PDFWAC 468-15-040

Contractors questionnaire form—Information required.

Contractors desiring to be included on a small works roster established by Washington state department of transportation pursuant to RCW 39.04.155, shall submit a completed small works roster questionnaire on a form prescribed by the secretary of transportation. Copies of the form may be obtained from the department's contract ad and award office. The completed questionnaire shall be prepared and transmitted to the secretary, attention: Contractor prequalification office. The questionnaire shall include the following information:
(1) The contractor's name, address, telephone number, fax number, email address, and type of organization (corporation, partnership, sole proprietorship, etc.);
(2) A statement of ownership of the firm and, if a corporation, the name of the parent corporation, if any, and the names of any affiliated or subsidiary companies;
(3) State contractor's license number;
(4) State of Washington unified business identifier number (UBI) and UBI expiration date;
(5) Federal tax ID number;
(6) List of classes of work as enumerated on the form that the firm desires to be considered for such work class;
(7) Indication of those counties in which the contractor is interested in being considered for small works projects;
(8) Indication whether the contractor is certified as a minority or women's business enterprise or a disadvantaged business enterprise by the office of minority women business enterprises;
(9) List all contracts or subcontracts performed in whole or in part within the immediate three preceding years. Include the contract amount, date of completion, classes of work performed, owner or prime contractor's name, mailing address, phone number, fax number, and name of a contact person for the owner/prime for which the contractor performed the work. Only that work completed by the contractor's own organization under its own supervision will be considered for qualification. A minimum three completed projects must be listed.
(a) Personnel requirements.
(i) List principal officers and key employees indicating their years of experience in the classes of work for which qualification is sought.
(ii) A firm must have, within its own organization, qualified permanent, full-time personnel having the skills and experience including, if applicable, technical or specialty licenses, for each work class for which qualification is sought. Those firms seeking qualification for electrical work (classes 9, 16, 41, and 42) must provide photocopies of current Washington state electrical licenses. The skills and experience must be substantiated by education and practical experience on completed construction projects.
(iii) "Its own organization" shall be construed to include only the contractor's permanent, full-time employed office and site supervisory personnel. Workers of the organization shall be employed and paid directly by the prime contractor.
(b) The applicant shall list the following occurrences within the previous three years:
(i) Instances of having been denied qualification, or a license, or instances of having been deemed other than responsible by any public agency.
(ii) Convictions for felonies listed in WAC 468-16-050.
(iii) Failure to complete a contract.
(c) The small works roster questionnaire shall be processed as follows:
(i) A small works roster questionnaire will be reviewed and a written notice provided to the applicant, within thirty days of its receipt, stating whether or not the applicant has qualified for or been denied qualification for the small works roster. The applicant will be advised of lack of receipt of data corroborating project completion and error or omissions in the questionnaire and a request for additional information necessary to complete the evaluation of the applicant. If the information is not provided within twenty calendar days of the request, the application will be processed, if possible, with the information available or it will be returned to the applicant without further action.
(ii) The department will enter the contractor's information on the appropriate small works roster. The department will notify the contractor by letter of placement on the appropriate small works roster. An applicant should not consider itself enrolled on the small works roster until receipt of such written notice.
It is the responsibility of the contractor to notify the department of any incorrect information set forth in the notice, and to notify the department of any change in the information set forth in its application.
[Statutory Authority: RCW 39.04.155, 47.01.101, 47.28.030. WSR 06-24-118, § 468-15-040, filed 12/6/06, effective 1/6/07. Statutory Authority: RCW 47.01.101, 39.04.155. WSR 03-03-012, § 468-15-040, filed 1/7/03, effective 2/7/03.]