REQUEST FOR QUALIFICATIONS (RFQ)

STRUCTURAL MONITORING SYSTEM (SMS)

PEARL HARBOR MEMORIAL BRIDGE

The Connecticut Department of Transportation (CTDOT / Department) seeks qualifications from

firms (including Joint Ventures) with experience in the installation and operation of structural

monitoring systems as well as field operation of bridge load tests and cable plucking tests.

Project Description and Requirements

These qualification requirements are a supplement to the State of Connecticut Department of

Transportation, Standard Specifications Form 817, including the latest supplements thereto, and

the Construction Contract Bidding and Award Manual unless otherwise specified in these

provisions. If there are any conflicts between the instructions in this RFQ and any other proposal

document(s), these Instructions shall prevail.

The anticipated CTDOT Scope Code for this project is “E”- $1,000,000 - $2,499,999.

The Pearl Harbor Memorial Bridge (PHMB), also known as the Q-Bridge, is a dual structure

extradosed bridge that carries I-95 over the Quinnipiac River in New Haven, Connecticut. The

five-lane northbound bridge was opened to traffic in June 2012, and the five-lane southbound

bridge was opened to traffic in September 2015.

A Structural Monitoring System (SMS) will be installed to the PHMB for monitoring and

assessing its structural performance over a two (2) year time period. The SMS will be comprised

of the following major components with approximate sensor quantities in the parentheses:

1) Accelerometers (biaxial) for cable vibrations (8)

2) Anemometer for wind characteristics (1)

3) Crackmeters for activeness of existing concrete cracks (40)

4) Displacement transducers for expansion bearing movements (12)

5) Strain gages on concrete elements for stresses due to in-situ loads (152)

6) Strain rosettes on steel elements for stresses due to in-situ loads (4)

7) Temperature sensors on concrete and steel surfaces and in the air (17)

8) Tiltmeters (biaxial) for tilting movements of bridge tower legs (6)

9) Reference, or dummy, sensors for baseline responses to ambient environment (10)

10) Data acquisition and transmission network

The entire monitoring system shall be installed and protected for performance in the outdoor

environment during the entire data collection period. GFI duplex receptacles for 120V AC power

are available at multiple locations on the bridge. However, the Contractor shall be responsible for

local backup batteries to avoid interruptions to continuous monitoring due to unexpected events

such as storms.

The general responsibility of the Contractor shall be to furnish, install, operate, and maintain for

full functionality of the SMS continuously for a time period of two (2) years. The Contractor

shall also be responsible for collecting and delivering the monitoring data remotely to a

designated server to be maintained by CTDOT’s Design Consultant. Additionally, the Contractor

shall be responsible for performing three (3) live load tests and three (3) cable plucking tests

during the two-year monitoring period.

All data and information generated by the SMS shall become the sole property of the CTDOT to

use for any purpose and to distribute as desired. CTDOT’s Design Consultant will be responsible

for validating and analyzing the monitoring data for the purpose of assessing the structural

performance of the PHMB.

At the end of the monitoring period, the Contractor shall be responsible for removing all the data

acquisition equipment as well as all the sensors and wiring. The Contractor shall also be

responsible for restoring the bridge surface condition for any damages after the removal. CTDOT

does not desire to own any of the monitoring equipment after removal.

Contractor Selection Process

The Contractor for the PHMB SMS project will be selected based on a two-step process: (1) all

interested contractors must submit a Qualification Application/Statement for evaluation and

approval by the Department to become a Qualified Contractor to bid on this project; and (2) only

Qualified Contractors approved by the Department will be issued a complete set of bid/contract

documents including SMS plans, technical specifications and a bid proposal form.

The Contract will be awarded to the lowest responsible bidder in accordance with the CTDOT

Construction Contract Bidding and Award Manual.

Submission for Qualification

In order to be approved for being a Qualified Contractor, interested parties must submit the

following materials to demonstrate that they possess the qualifications and experience required

for this project. Qualification packages will be evaluated on a pass/fail basis. The Department

will approve or deny each applicant based on the following evaluation criteria:

A: A completed and signed SMS Qualification Application/Statement. If submitting as a joint

venture, then each member of the joint venture must submit a Qualification

Application/Statement. See Attachment 1. This project specific Qualification

Application/Statement replaces the Department’s standard “prequalification” application form

(CON 16) for this project only.

B: Minimum experience requirements for the proposing firm or joint venture (JV), key staff, and

technology.

The collective experience of the proposing firm or joint venture (JV) and its proposed

Instrumentation Supervisor must include at least three (3) bridge monitoring projects in the

United States within the past eight (8) years, each for a monitoring period of 12 months

minimum. Each project must have employed wireless data transmission and have used strain

gages plus at least one other sensor type among those listed previously under Project

Descriptions and Requirements.

There are no restrictions to the type(s) of technology for the sensors and data acquisition

equipment of the SMS, as long as they meet all the functional and system requirements to

accomplish the project objectives. Possible technologies may include, but be not limited to,

electrical resistance (ER), fiber optical (FO), micro electro-mechanical systems (MEMS),

piezoelectric (PE), and vibrating wire (VW).

The following requirements will be used to determine if an applicant meets the minimum

experience for bidding on the PHMB SMS project. The requirements are met only if ‘Yes’ is

checked for all the items as listed.

Item Yes No

B1. The collective experience of the proposing firm/JV and Instrumentation

Supervisor includes at least three (3) bridge monitoring projects in the U.S.

B2. The proposing firm/JV or the Instrumentation Supervisor performed

sensor installation, data collection, and wireless data transmission in each

bridge monitoring project.

B3. Each bridge monitoring project started within the last 8 years.

B4. Each bridge monitoring project has a monitoring period of at least 12

months.

B5. Each bridge monitoring project employed wireless data transmission.

B6. Each bridge monitoring project used strain gages plus one other sensor

type as listed for this project under Project Descriptions and Requirements.

The applicant shall also provide the following supporting documentation for each of the three

projects. This information is for reference only and will not be used directly as pass/fail criteria

for evaluating the qualification packages. However, please note that the Reference Letters

provided serve to verify this information and will be used as pass/fail criteria as noted in Part C

below.

a. Bridge descriptions (name, location, year built, structural type, etc.)

b. SMS descriptions (sensor types, layout and quantities; installation/removal dates; data

collection equipment & plan; data storage & transmission; current status; etc.)

c. Measures for maintaining system functionality for continuous data collection

d. Bridge owner contact information as a reference (name, phone number, and email of

responsible person familiar with the SMS)

e. Resume of the proposed Instrumentation Supervisor including employment history and

role responsible in the listed bridge monitoring projects

C: Positive feedback from reference checking of previous projects.

The proposing firm or JV must submit with this application a reference letter provided to

CTDOT, by the project owner, for each of the three projects listed as previous experience.

In order for the proposing firm or JV to be approved for qualification, the submittal must follow

the format and instructions listed on the QUALIFICATION REFERENCE LETTER (see

Attachment 2), which serves to:

1. Confirm key information of each listed project, including:

a) Project information (bridge, location, owner, start and end dates, etc.)

b) Length of continuous monitoring period (e.g., 12 months)

c) Types, quantities, and sensing technologies including models and associated data

acquisition and transmission equipment (e.g., 10 VW strain gages of Geokon

Model 4000, 4 VW displacement transducers of Geokon Model 4450, 2 VW

tiltmeters of Geokon Model 6350, a 16-channel VW datalogger of Geokon Model

8002-16, a cellular digital data modem of Sierra Wireless Airlink Raven XTV,

etc.)

2. Identify the performing firm or JV as well as the key staff and their responsibilities, as

applicable.

3. Indicate if the overall performance of the identified key staff who performed the listed

bridge monitoring project was acceptable.

4. Indicate if the overall performance of the company/JV that was contracted for the listed

bridge monitoring project was acceptable.

The following requirements will be used to determine if an applicant meets the minimum

reference check for bidding on the PHMB SMS project. The requirements are met only if ‘Yes’

is checked for all the items listed, as applicable.

Item Yes No

C1. The CTDOT Qualification Reference Letter verified all the project

information provided by the applicant regarding a) project information, b)

monitoring length, and c) sensor types, quantities, and technologies.

C2. The CTDOT Qualification Reference Letter verified the firm/JV and the

key staff for each of the three projects listed as project experience by the

applicant.

C3. The CTDOT Qualification Reference Letter indicated the overall

performance of the identified key staff for each of the three projects listed as

project experience was acceptable.

C4. The CTDOT Qualification Reference Letter indicated the overall

performance of the contracted company/JV for each of the three projects

listed as project experience was acceptable.

Additional Requirements in Contract Execution

The applicants shall be aware that the technical specifications in the contract documents will

have similar experience requirements as above for the individuals assigned to the project in

contract execution. As a condition of award, the Instrumentation Supervisor shall have the

experience of at least one bridge monitoring project in the U.S. meeting the requirements of

Items B2 through B6 as listed previously. The technical specifications will also require any new

technologies that have not been used in previous projects be compared with proven technologies

at select locations in order to demonstrate their validity during the monitoring period of this

project.

Applicants shall submit a Bid Proposal Request Form (aka Part C) listing all outstanding work

and associated dollar values. This affidavit will be used by the Department to compare to the

applicant’s maximum bidding capacity stated in their Surety/Bond letter required by the

Qualification Application/Statement. An additional (updated) Bid Proposal Request Form will

also be required from the apparent low bidder prior to contract award.

Please submit all questions related to the RFQ via email to dotcontracts@ct.gov. Please include

“State Project 92-676 RFQ” in the subject line and provide necessary contact information

including name, email, phone number, and address. Answers to questions will be posted on the

State Contracting Portal under the Solicitation

(https://biznet.ct.gov/SCP_Search/BidResults.aspx?groupid=64). The deadline to submit questions

regarding this RFQ is August 29, 2018 (2:00 p.m. EDT).

The Qualification Application/Statement must be received by CTDOT by September 12, 2018

(2:00 p.m. EDT). NO EXCEPTIONS.

Please submit the Qualification Application/Statement in PDF format via email to:

Gregory D. Straka, Contracts Manager, CTDOT, at: dotcontracts@ct.gov. Please provide a

name, email, phone number and address of the individual(s) who shall receive further

notification regarding the status of the Qualification Application/Statement.

CTDOT may notify the Firms (applicants) regarding the decision to approve or deny their

Qualification Application/Statement by November 7, 2018 (2:00 p.m. EDT). Applicants will

receive advance notification via email. A formal letter will follow.

CTDOT reserves the right to request additional information from a Firm (applicant) at any time,

as deemed necessary by CTDOT.

CTDOT further reserves the right to alter the date and time of application deadlines and

notification of decision to approve or deny the application as deemed necessary by CTDOT.

Qualified bidders are hereby notified that CTDOT will be utilizing our standard bidding

process with Bid Express (Bidx.com). All bidders must subscribe to Bid Express, download

the Expedite Bid software and obtain a digital ID in order to bid on this project. Please

refer to the Construction Contract Bidding and Award Manual for more detailed

information regarding the Department’s bidding process and requirements.

ATTACHMENT 1

STRUCTURAL MONITORING SYSTEM (SMS)

PEARL HARBOR MEMORIAL BRIDGE

CONTRACTOR QUALIFICATION APPLICATION/STATEMENT

PART ONE – GENERAL INFORMATION

1) THE PAGES IN THIS APPLICATION MAY NOT BE MODIFIED OR SUBSTITUTED.

2) To be eligible for qualification, applicants must have been engaged in active business as a

construction, engineering, or testing contractor for a minimum of one year under the name of

the firm applying for qualification, and must provide a current one year, audited or reviewed

financial statement (non-consolidated) for that firm. If the financial statement is consolidated

with other affiliates/subsidiaries of the applicant/firm, a consolidating balance sheet showing

the allocation (breakout) of all the affiliates must be included in the financial statement. The

financial portion of the statement may be based upon the contractor’s most recently-

completed fiscal year for which data is available. The Department reserves the right to

require a more recent financial statement at any time, as deemed necessary and in the best

interest of the State of Connecticut.

3) For corporations, a current Certificate of Authority (foreign corporation) or current

Certificate of Incorporation (domestic corporation) whichever is applicable, is required to be

on file with the Connecticut Secretary of the State.

4) Limited Liability Companies (LLCs) must have been legally formed and organized in

accordance with Connecticut General Statutes 34-110 to 34-242 and shall not be in default

for failure to file its annual report with the Connecticut Secretary of the State.

5) Documentation from the Connecticut Secretary of the State relative to the status of

corporations and LLCs must be provided by the applicant if requested by the Department.

6) Corporations related to each other through ownership interests or an interlocking directorate

or in other significant respects, may not seek qualification in combination, and may not

submit consolidated financial statements in seeking qualification. The legal independence of

a corporation or joint venturer must be reflected in the presentation of information about its

finances; e.g., in presenting the assets of an applicant corporation, one may include the value

of the stock owned by the applicant in a wholly-owned corporate subsidiary, but not, for

instance, the value of equipment owned by the subsidiary corporation. In addition, only

organizations which the Department deems to be true construction, engineering, or testing

contractors with respect to the specialized services for which they seek qualification (i.e.,

organizations having sufficiently-experienced personnel, sufficient equipment and finances,

etc. to perform the work) may seek or be granted qualification to bid for this project. If the

Department deems that a substantial portion of the resources of an organization seeking

qualification is devoted to activities other than the work within the specialized services, the

Department may make what it deems to be an appropriate adjustment of the organization’s

bidding capacity.

7) CONFIDENTIALITY – Contractor’s statements and requests for bid proposal forms

submitted to the Department may be subject to disclosure pursuant to the Freedom of

Information Act. To the extent that a contractor claims otherwise, such a claim must be

made at the time of the document’s submittal to the Department, including in accordance

with Conn. Gen. Stat. §1-210(b)(5)(A and B). Upon a Freedom of Information request for a

contractor’s qualification statement or bid proposal request, the Department will evaluate

whether the records claimed as trade secrets or commercial or financial information (or

otherwise claimed as exempt from disclosure) meet the requirements of Conn. Gen. Stat. §1-

210(b)(5) (or some other exemption from disclosure) and can be withheld.

8) OTHER BIDDING INFORMATION – Bidding requirements and conditions are set forth in

Section 1.02, as amended, "Proposal Requirements and Conditions” of the State of

Connecticut, Department of Transportation Standard Specifications for Roads, Bridges, and

Incidental Construction, as revised, and the State of Connecticut Department of

Transportation Construction Contract Bidding and Award Manual, as revised.

No bidders that have mutual financial interests, or common ownership, directors, officers or

principal shareholders (i.e., shareholders holding at least {5%} of either the common or the

preferred shares of the company's stock) may bid for the same Department contract. Such

proscribed bidders shall include, but not be limited to, affiliates and subsidiaries of each other.

If any non-bidding party has an ownership interest in more than one bidder that is bidding for

a given contract, either directly or through the former's ownership interests in another

company, no matter how high up removed in a vertical or horizontal chain of ownership that

party might be from the bidders, the bids of those bidders shall not be accepted. In addition,

with respect to any given Department contract that is advertised for bidding, no bidder owned

by, or in the chain of ownership of, a bonding company may bid against a bidder for whom a

bond has been or will be provided by that bonding company for the given contract bidding.

Bid documents will be provided only to potential bidders qualified to perform the type of

work required by the subject contract, and will be awarded only if they have sufficient

bidding capacity remaining after taking into account all outstanding work to be completed by

the bidder. Bidders must have sufficient bidding capacity to be eligible for award of that

contract.

ATTACHMENT 1

STRUCTURAL MONITORING SYSTEM (SMS)

PEARL HARBOR MEMORIAL BRIDGE

CONTRACTOR QUALIFICATION APPLICATION/STATEMENT

PART TWO – APPLICATION INSTRUCTIONS

1) DETAILS OF ORGANIZATION AND EXPERIENCE – The applicant must answer all

questions and provide all items of information requested pertaining to the organization and

experience of the firm.

2) FINANCIAL STATEMENT REQUIREMENT - The applicant must submit the most recent

audited or reviewed financial statement (non-consolidated) prepared by an independent

Certified Public Accountant (CPA) and must conform with generally-accepted accounting

principles (GAAP). If the financial statement is consolidated with other affiliates/subsidiaries

of the applicant/firm, a consolidating balance sheet showing the allocation (breakout) of all

the affiliates must be included in the financial statement. The financial statement shall

include at minimum, the CPA's opinion statement, balance sheet, profit and loss statement,

line(s) of credit information and all related notes.

3) CERTIFICATION OF CONTRACTOR'S QUALIFICATION STATEMENT - This

statement must be properly completed and signed by a duly-authorized representative of the

applicant; must bear the Corporate Seal, if applicable, and must be properly notarized.

4) CERTIFICATE OF AUTHORITY - This statement must be properly completed and indicate

those individuals in your organization who have the authority to sign bonds, legal documents

and contracts on behalf of your organization. The individuals given such authority under this

document must affix their signatures and indicate their titles, on the Certificate of Authority.

This form may not be altered and cannot be substituted for; must bear the Corporate Seal, if

applicable and must be properly notarized. PLEASE NOTE: Individuals cannot certify

themselves.

5) BONDING / SURETY COMPANY LETTER REQUIREMENT – The Letter must be

submitted with the application.

The Department will determine the applicant’s maximum bidding capacity based on a letter

provided by the applicant’s bonding company, which at a minimum, satisfies the following

requirements:

a) The letter must be from a bonding company that is listed on the current United States

Department of Treasury’s listing of certified companies approved to issue bonding for

federal construction projects (“U.S.Treasury list”) For a list of certified companies go to:

http://www.fms.treas.gov/c570/index.html, under Updates, Certified Companies.

b) The letter must be on the bonding company’s letterhead;

c) The letter must state the full legal name of the surety company (if not noted on the

letterhead), must be an original, must be dated, and must show the original signature;

d) The letter must state the legal name and address of the applicant;

The letter must state the maximum value of work the applicant is capable of undertaking

for all projects/work, both bonded and non-bonded (a/k/a “aggregate work capacity” or

“maximum bidding capacity”). If only one amount is stated in the letter, that amount will

be interpreted to mean the aggregate (total) of both bonded and non-bonded work.

The letter must set forth the contact information for the bonding company representative

including the name, phone number and email address for such representative.

The maximum bidding capacity established by such letter cannot exceed the bonding

company’s underwriting limitation as set forth on the current U.S. Treasury list.

ATTACHMENT 1

PEARL HARBOR MEMORIAL BRIDGE

STRUCTURAL MONITORING SYSTEM (SMS)

CONTRACTOR QUALIFICATION APPLICATION/STATEMENT

PART THREE – QUALIFICATION APPLICATION/STATEMENT FORM

CONTINUE BELOW FOR

APPLICATION

CONTRACTOR QUALIFICATION APPLICATION/STATEMENT

LEGAL NAME OF FIRM

CONTRACTOR’S FEDERAL IDENTIFICATION NUMBER

ADDRESS

CORPORATION

COMPANY

LLC

Telephone & Area Code

Fax Number & Area Code

DATE INCORPORATED

IN BUSINESS SINCE

CONTACT PERSON REGARDING APPLICATION:

Name:

Phone Number:

E-Mail Address:

DETAILS OF ORGANIZATION AND EXPERIENCE

1. How many years of experience in related construction, engineering, or testing work does your organization have:

(a) As a general contractor? (b) As a subcontractor?

2. Have you, your organization, your parent company*, your subsidiaries or your affiliates or any officer or

partner thereof, ever been barred or suspended from bidding, found non-responsible as a low bidder, had a

contract terminated or been denied the award of a contract for any reason by any Federal, State or Municipal

entity in any jurisdiction or agreed with any governmental entity not to bid for its contracts for a given period of

time? NO. If YES, please explain details and grounds of action taken. Include name of agency or

municipality and length of suspension or debarment. ________________________________________________

3. Have you, your organization, your parent company*, your subsidiaries or your affiliates or any officer or

partner thereof, ever failed to complete the construction, engineering, or testing work under any contract

awarded to it either as a prime contractor or subcontractor? ____NO. ____ If YES, please attach a detailed

explanation:

4. In the past 5 calendar years, have you, your organization, your parent company*, your subsidiaries or your

affiliates or any officer or partner thereof, ever been charged with a criminal violation, been indicted or convicted

of a crime by a governmental entity in any jurisdiction? ____NO. If YES, please attach a detailed explanation:

5. In the past 5 calendar years, have you, your organization, your parent company*, your subsidiaries or your

affiliates or any officer or partner thereof, ever had any formal charge or notice of proceeding concerning the

possibility of any debarment, suspension, or finding of non-responsibility by a governmental entity in any

jurisdiction? ____NO. If YES, please attach a detailed explanation: _____________________________________

6. List the names, detailed address and titles of your firm's employees, officials and/or spouses (including

yourself) who have an ownership and/or financial involvement with your firm. In addition give names and

detailed addresses of all others owning 5% or more of the outstanding stock of your firm:**

7. List the names, detailed address and titles of the applicant firm's officials and/or spouses (including yourself) who are employees or have at least 5 % ownership and/or financial involvement with any other construction-related entity (including, but not limited to, bonding companies, construction or engineering firms, suppliers, manufacturers or consultants). Include names of other entities, detailed addresses and positions held)**

8. Give names and detailed addresses of your parent company* (if any) and all of the applicant's affiliates and/or

subsidiaries and the officers thereof. Please provide organizational chart. **______________________________

9. Control of firm: Identify by name and title, those individuals in the applicant's firm who are

responsible for day-to-day management and policy decision making:

A. Financial Decisions: __________________________________________________________________

B. Estimating: _________________________________________________________________________

C. Purchases of Major Items or Supplies: ____________________________________________________

D. Field Operations: ___________________________________________________________________

E. Who has signatory authority over bank accounts: __________________________________________

PLEASE ATTACH ADDITIONAL SHEETS AS NECESSARY - DNA AND N/A ARE NOT ACCEPTABLE * Parent company shall mean not only a party or entity that holds a direct controlling interest in the applicant

but any and all parties that are above the applicant in a chain of ownership or control.

** If there are no individual names or companies pertinent to Items 4, 5 and 6, please indicate NONE in the space

provided above.

10. List the principal members of your organization and their relevant experience. Resumes must also be attached in

addition to the information below.

INDIVIDUALS

NAME

PRESENT

POSITION IN

YOUR

ORGANIZATION

YEARS OF

EXPERIENCE

TYPE OF

WORK/EXPERIENCE EMAIL ADDRESS

11. WORK EXPERIENCE - List the principal projects your organization has currently underway and completed in the past eight years (or more if necessary) related to

bridge monitoring.

(a) Please provide the list of project history in the following format below. You may attach your own document/form using this exact format.

(b) Attached detailed descriptions of the role self-performed by your firm for each project listed.

(c) Attach detailed explanations of any of the following actions imposed on any projects.

• Penalties imposed on any projects

• Claims filed on any projects

• Stop Notices imposed on any projects

• Necessary time extensions filed

Start Date

Complete Date

Project/Contract Description

Sub or Prime

Contract Amount

Owner’s Project Number

Location of actual work performed (Town, State)

Project Contact Information (Name, Address and Phone Number of Owner)

Owner’s Email Address

CERTIFICATION OF CONTRACTOR'S QUALIFICATION STATEMENT

This Contractors Statement must be submitted in the name of a single firm.

It cannot be combined with other firms.

I do hereby certify and affirm that all of the statements contained in this application, including

the declaration of ownership and organization, the Financial Statement and all supporting schedules

and records of experience have been examined by me and to the best of my knowledge and belie f are

true and accurate. And I hereby authorize the banks, individuals, firms and corporations listed in this

application and financial statement to provide to the Connecticut Department of Transportation any

and all information requested in connection with this application.

NAME: _____________________________________________________________________________________

SIGNATURE: _______________________________________________________________________________

TITLE: _____________________________________________________________________________________

(Corporate Seal)

(if applicable)

Sworn to and subscribed before me by: ________________________________________________________

Who is personally known to me this day of ,

Year

___________________________________________________

Notary Public/ Commissioner of the Superior Court

(Notary Seal)

My Commission Expires _________________________________________________

THIS FORM CANNOT BE SUBSTITUTED

CONTRACTORS QUALIFICATION STATEMENT CERTIFICATE OF AUTHORITY

I, , certify that I am (the) (a)

of _, a firm

organized under the laws of (State), and do hereby certify that the following

individuals or any one of them possess the title(s) indicated with this firm,

Name: Title: _

Signature: _

Name: Title: _

Signature: _

Name: Title: _

Signature: _

Name: Title: _

Signature: _

and has (have) the authority and is (are) empowered to execute and deliver in the name and on behalf of

this firm, this firm's contracts, bonds and other documents required by the Connecticut Department of

Transportation.

In witness whereof, the undersigned has affixed his/her signature this

day of ,

Year

Name (Title) (Corporate Seal)

(if applicable)

Sworn to and subscribed before me by :

who is personally known to me this , day of ,

Year

__________________________________________________ _____________________________

Notary Public/Commissioner of the Superior Court My Commission Expires

THIS FORM CANNOT BE SUBSTITUTED - INDIVIDUALS CANNOT CERTIFY THEMSELVES

ATTACHMENT 2

STRUCTURAL MONITORING SYSTEM (SMS)

PEARL HARBOR MEMORIAL BRIDGE

QUALIFICATION REFERENCE LETTER

PART ONE – REFERENCE LETTER REQUIRMENTS

Applicants must submit, with this application, a reference letter provided to CTDOT, by the

project owner, for each of the three projects listed as previous experience. The reference letter

must follow the format and instructions listed below and on the letter:

a. Reference letters must be from project owners other than CTDOT.

b. Letters must be dated, completed, and signed within 6 months of the receipt date of the

application by CTDOT.

c. Letters must be project specific and based on projects that have started within 8 years of

the receipt date of the application by CTDOT.

d. If the applicant wants to provide further information regarding contractor performance,

responsibility and integrity, please attach this information to the reference letters.

The Department reserves the right to request more reference letters directly from project/contract

owners, at any time, including but not limited to, prior to award of contract, as deemed necessary

and in the best interest of the State.

ATTACHMENT 2

STRUCTURAL MONITORING SYSTEM (SMS)

PEARL HARBOR MEMORIAL BRIDGE

QUALIFICATION REFERENCE LETTER

PART TWO – REFERENCE LETTER TEMPLATE

CONTINUE BELOW FOR

REFERENCE LETTER

S T A T E O F C O N N E C T I C U T

DEPARTMENT OF TRANSPORTATION

CONTRACTS UNIT

2800 BERLIN TURNPIKE, P.O. BOX 317546

NEWINGTON, CONNECTICUT 06131-7546

CTDOT QUALIFICATION REFERENCE LETTER

For Project 92-676 – RFQ – PHMB

The following “applicant” information listed below shall be completed by the contractor responding to

the RFQ. The applicant shall then solicit and submit the reference letters in accordance with the RFQ

Instructions.

Applicant Information

Contractor/Applicant Legal Name:

Contractor/Applicant Address/City/State:

Indicate Prime or Subcontractor on Subject Project:

The following “project” information listed below, including project description, level of acceptability,

comments, and signature section, shall be completed by the owner of the project. When completed in

full, the letter shall then be returned to the contractor responding to the RFQ (the applicant).

Construction Project and Owner (Non-CTDOT) Information

Date of this Reference Letter:

Legal Name of Project Owner:

Name of Owner Contact Person:

Address, City, State of Project Owner:

Project#:

Verify key information of the bridge monitoring project:

Contract Start and End Date (if applicable):

Total Contract Value between Owner and Contractor/Applicant:

Location of Project (Town and State):

Bridge No(s).:

Location:

Project Objective:

Duration of Monitoring:

Type of Equipment/Sensors Used:

Quantity of Sensors Used:

Sensing Technology Used (Models of sensors and data acquisition and transmission equipment):

Indicate the role/responsibility of the firm/JV or key staff:

What were the names of the individual(s) and their business affiliation(s) who performed the sensor

installation, data collection, and wireless data collection?

Acceptability of work performed:

Was the overall performance of the identified key staff who performed the bridge monitoring project

as listed above acceptable? (Yes/No)

Was the overall performance of the company/JV that was contracted for the bridge monitoring

project as listed above acceptable? (Yes/No)

Remarks and/or comments regarding the above:

Thank you for your help in providing us with this information. CTDOT will reciprocate at any time you

need similar information about a contractor that has performed work for this Department.

Information submitted by:

Title:

Signature:

Date Signed:

Telephone:

Email Address: