grants from the Federal Transit Administration (FTA) of the United States Department of Transportation. The award of any contract is subject to the requirements of financial assistance contracts between the City of Fresno and the U.S. Department of Transportation.
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Although there is no specific goal or requirement to use participation by Disadvantage d Business Enterprises (DBE) for this project, The City of Fresno highly encourages the participation of Disadvantaged Business Enterprises (DBE). The City of Fresno encourages all prime Contractors to utilize qualified SBE (Small Business Enterprise) sub-Contractors on the City of Fresno projects and promotes the direct purchase of goods from qualified SBEs by utilizing SBE/DBE vendors when such vendors are available and the price of the goods or services sought is reasonable.
The Contractor is required to comply with all terms and conditions prescribed for third- party contracts by the U.S. Department of Transportation, Federal Transit Administration (FTA). If FTA requires any change to this Contract to comply with its requirements, both parties agree to amend the Contract as required by FTA. If such changes cause an increase or decrease in the work to be performed by the Contractor or the time for such performance, then the compensation to be paid the Contractor and time of perf ormance shall be equitably adjusted.
The City of Fresno reserves the right to reject any and all proposals.
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INSTRUCTIONS TO PROPOSERS
FOR
PLANNING SERVICES FOR
HYDROGEN INFRASTRUCTURE & FACILITY MASTER PLAN
REQUEST FOR QUALIFICATIONS NO. 12502218
1) No proposal will be considered for award unless it is submitted on the proposal forms furnished by the Projects Administrator, completely filled out, properly signed by the Proposer and delivered, under sealed cover plainly marked or submitted electronically via Planet Bids before the date and time specified in the Notice Inviting Proposals. The time clock on Planet Bids will be the official clock for documenting the time of filing. Electronically filed is defined as by means of electronic equipment or devices. In the event that both a paper and electronic proposal for the same project are submitted, the City will use and accept the electronic version as the authorized submittal
2) The City will award a Contract or reject any or all proposals within the time stated in the Specifications, and no proposal may be withdrawn within that period of time.
Any award of a Contract exceeding $10 0,000 shall be subject to the approval of the City Council.
3) The City reserves the right to reject any and all proposals.
Submittal of Proposal
4) Each Proposer shall carefully examine each and every term of this Request for Qualifications; and each Proposer shall judge all the circumstances and conditions affecting its proposal. Failure on the part of any Proposer to make such examination and to investigate thoroughly shall not be grounds for any declaration that the Proposer did not understand the conditions of this Request for Qualifications.
5) The Proposer shall comply with any and all federal, state or local laws, now in effect or hereafter promulgated, which apply to the services and products herein specified.
6) Proposers will submit an original proposal in a sealed envelope, marked on the outside RFQ No. 12502218 and will include the name of the Proposer and the date and time of proposal submittal deadline. If proposals are submitted electronically, hard copies are not applicable.
7) This solicitation for proposals does not commit the City of Fresno to enter into a Contract or to pay any costs incurred in the preparation of responses to the request. The City of Fresno reserves the right to accept or reject any proposals, and to negotiate with any qualified source, or to cancel in part or in its entirety this Request for Qualifications. It may accept the proposal that it considers to be in the Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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interest of the City of Fresno, with or without negotiation.
8) The City reserves the right to waive any informality or minor irregularity when it is in the best interest of the City to do so, to negotiate for the modification of any proposal with mutual consent of the Proposer, to re- advertise for proposals if desired, and to accept the proposal which in the judgment of the City, even though it does not offer the lowest cost, is nevertheless deemed to offer the best value for the public and City. Any proposal which is incomplete, conditional, obscure, or which contains irregularities of any kind, may be cause for rejection.
9) The proposals received shall become the property of the City of Fresno and are subject to public disclosure. Those parts of a proposal which are defined by the Proposer as business or trade secrets as that term is defined in California Evidence Code, Sect ion 3426.1, and are reasonably marked "Trade Secrets", "Confidential", or "Proprietary", and placed in a separate envelope shall only be disclosed to the public if such disclosure is required or permitted under the California Public Records Act or otherwise by law. Proposers who indiscriminately and without justification identify most or all of their proposal as exempt from disclosure may be deemed non- responsive. Proposals, excluding confidential information, will be available for review after posting of staff recommendation.
Minimum Qualifications
The firm must be licensed to do business in the State of California.
Brooks Act
Proposers are put on notice that this solicitation is subject to 40 U.S.C 1101- 1104 (“Brooks Act”) and qualification-based procurement procedures will be used to determine the most qualified offeror. T he Selection Committee shall attempt to negotiate fair and reasonable compensation with the most highly qualified firm. If the Selection Committee is unable to negotiate a satisfactory contract with the firm, the Selection Committee shall formally terminate negotiations and then undertake negotiations with the next most qualified of the selected firms, continuing the process until an agreement is reached. If the Selection Committee is unable to negotiate a satisfactory contract with any of the selected firms, the Selection Committee shall select additional firms in order of their competence and qualification and continue negotiations in accordance with this section until an agreement is reached.
In accordance with 2 CFR 200.324, to establish fair and reasonable compensation, each element of cost (that is, labor hours, overhead, materials, and so forth) will be examined.
Profit shall be negotiated as a separate element and will be based on the complexity of the work to be performed, the risk borne by the contractor, the contractor's investment, the amount of subcontracting, the quality of its record of past performance, and industry profit rates in the surrounding geographical area for similar work.
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Lastly, the requirements to 49 U.S.C. § 5325(b)(2) apply and require that (1) third party contract or subcontract must be performed and audited in compliance with FAR part 31 cost principles, (2) third party contractor and its subcontractors, if any, must accept FAR indirect cost rates for the one- year applicable accounting periods established by a cognizant Federal or State government agency, if those rates are not currently under dispute, and (3) after a firm’s indirect cost rates established as described above are accepted, those rates will apply for purposes of contract estimation, negotiation, administration, reporting, and payments, and will not be limited by administrative or de facto ceilings.
Selection Process and Evaluation Criteria
Proposal Evaluation
The City will establish a selection committee to score proposals based on the evaluation criteria stated herein.
The Selection Committee will review and evaluate all proposals after formal receipt. To receive proper consideration, the proposal must meet the requirements of these Specifications. The evaluation process will provide credit only for those capabilities and advantages which are clearly stated in the Proposer's written proposals. In other words, advantages which are not stated will not be considered in the evaluation process.
Proposers whose proposals include a failure to comply with or take exception to these Specifications may be considered nonresponsive and dropped from the evaluation process.
The Selection Committee will evaluate the proposals based upon three categories (in order of relative importance):
a. Presentation on Approach to Work
After proposals are opened, each proposer will be scheduled for an in- person or virtual presentation to describe their approach to the Statement of Work and the benefits to the proposed approach . Any proposer who does not provide a presentation will be found non-responsive.
b. Qualifications of Key Personnel
Technical experience in performing work of a closely similar nature; experience working with public agencies; experience in proving specifically this type of service, strength and stability of the firm; strength, stability, experience, and technical competence of sub- consultants; assessment by client references; references with demonstrated success in providing similar services.
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c. Past Performance and Experience
What is the Contractor’s experience and history in planning services for hydrogen infrastructure and Facility Master Plans relevant to FAX’s needs, including a description of direct experience on projects of similar size, scope, complexity , and references?
d. References
The Proposer shall provide a minimum of three (3) references. For each reference, provide the agency name, address, contact person, telephone number and email address. FAX reserves the right to contact references provided by the Proposer and solicit additional references to determine best value.
The City reserves the right to accept or reject any or all proposals and may select, and negotiate with one or more Proposers concurrently, and enter into a Contract with such Proposer who is determined, by the City, to provide the services which are in the interest of the City. The City may agree to such terms and conditions as it may determine to be in its interest.
The Selection Committee reserves the right to request additional information from Proposers, to negotiate terms and conditions of the Contract, to visit sites, to request demonstrations or oral presentations, to establish a competitive range, or ask Proposers to appear before the Selection Committee to clarify points of their proposal.
Selection will be based on qualitative analysis and cost. Any award shall be on the basis of the criteria specified and made to the Proposer whose proposal is judged as providing the best value in meeting the interest of the City and the objectives of the project.
The City reserves the right to make the selection of a Proposer , at its sole discretion, based on any or all factors of value, whether quantitatively identifiable or not, including, but not limited to, the anticipated initiative and ability of the Proposer to perform the services set forth herein.
Prevailing Wage
Work hereunder constitutes a “public work” as defined in Chapter 1, Part 7, Division 2 of the California Labor Code, and Contractor shall cause the work to be performed as a “public work” in accordance with such Chapter of the California Labor Code. The Council of the City of Fresno has adopted Resolution No. 82-297 ascertaining the general prevailing rate of per diem wages and per diem wages for holidays and overtime in the Fresno area for each craft, classification, or type of worker needed in the executi on of Contracts for the City. Information specific to the Work to be done under this Contract can be obtained by contacting the Contract Coordinator.
This project is being funded with federal funds administered by the Federal Transportation Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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Authority. This project is subject to the payment of predetermined minimum wages mandated by the Davis-Bacon Act of 1931.
Pre-Proposal Conference
A pre-proposal conference will be held at 2223 G Street, Fresno, CA 93706 and virtually on May 14, 2025 at 1:00 PM. The meeting will be held virtually at Join the meeting now Meeting ID 271 591 038 616 4. Participants can also dial in at +1 323- 676- 6164,,243742495#. Prospective Proposers are encouraged to attend. City Staff will be present to answer any questions regarding the Specifications and provide a tour of the job site.
Time to Award
The Proposer agrees that the City may have ONE HUNDRED SIXTY (160) DAYS to accept or reject proposals. It is further understood that, if the Proposer to whom any award is made fails to enter into a Contract as provided in the Specifications, award may be made to another Proposer, who shall be bound to perform as if she/he had received the award in the first instance.
Contract Documents
The proposer shall submit the required contract documents in a form acceptable to FAX at 2223 G Street, Fresno CA 93706 within 15 calendar days (except in the event federal funding is applicable to the Contract, then 10 working days) from the Notice of Award of proposal. Failure to provide said documents within the designated period shall be sufficient cause to find the pr oposal non- responsive and move to award to the next proposer offering the next best value to the City.
Questions, Clarifications and Concerns
The Specifications describing this project have been carefully prepared. Any questions or concerns relating to these Specifications shall be directed in writing via Planet Bids or e-mail to [email protected]. Please include the proposal file number and the title of the project in the subject heading of your e-mail.
Questions will be accepted only up to 5 working days prior to the proposal opening date to allow the City, if necessary, to issue an addendum to all proposals stating revisions, deletions, or additions to be made to the Specifications as a result of any questions. If questions arise after the deadline, please contact the designated FAX, but the City will not guarantee a response.
The City will not be responsible for verbal responses made by parties other than FAX or designee.
Any questions concerning Disadvantaged Business Enterprise (DBE) issues shall Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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be addressed to DBE Program staff at telephone n o. (559) 621-1154 or email at [email protected].
Regulated Communications In City Procurement Process Ordinance
The Regulated Communications in City Procurement Process Ordinance ( Chapter 4, Article 6 of the Fresno Municipal Code) became effective May 7, 2004. With certain specified exceptions, the Ordinance provides that no Respondent, Bidder, Proposer (as the case may be) shall initiate, engage in, or continue any communication to or with a ny City elected official concerning or touching upon any matter which is the subject of this competitive procurement process.
Any Respondent, Bidder, Proposer or elected official (as the case may be) who initiates, engages in, continues in, or receives any regulated communication shall file the written disclosure required by the Regulated Communications in City Procurement Proces s Ordinance.
Any Respondent, Bidder, or Proposer violating the Regulated Communications in City Procurement Process Ordinance may be disqualified from participating in this procurement process and/or determined to be non-responsible. Additionally, the City may set aside the award of a contract, prior to its execution, to a party found to have violated the Ordinance.
Note: The full text of Fresno Municipal Code, Chapter 4, Article 6 may be viewed on the City’s website at, http://www.fresno.gov. Under Departments , “City Clerk” - Fresno Municipal Code- Or view the Fresno Municipal Code directly at https://library.municode.com/ca/fresno/codes/code_of_ordinances?nodeId=MUCOFR_C H4CIPUCOSA_ART6RECOELOFPRPR
Debarment
A Proposer may be debarred from bidding or proposing upon or being awarded any contract with the City, or from being a subcontractor or supplier at any tier upon such contract, in accordance with the procedures in Fresno Municipal Code Section 4- 104 adopted by Council on May 17, 2018. The initial period of any such debarment shall not be less than one year and may be permanent depending on the violation. A Proposer may request a hearing, in accordance with Fresno Municipal Code Section 4- 104, upon receipt of a notice of proposed debarment from the City Manager or designee. A copy of the Ordinance may be obtained from the City Clerk’s Office, 2600 Fresno Street, Fresno, California 93721.
Outreach To Small Business Enterprises In Subcontracting
The City of Fresno hereby notifies all Proposers that it is the City's policy to provide all small business enterprises, including minority, women, and disabled veteran business enterprises, equal access and opportunity for participation in the performance of all Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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construction contracts, professional service contracts, procurement of supplies, equipment and other services. Therefore, the City requests that a Proposer who intends to subcontract a portion of the work seek out small business enterprises that are potential subcontractors, suppliers, or consultants, and actively solicit their interest, capability, and prices.
Furthermore, the City of Fresno hereby notifies all Proposers that it will affirmatively ensure that in any contract entered into pursuant to this advertisement, minority business enterprises will be afforded full opportunity to submit proposals in response to this invitation and will not be discriminated against on the grounds of race, color, sex, national origin, religion, age, or disability in consideration for an award.
Proposers are advised that, as required by federal law, the City of Fresno is implementing new Disadvantaged Business Enterprise requirements for Disadvantaged Business Enterprises (DBE). The national goal for participation of Disadvantaged Business Enterprises (DBE) is 10%. The agency’s overall goal for DBE participation is 3.4%. No goal has been established for this contract.
ACH Payment Initiative - Electronic Payment
Proposer shall provide complete and accurate billing invoices in order to receive payment.
Billing invoices submitted must contain all information and supporting documentation required by the contract. Payment for invoices submitted by the proposer shall only be rendered electronically unl ess payment by paper check is expressly authorized by the Controller, in the Controller’s sole discretion, due to extenuating circumstances. Such electronic payment shall be made in accordance with ordinary City procedures and practices. The proposer shall comply with the Controller’s procedures to authorize electronic payments. Proposer acknowledges that it will not receive payment on any invoices submitted under this Contract if it does not comply with the Controller’s electronic payment procedures, except where the Controller has expressly authorized payment by paper check as set forth above.
ADA
Accessibility Requirements: Supplier warrants that it complies with California and federal disabilities laws and regulations; and the Services will conform to the accessibility requirements of WCAG 2.0AA. Supplier agrees to promptly respond to and resolve any complaint regarding accessibility of its Services. The City may require proposer to comply with these accessibility requirements if they are awarded a contract.
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DIVISION II – BIDDING AND CONTRACT
DOCUMENTS
Summary:
Division II provides the proposer with a checklist and required documentation to be submitted with their proposal.
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PROPOSER’S NAME: _____________________
(Submit with Proposal)
PROPOSER’S CHECKLIST
Proposals shall be submitted in a three- ring binder, one (1) original. (If submitted electronically, hard copies are not applicable). The total proposal packet must be sealed and clearly marked on the outside RFQ No. 12502218.
Proposers are requested to submit this Checklist and the following information, providing the content in the sequence shown below. If the documentation provided is incomplete, the Proposer may be ineligible for award of a Contract.
REQUIRED
[X] 1. BUSINESS LICENSE INFORMATION, page 4
[X] 2. PROPOSER’S QUALIFICATION QUESTIONNAIRE, pages 5-6 [X] 3. REFERENCES, page 7
[X] 4. ACCEPTANCE OF INDEMNIFICATION & INSURANCE REQUIREMENTS, page 8 [X] 5. DBE LISTING, pages 9-10
[X] 6. DEBARMENT AND SUSPENSION CERTIFICATION, page 11
[X] 7. NONLOBBYING CERTIFICATION, page 12
[X] 8. FEDERAL TAX LIABILITY & FELONY CONVICTION CERTIFICATION, page 13 [X] 9. DISCLOSURE OF CONFLICT OF INTEREST, page 14
[X] 11. DOE CERTIFICATION FORM, page 15
[ ] 12. SAMPLE SERVICE CONTRACT, pages 16-17
[ ] 13. PRE-PROPOSAL CONFERENCE (See Instructions to Proposers, pg. ii for details) [X] 14. ADDENDA - Signature page of all Addenda issued, Addenda No. to . (Enter numbers if applicable)
FOR THE MOST QUALIFIED PROPOSER ONLY
[_] 15. COST PROPOSAL INSTRUCTIONS, pages 18 - 19
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PROPOSER’S NAME: _____________________
(Submit with Proposal)
ADDENDA
The City makes a concentrated effort to ensure any addenda issued relating to these Specifications are distributed to all interested parties. It shall be the Proposer's responsibility to inquire as to whether any addenda to the Specifications have been issued. Upon issuance by the City, all addenda are part of the proposal. Signing the proposal on the signature page thereof shall als o constitute signature on all addenda.
TIME PERIOD TO AWARD/REJECT
The undersigned Proposer agrees that the City may have ONE HUNDRED SIXTY (160) DAYS from the date proposals are opened to accept or reject proposals. It is further understood that, if the Proposer to whom any award is made fails to enter into a Contract as provided in the Specifications, award may be made to another Proposer, who shall be bound to perform as if she/he had received the award in the first instance.
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PROPOSER’S NAME:
(Submit with Proposal)
BUSINESS LOCATION
( ) The undersigned Proposer does not maintain a place of business in the City of Fresno.
( ) The undersigned Proposer maintains a place of business in the City of Fresno at: , Fresno, CA
BUSINESS LICENSE
( ) The undersigned Proposer has a current City of Fresno Business License and the number is
If the successful proposer does not have a City of Fresno Business License, he/she shall obtain such a license prior to the issuance of a Notice to Proceed for the Work and maintain in effect throughout the term of this Contract.
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PROPOSER’S NAME:
(Submit with Proposal)
PROPOSER QUALIFICATION QUESTIONNAIRE
REQUEST FOR QUALIFICATIONS FOR
PLANNING & DESIGN SERVICES FOR
HYDROGEN INFRASTRUCTURE & FACILITIES MASTER PLAN
REQUEST FOR QUALIFICATIONS NO. 12502218
TO: FRESNO AREA EXPRESS
The undersigned Proposer submits the following information in accordance with the proposal Specifications:
(Use additional sheets as needed.)
1. a. Business Name (If using more than one business name, please list all names.):
_______________________________________________________________ _______________________________________________________________ _______________________________________________________________
b. Address: _______________________________________________________
Is your firm operating as a franchisee? Yes_________ or No ________
If yes, list the franchiser, and number of years your business has been franchised:
_______________________________________________________________ _______________________________________________________________
2. Provide the names, titles, qualifications, years of experience, and years with your firm, for all key personnel in authority in your business, including the key personnel that will be involved in this project, and the extent to which they will be involved in the performance of this Contract.* __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
3. How many years has your business been established? ______________________
How many years has your business been under your present name? __________
How many years under former names? (List name and number of years) __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
4. How many years has your business been providing relevant services? _________
5. What other types of services does your business provide? __________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
6. Do you have any affiliated companies? (If parent company, list subsidiaries and divisions. If subsidiary or division, name parent company, its principals and their addresses):
__________________________________________________________________ Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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__________________________________________________________________ __________________________________________________________________
PROPOSER QUALIFICATION QUESTIONNAIRE (Continued)
REQUEST FOR QUALIFICATIONS FOR
PLANNING & DESIGN SERVICES FOR HYDROGEN INFRASTRUCTURE
REQUEST FOR QUALIFICATIONS NO. 12502218
7. Have there been any contract terminations for the services, relevant or otherwise, your firm performs before the fulfillment of the contract within the past three years? Yes______ or No _________
If so, list the date, client, and reason for termination below:
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
8. Provide an organization chart, indicating full-time personnel, job titles, locations, and whether each individual works out of an office or is in the field. Organization chart attached? Yes _____ or No ____
9. Outline your support services including establishing direct lines of communication between City technical staff and the program manager. *
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
10. Submit a comprehensive plan for addressing the requirements per Appendix D - Statement of Work.
__________________________________________________________________ __________________________________________________________________ __________________________________________________________________
*Provide attachments as needed to accommodate responses.
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PROPOSER’S NAME:
(Submit with Proposal)
REFERENCES
Please list at least three references of similar size and type of services, including governmental agencies, if available.
1.AGENCY/COMPANY
NAME:________________________________________________________________________ ADDRESS:____________________________________________________________________ CONTACT PERSON: _____________________________ EMAIL _________________________ PHONE NUMBER: ________________ LENGTH OF CONTRACT: ________________YEARS TYPE OF SERVICES PROVIDED: ____________________________________________________
2.AGENCY/COMPANY
NAME:________________________________________________________________________ ADDRESS:____________________________________________________________________ CONTACT PERSON: _____________________________ EMAIL_________________________ PHONE NUMBER: ________________ LENGTH OF CONTRACT: ________________YEARS TYPE OF SERVICES PROVIDED: ____________________________________________________
3.AGENCY/COMPANY
NAME:________________________________________________________________________ ADDRESS:____________________________________________________________________ CONTACT PERSON: _____________________________ EMAIL_________________________ PHONE NUMBER: ________________ LENGTH OF CONTRACT: ________________YEARS TYPE OF SERVICES PROVIDED: ____________________________________________________
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PROPOSER’S NAME:
(Submit with Proposal)
STATEMENT OF ACCEPTANCE OF THE INDEMNIFICATION
AND INSURANCE REQUIREMENTS
REQUEST FOR QUALIFICATIONS FOR
PLANNING & DESIGN SERVICES FOR HYDROGEN INFRASTRUCTURE & FACILITY MASTER PLAN
REQUEST FOR QUALIFICATIONS NO. 12502218
The Proposer shall sign below that the Proposer accepts in whole the Indemnification and Insurance Requirements set forth in these Specifications. If the Proposer takes exception to some portions, those portions shall be listed here below and the Proposer shall sign that the Proposer accepts all portions of the requirements not listed.
Note: Any exceptions may render the proposal non-responsive.
[ ] ACCEPT
[ ] DO NOT ACCEPT
If "DO NOT ACCEPT" is checked, please list exceptions:
Signature of Authorized Person
Type or Print Name of Authorized Person
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PROPOSER’S NAME: _____________________
(Submit with Proposal)
DISADVANTAGED BUSINESS ENTERPRISES (DBE) LISTING
Bidders are advised that, as required by federal law, the City is required to report to the Federal Transit Administration on DBE participation for all Federally aided contracts each year so the attainment efforts may be evaluated.
The proposal will be considered non-responsive if this form is not fully completed.
Complete all information below (whether DBE or not) and list all Subcontractor information including, without limitation, DBE’s that will perform any portion of the work or provide any products for this project, even if the dollar amount of the work the DBE will perform is less than one half (½) of one percent (1%) of the total bid amount.
Prime Contractor:
Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
Subcontractors: ☐ Check as N/A if a subcontractor(s) will not be used Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City: _______________________________ State: _______________ Zip Code: _________________ Check one: ☐ DBE or ☐ Non-DBE DBE Cert Number: _______________________ Race of firm’s majority owner: __________________________________________________________ Gender of firm’s majority owner: ________________________________________________________ NAICS code(s) (applicable to each scope of work the firm seeks to perform in its bid): ☐ Check if N/A __________________________________________________________________________________ Age of firm: _________________________________________________________________________ Annual Gross: ☐ less than $1 million ☐ $1-3 million ☐ $3-6 million ☐ $6-10 million ☐ over $10 million
NOTE: Use additional sheets if necessary Revised 10/16/24
Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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PROPOSER’S NAME:
(Submit with Proposal)
DEBARMENT AND SUSPENSION CERTIFICATION
Contractor and all subcontractors shall meet debarment, suspension, ineligibility, and voluntary exclusion requirements pursuant to Executive Order 12549. See Federal Requirements, of these Specifications. A list of excluded parties may be found at the following website:
https://sam.gov/content/home
Contractor shall return with its Proposal this form.
Note: Providing false information may result in criminal prosecution or administrative sanctions.
Date _________________________________________________________ Signature______________________________________________________ Company Name_________________________________________________ Title __________________________________________________________
Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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PROPOSER’S NAME:
(Submit with Proposal)
NONLOBBYING CERTIFICATION
LOBBY RESTRICTIONS
Certification for Contracts, Grants, Loans, and Cooperative Agreements (To be submitted with each bid or offer exceeding $100,000) The undersigned [Contractor] certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
__________________________ Signature of Contractor's Authorized Official __________________________ Name and Title of Contractor's Authorized Official __________________________ Date
Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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PROPOSER'S NAME___________________________
(Submit with Bid Proposal)
Federal Tax Liability and Recent Felony Convictions Certification
FTA Master Agreement Section 4(g)
The undersigned [Contractor] certifies, to the best of his or her knowledge and belief, that they and their organization:
1. Does not have any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and
2. Was not convicted of felony criminal violation under any Federal law within the preceding 24 months.
The Contractor agrees to flow this requirement down to participants at all lower tiers, without regard to the value of any sub-agreement.
Date __________________________________________________________
Signature_______________________________________________________
Company Name__________________________________________________
Title ___________________________________________________________
Planning & Design Services for Hydrogen Infrastructure & Facility Master Plan, Request for Qualifications No. 12502218
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DISCLOSURE OF CONFLICT OF INTEREST
YES* NO
1 Are you currently in litigation with the City of Fresno or any of its agents?
2 Do you represent any firm, organization, or person who is in litigation with the City of Fresno?
3 Do you currently represent or perform work for any clients who do business with the City of Fresno?
4 Are you or any of your principals, managers, or professionals, owners or investors in a business which does business with the City of Fresno, or in a business which is in litigation with the City of Fresno?
5 Are you or any of your principals, managers, or professionals, related by blood or marriage to any City of Fresno employee who has any significant role in the subject matter of this service?
6 Do you or any of your subcontractors have, or expect to have, any interest, direct or indirect, in any other contract in connection with this Project?
* If the answer to any question is yes, please explain in full below.
Explanation:
Signature
Date
Name
Company
Address