Request for Qualifications

To Provide

Construction Management-at-Risk Services

Step 1

25 Block Renovation – Annex Façade Redesign

Georgia State University , Georgia

GSU Project No. 081-069-15

Solicitation Issue Date: July 31, 2015

Qualifications Submittals Due: August 28, 2015 at 4:00 PM

Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

GEORGIA STATE UNIVERSITY

REQUEST FOR QUALIFICATIONS

Construction Management-at-Risk Services

Step 1

25 Park Place Block Renovation – Annex Façade Redesign

GSU Project No. 081-069-15

1. GENERAL INFORMATION

Georgia State University (“GSU”, “Owner”), a representative of the Board of Regents of the University System of Georgia, is soliciting statements of qualifications from firms interested in providing Construction Management-at-Risk (“CM/GC”) services for the project known as 25 Park Place Block Renovation – Annex Façade Redesign, Project #081-069-15. This Request for Qualifications (“RFQ”) seeks to identify potential providers of the above-mentioned services. Some firms that respond to this RFQ, who are determined by the Owner to be especially qualified, may be deemed eligible and may be invited to interview and offer proposals for these services. All respondents to this RFQ are subject to instructions communicated in this document, and are cautioned to completely review the entire RFQ and follow instructions carefully. The Owner reserves the right to reject any or all statements of qualifications or proposals, and to waive technicalities and informalities at its discretion.

2. PROJECT BACKGROUND

Established in 1913, GSU is the largest of the 31 institutions that make up the University System of Georgia. Located in the heart of , this major research university has more than 32,000 students seeking degrees.

The Annex to the 25 Park Place complex is a six-story building originally built in the 1940’s as a parking garage. It was converted to office space in the 1950’s, with parking remaining on the street level. The building currently houses GSU’s CollabTech business incubator and various campus services. While the interior use of the building is of value to the University due to growth in academic and administrative functions, the exterior is dated, and in need of improvement. Additionally, the upper floors are not easily accessible from the ground floor of the building. Instead, users must enter through the ground-level parking garage and pass through a keyed access door into an elevator vestibule in order to get to the upper-floor offices.

3. PROJECT DESCRIPTION

The renovation to the Annex will include but not be limited to opening up a street-level entrance and lobby complete with an ADA accessible ramp, replacement of all windows in the building, modifications to existing emergency stairs, and modifications and repairs of the existing façade, including floor-to-ceiling windows along the entrance and a full-height, back-lit, blue-glass feature wrapping the corner of the building at the intersection of and Equitable Place to make the building more welcoming and visually interesting at the street level.

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

4. PROJECT DELIVERY METHOD

The project delivery method will be Construction Management at-Risk (CM/GC). Selection of these services will be by Qualifications Based Selection (QBS) herein described. The CM-at-Risk method has been specifically chosen to give the Owner flexibility in undertaking a complex project.

The owner currently has a design services contract with Praxis 3 to provide design services. The selected CM/GC is expected to work closely with the design professional, as well as any other consultants that the Owner may employ on the project. A spirit of cooperation and collaboration among the professional construction services providers on this project is of utmost importance to the Owner.

The CM/GC will be responsible for means and methods of construction, safety, and the scheduling and coordination of all subcontractors and miscellaneous contracts required for the completion of the project within its predetermined budget and schedule.

The CM/GC will competitively bid all subcontractors and other work/suppliers appropriate for competitive selection, but is free, subject to owner approval, to use qualification factors other than price that will deliver the greatest value to the Owner.

Proposers are encouraged to review the required CM/GC form of contract, which may be viewed at the Georgia Board of Regents website. The contract will be Actual Cost Plus a Fixed Fee not to exceed the GMP. All savings, including unused construction contingency, will be returned to the Owner. The Owner does not accept modifications to this contract from the selected CM/GC.

5. PROJECT BUDGET

The Stated Cost Limitation (SCL) for the project will be $2,700,000. This cost is to include the cost of the work, construction requirements, construction manager general conditions and fee, and some reserved construction contingency. The SCL may be adjusted as the program for the project is developed.

The CM/GC will commit to a Guaranteed Maximum Price (GMP) at an appropriate point prior to the start of actual construction. The amount of time the CM/GC has to prepare the GMP will be negotiated into the contract. The GMP will be backed by a Performance and Payment bond as per the contract.

6. PROJECT SITE The project location is 58 Edgewood Ave., Atlanta, GA 30303

7. PROJECT SCHEDULE

The Construction Manager at-Risk services are anticipated to commence by September 15, 2015.

Construction documents are scheduled for completion by September 15, 2015.

Construction is targeted for completion by July, 2016. 2

Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

Based on those target dates, the CM/GC will develop an overall project schedule, which will become a contractual obligation. The above listed dates are subject to change at the Owner’s discretion.

8. SCOPE OF WORK

The scope of work for the project will include: • Permitting • Demolition to the extent called for in the contract documents • Coordination with campus staff and local authorities to minimize disruptions due to construction • Work closely with building tenants to minimize the impact of the window replacement • Construction of new lobby, including all MEP and architectural finishes • Repair and Modification of the building façade • Replacement of existing windows with new, energy efficient windows

This project occurs within a GSU Foundation building and, as such, is regarded as a non-university structure subject to codes, requirements, and permitting as legislated and issued by the City of Atlanta.

9. SCOPE OF SERVICES

Required elements of the Construction Manager at-Risk services include, but may not be limited to: • Provide all typical pre-construction phase services for a CM-at-Risk contract • Reconcile budgeting with the project budget and propose cost saving alternatives to resolve potential budget problems • Develop a master CPM schedule for construction, track progress and update on a regular basis • Perform inspection of existing and/or space and conditions (if appropriate) • Develop requirements for safety, quality assurance, and schedule adherence • Perform constructability review of design documents • Perform maintainability review of proposed project to assess potential maintenance issues • Provide assessments for alternative methods, materials, and approaches to reduce cost and enhance value; also known as value engineering (VE) or value analysis (VA) • Generate a Guaranteed Maximum Price (GMP ) within the SCL • Assemble procurement packages for trades to competitively bid • Administer pre-bid conferences for subcontractor trades • Review and analyze subcontractor qualifications • Competitively bid all trade subcontractors and material suppliers. Subject to Owner approval, and using input from Owner and Design Professional, CM/GC may select subcontractors based on best value provided to the owner in addition to price alone. Final subcontractor and supplier selection will be subject to the approval of the owner • Validate compliance of subcontractor bids with project scope and review with the owner and design professional in detail, making changes as needed • Commence work upon receipt of Notice to Proceed (NTP) and execution of GMP change order • Obtain all required permits • Provide and maintain schedule for submittals and shop drawings

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

• Review submittals and shop drawings, and administer submittal, distribution, and revision of these documents with the project team • Issue Requests for Information as needed to the design team, and track the status of these in a log provided to the project team • Review subcontractor applications for payment for accuracy before issuing applications for payment to the design professional for review • Participate in commissioning plan and activities, if applicable • Administer progress meetings with the Owner, design professional and other parties as appropriate, including updating and issuing action items, schedules, logs, minutes, etc. • Coordinate the scheduling of the work with the current building occupants • Undertake the renovation of the space, or new construction, in accordance with the construction documents approved by the owner • Conduct the work in a manner that will meet the special requirements of working in an occupied building, such as noise, dust and vibration control • Provide all typical project management services during the course of construction • Complete the work by the scheduled completion date • Perform Punch-list review with subcontractors prior to Punch-list review with design professional and Owner • Cooperate with the Owner’s commissioning program • Obtain a certificate of occupancy from the authority having jurisdiction • Conduct owner-training in newly installed systems as required • Provide Record Drawings and all other required close-out documents at the completion of construction (closeout documents must be received prior to release of retainage) • Provide complete cost accounting at the completion of the project • Provide warranty services for one-year after the project is accepted by the owner

10. RFQ SCHEDULE OF EVENTS

The following RFQ Schedule of Events represents the Owner’s best estimate of the schedule that will be followed. The Owner reserves the right to adjust the schedule as the Owner deems necessary. Any changes will be posted on the Georgia Procurement Registry website.

a. Owner issues public advertisement of Request for Qualifications 7/31/15 -----

b. Deadline for written questions/requests for clarification (see section 12) 8/14/15 4 pm

c. Deadline for submission of Statements of Qualifications 8/28/15 4 pm

d. GSU Selection Committee completes evaluation of submittals, posts results, and 9/2/15 --- issues notification to finalist firms 10 am e. Owner conducts MANDATORY Site visit / Conference for finalist firms. 9/4/15

f. Selection Committee interviews finalist firms. (Fee envelope to be submitted 9/8/15 TBD by all interviewee firms in sealed envelope)

g. Selection Committee completes interview evaluation and notifies firm chosen. 9/9/15 ---

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

11. SELECTION PROCESS

a. Selection of the CM/GC will be a two-step process. First, Statements of Qualifications will be solicited and evaluated by the Selection Committee, then a list of finalist firms will be selected. Second, these finalist firms will be invited to interview with the Selection Committee, and after these interviews a CM/GC will be selected. This RFQ constitutes the first step in this process.

b. The Selection Committee will consist of representatives of Georgia State University.

c. In selecting a firm, the Owner will emphasize the experience of the firm and its assigned personnel in providing like functions on projects of similar size and complexity as the proposed project. Selection preference will be towards firms that have a depth of knowledge of and resources for scheduling and budget control, as well as familiarity with BOR and GSU construction procedures.

d. The construction schedule requires the Owner to make as an important selection criteria the ability of the firm to place quality personnel on the job ready to work within an effective timeframe.

e. Firms must meet the minimum criteria listed below. Firms that do not meet these criteria are automatically disqualified:

i. Firm MUST have all necessary, valid and current licenses to do business in the state of Georgia. ii. Firm MUST have a Safety Experience Modification Rate average of less than 1.5 over the last three years. iii. Firm MUST have bonding capacity to provide a payment and performance bond for the total cost of work. iv. Firm MUST have a current Builder’s Risk Insurance Policy. v. Firm MUST have a current Contractor’s Public Liability Insurance Policy, and MUST be insurable in the following amounts: Bodily injury, including death—limits of $1 million for each incident; Property damage—limits of $1 million for each incident and $2 million for the aggregate of operations. (The Owner reserves the right to require additional limits and coverage in the final contract based on the SCL of the project.) vi. Firm MUST comply with all e-verification requirements mandated by the State of Georgia for Board of Regents Contracts vii. Firm MUST have a financial current ratio of 1.0 or greater.

f. In order to be deemed eligible for evaluation, the submitting firm must create, officially sign and place in its submittal as affidavit confirming that they meet the above listed criteria.

g. Firms meeting the above referenced criteria are invited to submit their qualifications, as described in Sections 12 and 13 below.

h. The Selection Committee will receive and evaluate all Statements of Qualifications and arrive at a shortlist of the firms to be interviewed. Selections will be qualifications-based. Evaluation criteria will include but not be limited to: i. Assessment of qualifications of the firms and individual team members. ii. Stability of the firms, including corporate history, growth, resources, form of ownership, litigation history, financial information, and other evidence of stability. 5

Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

iii. Experience of firm as demonstrated by successful completion of projects similar in size, scope and complexity. iv. Experience of firm working on projects for educational institutions, public organizations, and in an urban environment. v. Recent and comprehensive experience or expertise of the individual members included on the team for the type of project. vi. Experience with renovation work in occupied buildings vii. Experience of firm’s project team working together on previous projects viii. Firm’s overall approach to the project ix. Firm’s apparent suitability for the project based on the range of services it offers, to include any special or unique qualifications it can bring to the project. x. References.

i. Short-listed firms will be notified by email and invited to an interview with the Selection Committee in order to present their qualifications in more detail. There will not be a separate written formal proposal to be submitted in advance of the interview.

12. PREPARATION OF STATEMENTS OF QUALIFICATIONS

a. All interested firms are requested to submit a Statement of Qualifications containing the following information: i. Cover letter with statement of interest ii. Description of the firm, to include: 1. Company name and complete contact information 2. Principal contact for firm 3. Proximity to jobsite of office that would manage the project 4. Form of ownership and years in business 5. Name of insurance carrier and types and levels of coverage 6. Annual average revenue and current ratio for the last five years 7. Main banking references 8. Personnel resources iii. Describe history and growth of firm iv. List or chart showing the proposed staffing of the team by function and percentage of time allocated to the project v. Provide resumes of all key individuals listed for the project team vi. Describe the team’s range of services, to include any special or unique qualifications it can bring to this project vii. List a of minimum of four (4) and a maximum of six (6) projects completed in last five years which are similar in size, scope, cost and complexity to this project. Provide project name, location, duration dates, a brief description (size, cost etc.) along with the current reference contact information. Place particular emphasis on projects similar to the project described in this RFQ. viii. List previous experience and success with CM at-Risk projects that the firm’s proposed team has worked on together ix. Describe approach and proposed process for this particular project x. Proposed schedule, from contract award to final completion of project 6

Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

xi. Description of firms’ safety program(s) and record(s) including EMR for the last three years xii. List and explain litigation with owners, subcontractors and/or design professionals in the last five years xiii. List and explain any active or pending litigation with owners, subcontractors and/or design professionals xiv. Indicate and explain if firm(s) have ever failed to complete any work awarded to it or has been removed from any project xv. Indicate firm’s nondiscrimination policies, and any proposed efforts for inclusion of MBE, WBE, SBE and local business enterprises on this project xvi. Provide a summary statement of why the proposed team should be selected xvii. Include the affidavit described in Section 11f above xviii. Include the certification shown as Exhibit A (attached to this RFQ) xix. Include the disclosure statement shown as Exhibit B (attached to this RFQ)

b. Qualifications submittals must be typed on standard (8½” x 11”) paper. Responses are limited to twenty, single-sided pages or less using a minimum of an 11-point font. Tabs, covers, and the table of contents do not count toward the page total. Expensive covers and/or packaging are not encouraged. The pages of the qualification submittals must be numbered. A table of contents, with corresponding tabs in the body of the submittal, must be included as well to identify each section. Placing multiple tabs on a single page is acceptable. If more than one item in the table of contents can be started on the same page, you may do so and place all corresponding tabs on that page. Any affidavits called for may be included in an appendix and will not count toward the page limit.

c. Please do not include additional information not specifically requested above.

d. All submittal costs in conjunction with this RFQ will be the responsibility of the submitting firm.

e. Georgia State University reserves the right to reject any and all submittals, and to waive any and all technicalities or irregularities in the submittal process.

13. SUBMITTAL OF QUALIFICATIONS

Proposers should deliver 1 hard copy and 1 electronic copy in PDF format of their Statement of Qualifications submittal to the Owner prior to the deadline indicated in the Schedule of Events (Section 10 of RFQ) at the exact address below:

Kimberly P. Bauer Director Facilities Design & Construction Services Georgia State University 34 Broad Street, Suite #1200 Atlanta, Georgia 30303

ATTN: Keith Martin

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

Electronic copies shall be submitted on a USB drive.

Firms must deliver their submittals in a sealed envelope. The name and address of the firm should appear on the outside of the envelope, and the project name and number should be referenced.

It is the sole responsibility of the Proposers to assure delivery to the noted locations by the specified deadlines. The Owner cannot accept responsibility for incorrect delivery, regardless of reason. No RFQ submittals will be accepted after the time stipulated above. RFQ submittals will not be accepted via facsimile, email, or any method other than specified above.

It is the responsibility of the Proposers to examine the entire RFQ, seek clarification in writing, and review their qualifications information for accuracy before submitting a response. Once the deadline has passed, all submittals will be final.

It is the proposers’ responsibility to check the Georgia Procurement Registry website frequently for any updates/changes to this RFQ.

All unsuccessful proposers may pick up their submittals within 2 weeks after the date of the submittal. After this time, all unaccepted submittals will be discarded.

14. FINALIST FIRMS SELECTION AND NOTIFICATION

After evaluation of the submitted Statements of Qualifications, the Selection Committee will prepare a shortlist of finalist firms. This list will be posted on the Georgia Procurement Registry website. Additionally, each firm will be contacted directly via email and provided detailed information concerning the second step of the selection process, including the time and location of the interview, and the information to be provided at the interview. There will not be a separate written proposal required in advance of the interview.

The successful CM/GC will be selected based on the interview process.

15. QUESTIONS AND REQUESTS FOR CLARIFICATION

Questions about any aspect of the RFQ, or the project, shall be submitted in writing via e-mail to:

Construction Project Manager: Keith Martin GSU Design & Construction Services [email protected]

The deadlines for submission of questions relating to the RFQ are the times and dates shown in the Schedule of Events- Section 10. All relevant questions and requests for clarification received by GSU and the corresponding responses will be posted on the Georgia Procurement Registry as an addendum to the original solicitation for services. Also see “16a - ADDITIONAL TERMS AND CONDITIONS - Restriction of Communication”.

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

16. ADDITIONAL TERMS AND CONDITIONS

a. Restriction of Communication - From the issue date of this RFQ solicitation until a successful proposer is selected and the selection is announced, proposers are not allowed to communicate about this solicitation or this Project for any reason with any members of the Selection Committee, GSU or the BOR except for submission of questions as instructed in the RFQ, or during the proposer's conference/site visit (if applicable), or during the interview, or as provided by any existing work agreement(s). For violation of this provision, the Owner reserves the right to reject the proposal of the offending proposer.

b. Submittal Costs and Confidentiality - All expenses for preparing and submitting responses are the sole cost of the party submitting the response. The Owner is not obligated to any party to reimburse such expenses. All submittals upon receipt become the property of the Owner. Labeling information provided in submittals “proprietary” or “confidential”, or any other designation of restricted use will not protect the information from public view. Subject to the provisions of the Open Records Act, the details of the proposal documents will remain confidential until final award.

c. Joint-Venture Proposals - The Owner does not desire to enter into “joint-venture” agreements with multiple firms. In the event two or more firms desire to “team up” it is required that one incorporated firm propose and maintain status as the contracted lead firm with the remaining firms participating as consultants to the lead firm.

d. Award Conditions - This request is not an offer to contract or a solicitation of bids. This request and any statement of qualifications or proposal submitted in response, regardless of whether the proposal is determined to be the best proposal, is not binding upon the Owner and does not obligate the Owner to procure or contract for any services. Neither the Owner nor any party submitting a response will be bound unless and until a written contract mutually accepted by both parties is negotiated as to its terms and conditions and is signed by the Owner and a party containing such terms and conditions as are negotiated between those parties. The Owner reserves the right to waive non-compliance with any requirements of this RFQ and to reject any or all proposals submitted in response. Upon receipt and review of responses, the Owner will determine the party(s) and proposal that in the sole judgment of the Owner is in the best interest of the Owner (if any is so determined), with respect to the evaluation criteria stated herein. The Owner then intends to conduct negotiations with such party(s) to determine if a mutually acceptable contract may be reached.

Refer to the Board of Regents website for the most current versions of contracts: http://www.usg.edu/facilities/documents

e. Sustainability – The project will incorporate the requirements of the Georgia Energy Efficiency and Sustainability Construction Act of 2008 and may include other sustainable concepts where feasible to do so.

f. Code Compliance – The project is to be designed and the work conducted in accordance with all applicable federal, state and local laws, codes, rules and regulations.

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

g. Reciprocal Preference Law - For the purposes of evaluation only, a proposer that resides in the State of Georgia will be granted the same preference over proposers that reside in another State in the same manner, on the same basis, and to the same extent that preference is granted in awarding bids for the same goods or services by such other State to proposers that reside therein. For the purposes of this law, the definition of a resident proposer is one who maintains a place of business with at least one employee inside the State of Georgia. A P.O. Box address will not satisfy this requirement.

h. Minority and Small Business Enterprise - It is the policy of the State of Georgia that minority- owned business enterprises (MBE), woman-owned business enterprises (WBE), small business enterprises (SBE) and local businesses have a fair and equal opportunity to participate in the State purchasing process. Therefore, the Owner encourages all MBE, WBE, SBE and local firms to compete for contracts to provide goods, services, and construction, and encourages contractors to solicit such firms in procuring subcontractors and suppliers. This desire on the part of the Owner is not intended to restrict or limit competitive bidding or to increase the cost of the work. Contractors and subcontractors who utilize qualified minority subcontractors may qualify for a Georgia state income tax credits for qualified payments made to minority subcontractors. See Official Code of Georgia Annotated (O.C.G.A.) O.C.G.A. Section 48-7-38. For more information, please contact:

The Governor's Entrepreneur and Small Business Office 75 Fifth Street, Suite 825 Atlanta, Georgia 30308 Phone: 404.962.4071 http://www.georgia.org/Business/SmallBusiness/

i. Statement of Agreement - With submission of a proposal, the Proposer agrees that he/she has carefully examined the Request for Qualifications (RFQ), and the Proposer agrees that it is the Proposer’s responsibility to request clarification on any issues in any section of the RFQ with which the Proposer disagrees or needs clarified. The Proposer also understands that failure to mention these items in the proposal will be interpreted to mean that the Proposer is in full agreement with the terms, conditions, specifications and requirements in the therein.

End of Request for Qualifications

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Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

Exhibit A

CERTIFICATION FORM

I, ______, being duly sworn, state that I am ______(title) of

______(firm) and hereby duly certify that I have read and understand the information presented in the attached proposal and any enclosure and exhibits thereto.

I further certify that to the best of my knowledge the information given in response to the Request for Qualifications is full, complete and truthful.

I further certify that the proposer and any principal employee of the proposer have not, in the immediately preceding five years, been convicted of any crime of moral turpitude or any felony offense, nor has had their professional license suspended, revoked or been subjected to disciplinary proceedings.

I further certify that the proposer has not, in the immediately preceding five years, been suspended or debarred from contracting with any federal, state or local government agency, and further, that the proposer is not now under consideration for suspension or debarment from any such agency.

I further certify that the proposer has not in the immediately preceding five years been defaulted in any federal, state or local government agency contract, and further, that the proposer is not now under any notice of intent to default on any such contract.

I acknowledge, agree and authorize, and certify that the proposer acknowledges, agrees and authorizes, that the Board of Regents may, by means that the Board of Regents deems appropriate, determine the accuracy and truth of the information provided by the proposer and that the Board of Regents or their agents may contact any individual or entity named in the Statement of Qualifications for the purpose of verifying the information supplied therein.

I acknowledge and agree that all of the information contained in the Statement of Qualifications is submitted for the express purpose of inducing the Owner to award a contract.

A material false statement or omission made in conjunction with this proposal is sufficient cause for suspension or debarment from further contracts, or denial of rescission of any contract entered into based upon this proposal thereby precluding the firm from doing business with, or performing work for, the State of Georgia. In addition, such false statement or omission may subject the person and entity making the proposal to criminal prosecution under the laws of the State of Georgia of the United States, including but not limited to O.C.G.A. §16-10-20, 18 U.S.C. §§1001 or 1341.

______Signature Sworn and subscribed before me

This _____ day of ______, 20__. ______

Firm ______NOTARY PUBLIC ______NOTARY SEAL My Commission Expires: ______11

Georgia State University – Request for Qualifications for CM-at-Risk services 25 Park Place Block Renovation – Annex Façade Redesign Project No. 081-069-15

Exhibit B

Proposer’s Disclosure Statement

All proposers should be aware that the project for which you are submitting a Statement of Qualifications is a public project, and the Owner is a public agency. Pursuant to the laws, rules and Executive Orders of the State of Georgia, the Owner shall make every effort to avoid even the appearance of a conflict of interest or any impropriety in both the selection process for this project and the negotiation and performance of any resulting contract. As part of the any submittal you intend to make for this project, you must include a Disclosure Statement with your submittal which answers the following specific questions:

1. Describe any business transactions occurring within the prior two years between your firm and the BOR, GSU or the ultimate end-user of the proposed project.

(insert response here)

2. Describe any gift, offer, hospitality or benefit of any sort that your firm has provided to the BOR, GSU or the ultimate end-user of the proposed project within the prior one-year period.

(insert response here)

3. A conflict of interest or potential conflict of interest is defined as any action, decision or recommendation by a person acting in a capacity as a public official the effect of which is or could be used to the private monetary or financial benefit or detriment of the person, the person’s relative, or any business with which the person or relative is associated. The potential conflict of interest is viewed from the perspective of a reasonable person who has knowledge of the relevant facts. Based upon this definition, describe any conflict of interest or potential conflict of interest that your firm has with the BOR, GSU or the ultimate end-user of the project.

(insert response here)

The Disclosure Statement should be dated and signed by an authorized signatory for the proposing firm, and submitted as directed with the Statement of Qualifications.

______Name of Firm

______Authorized Signature

______Date

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