Fillable Application For Contractor Prequalification (Arizona Department of Transportation)

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Application For Contractor Prequalification (Arizona Department of Transportation)

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APPLICATION FOR
CONTRACTOR
PREQUALIFICATION
Submit to:
Arizona Department of Transportation
Intermodal Transportation Division
Contracts and Specifications Section
205 S. 17th Avenue, Room 121-F
Phoenix, Arizona 85007-3217
NAME OF APPLICANT
MAILING ADDRESS
(CITY) (STATE) (ZIP CODE)
TELEPHONE NO. ( )
NAME OF CONTACT PERSON
(PRINT)
Re
vised 03/14/03
INDEX
INSTRUCTIONS AND INFORMATION
APPLICATION FOR PREQUALIFICATION .................................................... PAGE 1
FILING OF STATEMENTS................................................................................. PAGE 1
PERIOD OF PREQUALIFICATION................................................................... PAGE 1
EXCEPTIONS ...................................................................................................... PAGE 1
SUBMITTAL OF FINANCIAL STATEMENTS ................................................ PAGE 1
EXPERIENCE ...................................................................................................... PAGE 2
LICENSING.......................................................................................................... PAGE 2
EQUIPMENT........................................................................................................ PAGE 2
CORPORATION EVIDENCE OF AUTHORITY ............................................... PAGE 2
JOINT VENTURES.............................................................................................. PAGE 2
BID SUBMITTAL................................................................................................ PAGE 2
APPLICATION FOR PREQUALIFICATION
GENERAL INFORMATION ............................................................................... PAGE 3
TYPE OF WORK SOUGHT ................................................................................ PAGE 3
STATEMENT OF EXPERIENCE ....................................................................... PAGE 6
TABLE OF EQUIPMENT.................................................................................... PAGE 8
AFFIDAVIT FOR INDIVIDUAL ........................................................................ PAGE 9
AFFIDAVIT FOR COPARTNERSHIP .............................................................. PAGE 10
AFFIDAVIT FOR CORPORATION .................................. …………………… PAGE 11
CORPORATION EVIDENCE OF AUTHORITY.............................................. PAGE 12
JOINT VENTURE STATEMENT OF INTENT ................................................ PAGE 13
RULES FOR PREQUALIFICATION OF CONTRACTORS
GENERAL INFORMATION
DEFINITIONS .................................................................................................... PAGE 14
CONTRACTOR PREQUALIFICATION BOARD........................................ … PAGE 14
CONTRACTOR PREQUALIFICATION
CRITERIA........................................................................................................... PAGE 15
JOINT VENTURES ............................................................................................ PAGE 15
PREQUALIFICATION EXPIRATION AND EXTENSION ............................. PAGE 15
CLASSIFICATION OF CONTRACTORS......................................................... PAGE 15
CLASSIFICATION OF FINANCIAL STATEMENTS ..................................... PAGE 16
PREQUALIFICATION LIMITS......................................................................... PAGE 16
RECONSIDERATION OF PREQUALIFICATION .......................................... PAGE 16
ISSUANCE OF BIDDING DOCUMENTS................................................... …. PAGE 16
REDUCED PREQUALIFICATION AMOUNT OR DISQUALIFICATIONS……… .. PAGE 17
ACCESS TO DEPARTMENT PREQUALIFICATION FILES……….…..…….…….. PAGE 17
-1-
INSTRUCTIONS AND INFORMATION
FOR FILING
APPLICATION FOR CONTRACTOR PREQUALIFICATION
APPLICATION FOR PREQUALIFICATION
All persons/firms desiring to offer bids for construction work advertised by the Department must first
make application for prequalification. Application forms are available in Contracts and Specifications Section,
205 S. 17th Avenue, Room 121-F, Phoenix, AZ 85007, phone 602-712-7221 and on the internet
at www.azdot.gov/Highways/cns/prequal.asp.
The completed application is intended to develop information relative to the contractor’s experience,
organization and other pertinent and material facts to acquaint the Department with the bidder’s qualifications
for performing work of the type and magnitude that might be offered for bid. The application is to be
accompanied by a full financial statement including the balance sheet and related statements of income, retained
earnings and cash flows that shows the current financial condition of the contractor.
FILING OF STATEMENTS
Prequalification applications may be filed with the Department at any time provided that the date of filing is at least
15 calendar days prior to the proposed bid opening date of work on which a contractor seeks to bid. Proposal
(Bidding) pamphlets will not be issued to anyone who has not submitted an acceptable prequalification statement.
The Department at any time may request additional information to supplement the statement submitted.
PERIOD OF PREQUALIFICATION
Prequalification applications will be reviewed by the Department and the parties making application will be notified
of the Department’s decision in writing. Prequalification applications will be considered valid for 15 months from
the date of the financial statement.
EXCEPTIONS
The requirement for prequalification may be waived by the Department on projects consisting of specialty work.
SUBMITTAL OF FINANCIAL STATEMENTS
The contractor shall submit the financial statement on the accountant’s own forms provided that these forms are in
substantial compliance with the American Institute of Certified Public Accountants Professional Standards.
Assets such as negotiable securities or construction equipment shall be reflected at cost or book value in the
statement of financial condition. When assets are appraised by an independent appraiser, such value may be
submitted as additional information.
An adequate showing of the nature, amount and availability of personal assets or other securities pledged to the
applicant, if applicable, will be required. A letter from the applicant’s surety company (or parent company if
applicable) may be requested by the Department in instances where higher prequalification amounts are being
requested.
-2-
EXPERIENCE
The contractor’s statement of experience shall include information as to the contract amount, type of work, date of
completion and the name and address of the owner of the work for each contract completed as a prime contractor.
In lieu of any prime contract work, a similar statement should be provided for any subcontract work successfully
completed.
The experience record shall include the major projects completed within three years from the date of application.
Additional information covering experience may also be submitted.
LICENSING
A contractors commercial license to do work in Arizona is required prior to award of a contract. License
applications may be obtained from the Registrar of Contractors, 800 W. Washington , 6
th
Floor, Phoenix, AZ
85007, Phone (602) 542-1502.
EQUIPMENT
A list of the major items of construction equipment owned or controlled by the contractor shall be furnished
including information as to age, purchase price, depreciation charge off and book value.
CORPORATION EVIDENCE OF AUTHORITY
A list of the individuals authorized to sign and submit proposals, contracts, and contract bonds shall be furnished.
JOINT VENTURES
The prequalification applications of the individual contractors desiring to submit a bid as a Joint Venture will be
considered in extending prequalification to the Joint Venture. A statement of intent in the form prescribed herein
shall be filed with the Department at least five calendar days prior to the bid opening date on which the Joint
Venture seeks to bid.
BID SUBMITTAL
The contractor shall purchase bidding documents and submit bid proposals under the same exact name as shown on
his/her prequalification application.
-3-
GENERAL INFORMATION
Conducting Business As:
Individual Partnership Corporation Joint Venture
MAIN OFFICE LOCATION
BUSINESS NAME:
STREET ADDRESS:
City State Zip
MAILING ADDRESS:
City State Zip
PHONE NO.: ( )
FAX NO.: ( )
NAME OF CONTACT PERSON:
OTHER ADDRESSES AND PHONE NUMBERS: (If different than above)
TYPE OF WORK FOR WHICH PREQUALIFICATION IS SOUGHT
If the applicant is a general contractor interested in bidding on all types of highway construction, indicate “All
Classes of Construction” only. If interested in bidding on certain classes of work only, check the box(s)
provided for the particular type of work upon which the applicant wishes to bid.
All Classes of Construction Minor Concrete Structures
Asphalt Concrete Paving Miscellaneous Concrete
(i.e. Sidewalk, Curb & Gutter)
Bridges Pavement/Bridge Repair
Buildings Pavement Marking
Chip Seal Portland Cement Concrete Paving
Electrical Pump Stations and Pipelines
Grading and Draining Rest Areas
Guardrail/Fencing Signing
Landscaping and Irrigation Underground
Other
-4-
1. Is this the applicant’s first request for prequalification with the Arizona Department of Transportation?
Yes No
2. Does the applicant plan to bid an ADOT project as a prime contractor within the next 12 months?
Yes No
If Yes, Tracs/Project No. _________________________________ Bid opening date _____________
3. Has any officer or partner of the applicant ever applied for prequalification with the Arizona Department of
Transportation under a different name?
Yes No
If yes, give details:
4. How long has the applicant been doing business as a contractor under the applicant name? _______________
As a prime contractor? __________________________ As a subcontractor? _____________________________
5. Is the applicant licensed as a commercial contractor in Arizona?
Yes No
If yes, give License No. and Classification(s):
Lic No. Class Lic No. Class
Lic No. Class Lic No. Class
6. Has the applicant, or any subsidiary or affiliate of the applicant, ever been denied contractor prequalification
by any local, state, or federal agency?
Yes No
If yes, give details:
-5-
7. Has the applicant, or any subsidiary or affiliate of the applicant, ever been removed from the approved
bidders list by any local, state or federal agency?
Yes No
If yes, give details:
8. Has any officer or partner of the applicant been an officer or partner in some other firm that has either been
denied contractor prequalification or has been removed from the approved bidders list by any local, state, or
federal agency?
Yes No
If yes, give details:
9. Does the applicant have a financial interest or affiliation with any other highway construction firm, or related
(supplier, vendor, design engineering company, etc.) entity?
Yes No
If yes, give details:
10. Does any officer or partner of the applicant have a financial interest in and/or serve, in whole or in part, as an
officer or partner in any other highway construction firm, or related entity?
Yes No
If yes, give details:
11. List all companies, firms, or organizations that own any part of the applicant:
12. Has the applicant ever failed to complete a highway construction contract?
Yes No
If yes, give details:
13. Has the applicant ever performed highway construction as a prime contractor for the Department?
Yes No
If yes, give the details in paragraph 2 of the Statement
of Experience on page 6.
NOTE: If Additional Space is Needed, Attach a Separate Sheet
-6-
STATEMENT OF EXPERIENCE
1. List the construction experience of the principal individuals of the applicant:
NOTE: List all officers/key individuals that are active in the management and operation of the firm. A
company prepared resume of each officer may be attached in lieu of this section.
A.
Name: First Middle Last Present Position
Years in Construction
Type of Construction Experience: (Owner, Officer, Manager, Supervisor, Etc.)
B.
Name: First Middle Last Present Position
Years in Construction
Type of Construction Experience: (Owner, Officer, Manager, Supervisor, Etc.)
C.
Name: First Middle Last Present Position
Years in Construction
Type of Construction Experience: (Owner, Officer, Manager, Supervisor, Etc.)
D.
Name: First Middle Last Present Position
Years in Construction
Type of Construction Experience: (Owner, Officer, Manager, Supervisor, Etc.)
2. List the major projects completed by the applicant as a prime contractor. Include the largest projects completed for
any public agency. If list includes an Arizona Department of Transportation Highway Construction Project, provide
the TRACS/project number.
A.
Year Completed Type of Work If ADOT, Provide TRACS/Project Number
Contract Amount Owner Name and Address
B.
Year Completed Type of Work If ADOT, Provide TRACS/Project Number
Contract Amount Owner Name and Address
C.
Year Completed Type of Work If ADOT, Provide TRACS/Project Number
Contract Amount Owner Name and Address
D.
Year Completed Type of Work If ADOT, Provide TRACS/Project Number
Contract Amount Owner Name and Address
NOTE: A company prepared list of projects may be attached in lieu of this section if it contains the above information
and must clearly define prime from subcontractor projects.
-7-
3. If work has not been performed as a prime contractor, list the major projects completed
by the applicant as a
subcontractor
:
A.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
B.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
C.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
D.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
E.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
F.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
G.
Year Completed Contract Amount Prime Contractor Name(s) and Address(es)
Type of Work Owner Name(s) and Address(es)
NOTE: A company prepared list may be attached in lieu of this section if it contains the above information.
-8-
TABLE OF EQUIPMENT
List of construction equipment owned or controlled by the applicant.
QUANTITY
DESCRIPTION, NAME
CAPACITY, ETC.
MODEL
YEAR
PURCHASE
PRICE
DEPRECIATION
AMOUNT
BOOK
VALUE
NOTE: A company prepared list of equipment may be attached in lieu of this section.
-9-
AFFIDAVIT FOR INDIVIDUAL
STATE OF
)
) ss:
COUNTY OF
)
being duly sworn, deposes and says that the
foregoing application statements are true and that any depository, vendor or agency therein named is hereby
authorized to furnish the Arizona Department of Transportation with any information necessary to verify this
application.
(Name of Firm)
(Signature)
(Title)
(Signer’s name typed/printed)
Subscribed and sworn to before me this
day of 20
My Commission Expires:
Notary Public
-10-
AFFIDAVIT FOR COPARTNERSHIP
STATE OF
)
) ss:
COUNTY OF
)
being duly sworn, deposes and says that he/she is
a member of
(Name of Firm)
and says that the foregoing application statements are true and that any depository, vendor or agency therein named
is hereby authorized to furnish the Arizona Department of Transportation with any information necessary to verify
this application.
(Name of Firm) (Date of Organization)
(Signature of above named partner) (Partner name typed or printed)
(Signature) (Partner name typed or printed)
(Signature) (Partner name typed or printed)
(Signature) (Partner name typed or printed)
(Signature) (Partner name typed or printed)
Subscribed and sworn to before me this
day of 20
My Commission Expires:
Notary Public
-11-
CORPORATIONS MUST COMPLETE AFFIDAVIT FOR CORPORATION AND
EVIDENCE OF AUTHORITY (FOLLOWING PAGE)
STATE OF )
) ss:
COUNTY OF )
being duly sworn, deposes and says that
he/she is
(Title)
of and says that the foregoing
(Name of Firm)
application statements are true and that any depository, vendor or agency therein named is hereby authorized to
furnish the Arizona Department of Transportation with any information necessary to verify this application.
(Date Incorporated) (Signature of above named Officer)
(CORPORATE SEAL)
Subscribed and sworn to before me this
day of 20
My Commission Expires:
Notary Public
President Name (Typed or Printed)
Vice President Name (Typed or Printed)
Secretary Name (Typed or Printed)
Treasurer Name (Typed or Printed)
-12-
CORPORATION EVIDENCE OF AUTHORITY
The following individual(s) are authorized to execute, sign and submit proposals, contracts and contract bonds on
behalf of the corporation.
1.
(Print Name) (Signature of Authorized Officer) (Title)
2.
(Print Name) (Signature of Authorized Officer) (Title)
3.
(Print Name) (Signature of Authorized Officer) (Title)
4.
(Print Name) (Signature of Authorized Officer) (Title)
5.
(Print Name) (Signature of Authorized Officer) (Title)
6.
(Print Name) (Signature of Authorized Officer) (Title)
NOTE:
It is the responsibility of the corporation to notify the Department of any changes of signing authority.
If a corporation is incorporated in any state other than the State of Arizona, the corporation shall submit to the
Department prior to the award of contract, proof from the Arizona Corporation Commission that it has been granted
authority to do business in the State of Arizona.
-13-
JOINT VENTURE STATEMENT OF INTENT
To be filed with the Department at least five calendar days prior to the date of bid opening.
We, the undersigned, each being a Prequalified Contractor with the Arizona Department of Transportation, desire
to bid as a joint venture on Project:
(Tracs/Project Number) (Name of Project)
and do hereby certify that each of our respective Contractor Prequalifications are appropriate to the proposed joint
venture.
We further state that authorization to enter into a joint venture, to submit a bid, to execute all bid documents and, if
awarded a contract, to execute all contract documents, are hereby made a part of this Statement of Intent.
We further state that a fully executed, certified copy of the joint venture agreement between the undersigned firms
will be furnished to the Department upon request.
If one or more of the parties to the joint venture are corporations, a copy of a Resolution from the Board of
Directors authorizing the corporation to enter into the joint venture and execute all contract documents shall be
submitted with the statement of intent.
(Name of Firm) (Name of Firm)
(Signature) (Signature)
(Title) (Title)
If by a Corporation: If by a Corporation:
(Seal) (Seal)
Subscribed and sworn to before me this Subscribed and sworn to before me this
day of 20 day of 20
My Commission Expires: My Commission Expires:
Notary Public Notary Public
-14-
ARIZONA DEPARTMENT OF TRANSPORTATION
INTERMODAL TRANSPORTATION DIVISION
RULES FOR PREQUALIFICATION OF CONTRACTORS
(R17-3-201 thru R17-3-204)
R17-3-201. General
A. Definitions.
1. “Application” means a request for contractor prequalification, consisting of an application booklet available
from the Department’s office of Contracts and Specifications, and a financial statement prepared according
to the requirements of this subsection and R17-3-202.
2. “Board” means the Contractor Prequalification Board.
3. “Compiled financial statement” means a financial statement prepared for form, appropriateness, and
arithmetic accuracy. It does not express an opinion or provide any assurance regarding the financial
statement.
4. “Contractor” means the individual, partnership, firm, corporation, joint venture, or any combination
acceptable to the Department, that seeks to contract with the Department for constructing or reconstructing
state transportation facilities, unless the context requires otherwise.
5. “Contractor prequalification” means the Department’s process of review and evaluation of a contractor’s
work history and current financial condition before a contractor is allowed to submit a proposal for
constructing or reconstructing state transportation facilities.
6. “Department” means the Arizona Department of Transportation.
7. “Examined financial statement” means a financial statement that includes the amounts and disclosures in
the firm’s financial statement, an assessment of the accounting principles used and the significant estimates
made by management, and an evaluation of the overall financial statement presentation.
8. “Financial statement” means a financial report prepared according to generally accepted accounting
principles by an independent certified public accountant or an independent public accountant. The
financial statement includes a cover letter on the accountant’s letterhead, a balance sheet, a statement of
cash flows, an income statement, and all notes and appropriate supporting schedules.
9. “Joint venture” means the combination of two or more contractors for the purpose of submitting a proposal
to the Department and performing a contract for constructing or reconstructing state transportation
facilities.
10. “Prequalification amount” means the dollar limitation of each contract, based on the Department’s estimate
of contract value, for which a contractor may submit a proposal to the Department for constructing or
reconstructing state transportation facilities.
11. “Reviewed financial statement” means a financial statement that includes an inquiry of company personnel,
and a review of the analytical procedures applied to the financial data. It does not express an opinion
regarding the financial statement taken as a whole.
12. “State Engineer” has the meaning in A.R.S. § 28-6901(3).
B. Contractor Prequalification Board
1. The State Engineer shall appoint the Board to consider and decide on applications for contractor
prequalification.
2. The Board will be comprised of three Department employees, one of whom shall be a professional
engineer, registered by the Arizona Board of Technical Registration, and one a certified or licensed public
accountant.
3. The Board’s authority to determine prequalification does not limit the Department’s ability to establish
additional criteria for contracts.
-15-
R17-3-202. Contractor Prequalification
A. Criteria. An applicant for contractor prequalification shall include on the application and the Board shall
consider the following information in determining the prequalification amount for a contractor:
1. Key personnel and their work experience.
2. Organizational structure.
3. History of past or current projects and contracts.
4. Company affiliations.
5. Equipment owned or controlled.
6. Any applicable licenses.
7. Type of work requested.
8. Individuals authorized to act on behalf of the contractor.
9. Any prequalification or bidding disputes with a government agency, and
10. Financial condition.
B. Joint Ventures.
1. Each contractor in a proposed joint venture shall be prequalified. The joint venture shall submit a joint
venture statement of intent at least 5 calendar days before the applicable bid opening date.
2. If one or more of the parties to the joint venture are corporations, a copy of a resolution from the Board
of Directors authorizing the corporation to enter into the joint venture and execute all contract
documents shall be submitted with the statement of intent.
3. Contractors operating as a joint venture on a continuing basis may file for prequalification as a joint
venture.
4. The Board may allow a contractor operating as a joint venture to prequalify for a pro rata share of the
entire contract amount. The percentage share of work shall not exceed each individual contractor’s
prequalification amount.
C. Prequalification Expiration and Extension.
1. Prequalification expires 15 months after the end of a contractor’s fiscal year, as reflected on the
financial statement. Due to the time necessary to prepare an examined financial statement, the Board
may grant up to a 60 day extension on the expiration of prequalification, if:
a) The contractor submits a letter from its accountant stating the reasons for delay in preparing the
examined financial statement, and
b) The letter from the accountant states the anticipated completion date of the examined financial
statement, and
c) The contractor submits an interim compiled or reviewed financial statement that was prepared
within the previous six months.
2. The Board will notify each contractor in writing of its decision on the contractor’s prequalification
amount.
D. Classification of Contractors. The Board shall categorize contractors into the following classifications:
1. Inexperienced firms: Firms that have no experience as contractors in transportation facilities
construction work.
2. New firms: Recently organized firms that have officers with experience with other contractors in
positions of responsibility for transportation facilities construction.
3. Unknown firms: Firms that have experience as contractors but have not completed a transportation
facilities construction contract as a contractor for the Department within the past five years or at any
time.
4. Known firms: Firms that have successfully completed at least one transportation facilities construction
contract within the past five years as a contractor for the Department.
-16-
E. Classification of Financial Statements.
1. All financial statements shall be examined, reviewed, or compiled according to generally accepted
accounting principles, by either an independent certified public accountant or an independent public
accountant, registered and licensed under the laws of any state. A contractor shall not submit a
financial statement prepared by either a certified or public accountant who is directly or indirectly
interested in or affiliated with the business of the contractor.
2. A contractor that submits a compiled financial statement will be limited to a maximum prequalification
amount of $300,000.
3. A contractor that submits a reviewed financial statement will be limited to a maximum prequalification
amount of $1.5 million.
4. A contractor that desires a prequalification amount in excess of $1.5 million shall submit an examined
financial statement.
F. Prequalification Limits. In determining the prequalification amount for each contractor, the amount set by
the Board may be less than the maximum amount set out in this subsection due to the Board’s evaluation of
the contractor’s information under R17-3-202(A).
1. Inexperienced firms. An inexperienced firm will be limited to a maximum prequalification amount
of $300,000 until the contractor has satisfactorily completed at least one transportation facilities
construction contract for any public agency.
2. New firms. A new firm will be limited to a maximum prequalification amount of five times the firm’s
net worth.
3. Unknown firms. An unknown firm will be limited to a maximum prequalification amount of five
times the firm’s net worth or the amount of the largest transportation facilities construction contract it
has successfully completed as a contractor for any other public agency, whichever is larger.
4. Known firms. A known firm will be limited to a maximum prequalification amount of ten times the
firm’s net worth. An unlimited prequalification amount may be granted if the product of ten times the
firm’s net worth exceeds $100 million.
5. All firms. Evidence of additional assets pledged in behalf of a contractor or letters from a contractor’s
surety company may be considered in establishing higher prequalification amounts than stated in
subsections (F)(2) through (F)(4). A parent company that pledges assets in behalf of a contractor shall
submit a financial statement.
G. Reconsideration of Prequalification Determination.
1. If a contractor is dissatisfied with the Board’s decision, the contractor may request in writing a hearing,
within 15 days of receiving the Board’s decision. The hearing shall be conducted under A.R.S. § 41-
1062. The letter shall indicate the basis for the request and shall provide supportive data. The Board
shall review the request and accompanying information and decide on the request within 30 calendar
days of its receipt.
2. If the contractor is still dissatisfied with the decision of the Board, the contractor may appeal to the
State Engineer. The Board shall notify the contractor about the appeal procedures.
H. Issuance of Bidding Documents. A contractor shall not request bid documents for a contract for which it
is not prequalified.
I. The Department may waive the prequalification requirement on an individual contract when it is in the best
interest of the state. The advertisement for bids shall identify if prequalification is waived.
-17-
R17-3-203. Reduced Prequalification Amounts or Disqualifications
A. The Board may reduce the prequalification amount of a contractor already prequalified or disqualify a
contractor from bidding if a contractor:
1. Falsifies any document or misrepresents any material fact in the information furnished to the
Department;
2. Fails to enter into a contract with the Department;
3. Defaults on a previous contract with any public agency;
4. Has an unsatisfactory work performance record with the Department on the basis of workmanship,
competent superintendence, adequate and proper equipment, timely completion, or failure to submit
required documentation for closing out a contract; or
5. Fails to provide notification to the Board, within 30 calendar days of occurrence, of any change in
ownership, corporate officers or general partners, bankruptcy, receivership, court supervised
reorganization, or the entry of a judgement in a judicial or administrative proceeding adverse to the
contractor.
B. The Board shall notify a contractor in writing of its intention to reduce the prequalification amount or to
disqualify a contractor. The Board’s notice to reduce prequalification or to disqualify a contractor shall
become a final determination unless the contractor requests a hearing with the Board within 20 calendar
days after receiving such notification. The Board shall notify the contractor about the hearing procedures.
C. The contractor may appeal the Board’s decision to the State Engineer. The Board shall notify the
contractor about the appeal procedures.
R17-3-204. Access to Department Prequalification Files.
Prequalification files are considered to be strictly confidential. The files will be available only to:
1. Members of the Board,
2. The Director of the Department or any authorized agents of the Department,
3. Members of the Arizona State Transportation Board,
4. The division administrator of the Federal Highway Administration or any authorized representatives,
5. Agents of surety upon the filing of an application for bond duly signed by an authorizing party of the
prequalified firm contractor,
6. Members of the Arizona State Board of Accountancy or their duly authorized representatives, and
7. The contractor that is the subject of the file.
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Application For Contractor Prequalification (Arizona Department of Transportation)

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Completed 20 July 2020

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