Fillable Contractor's Handbook & Qualifications Application (White Plains, NY)

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Contractor's Handbook & Qualifications Application (White Plains, NY)

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Contractor's Handbook &
Qualifications Application
FOR CITY OF WHITE PLAINS
COMMUNITY DEVELOPMENT PROGRAM
NEIGHBORHOOD HOUSING REHABILITATION PROGRAM
Contractor's Handbook & Qualifications Application
Page | 1
Contractor's Handbook
Foreword
The Neighborhood Housing Rehabilitation Program has helped to rehabilitate over 4,600 housing units
in the City utilizing over $14 million in federal funds since 1974. Loans are available at below-market
rates to income qualified property owners. Typical home repairs include heating, plumbing, electrical
work, roofing, siding and window replacement, carpentry, masonry, drainage and more.
The Neighborhood Rehabilitation Program maintains an open list of pre-qualified, licensed and insured
contractors. Only pre-qualified professionals are eligible to submit bids. If your firm is interested in
being on the City's pre-qualified list, please complete the Qualifications Form for Contractors.
White Plains is committed to meeting and surpassing any guidelines for the support of Minority-owned
and Women-owned Business Enterprises (M/WBE). We encourage contractors to get involved in
registering your business in Westchester County and NYS Empire Development/Division of Minority
and Women Owned Business Development.
Thank you for your interest in becoming one of our prequalified contractors. The successful operation
and value of this program reflects highly on the attitudes and skills of our partners and will always be
a predominant factor for continued effectiveness.
The purpose of this document is to:
1. describe the procedures to be used while working on projects financed with CDBG program
resources
2. provide helpful information and familiarity with the forms used in the program
This guidebook will familiarize you with the criteria, procedures, and standards of the Community
Development Block Grant Rehabilitation Program. Becoming well versed on the information and
documents within this guidebook, and gaining a true understanding (and appreciation) of how these
materials are collectively used, will be of utmost value in facilitating a successful and valued program.
When new procedures develop or changes are made to the current procedures, copies will be issued
for inclusion in the handbook to all contractors on the bidder’s list.
If you have any questions or concerns about our program, please contact:
EDWARD NIXON
REHABILITATION OFFICER
914-422-1300
ENIXON@WHITEPLAINSNY.GOV
Contractor's Handbook & Qualifications Application
Page | 2
GENERAL INFORMATION AND CONTRACTOR REQUIREMENTS
Requirements to Enter Contractor Registry
Basic Requirements
To be eligible for participation in our program, a general contractor must provide:
•
Contractor’s Qualification Form, providing information on company structure and financial
ability to undertake projects
• Valid New York State Contractor’s License
•
Workmen's Compensation
• Federal Tax ID Number
•
Necessary “tools of the trade” to include: contractor tools and equipment, a vehicle for
work/job
transportation with capacity to haul tools, equipment and possibly some
construction materials and basic
small office equipment including cell phone
•
Basic communication/contact information consisting of phone numbers and email
addresses
•
Evidence of acceptable past performance record on housing rehabilitation projects (if
feasible)
Contractor's Handbook & Qualifications Application
Page | 3
COMMUNITY DEVELOPMENT REHABILITATION PROGRAM
Insurance Review Guidelines
Please carefully follow these guidelines to provide the required insurance certificates. If you have
already provided a certificate, if any information is missing or incomplete, resend a correct
certificate(s). The certificate(s) shall include:
1. The name of the Insurance Company.
2. The name of the contractor as insured and include the correct address.
3. “Certificate Holder” or “Additional Insured” shall specify “The City of White Plains Community
Development Rehabilitation Program and All Homeowners for Whom Insured is to do work
under the City of White Plains Community Development Rehabilitation Program” if you are
providing an annual policy.
4. For individual policies, please show “Certificate Holder” or “Additional Insured” as the City of
White Plains Community Development Rehabilitation Program and the name of the
homeowner(s).
5. The following minimum coverage is required:
a. Bodily injury
$500,000 for each person
$1,000,000 for each occurrence
b. Property damage
$100,000 for each occurrence
c. Workmen's compensation
entire obligation under NYS Law
6. Location: for annual policies statements like “all locations” or “all work in City of White Plains”
are acceptable as long as the particular location is covered. For individual policies it should
state the correct owners address.
7. The expiration date for each in number 5 (a) (b) and (c).
8. That if the policy is cancelled, ten (10) days advance written notice shall be given to the City of
White Plains.
9. The signature of an authorized person from the Insurance Company.
For Further Information Please Contact the Community Development Rehabilitation Office:
70 Church Street
White Plains, NY 10601
P: (914) 422-1300
E: planning@whiteplainsny.gov
70 Church Street, White Plains, New York 10601
Phone: (914) 422 - 1269 * Fax: (914) 422 - 1471
DEPARTMENT OF BUILDING
CITY OF WHITE PLAINS
INSURANCE COMPLIANCE
APPLICATION WILL NOT BE ACCEPTED WITHOUT A CERTIFICATE OF INSURANCE!
CERTIFICATE IS TO BE MADE OUT TO THE CITY OF WHITE PLAINS, 255 Main Street, White Plains, NY 10601.
LIABILITY POLICY SHALL INCLUDE THE CITY OF WHITE PLAINS AS ADDITIONAL INSURED AND ALL
POLICIES SHALL PROVIDE 30 DAYS NOTICE TO THE CITY OF WHITE PLAINS PRIOR TO CHANGE OR
CANCELLATION
Please submit the following information on a Certificate of Insurance form from your insurance company at the time
of submitting application:
Contractor's Applications - ( With employees).
A)------------- GENERAL LIABILITY $1,000,000 coverage each occurrence
B)------------- AUTOMOTIVE LIABILITY $1,000,000 coverage
C)------------- WORKER’S COMPENSATION STATUTORY (Acord Form not acceptable)*
D)------------- N.Y. STATE DISABILITY STATUTORY (Acord Form not acceptable)*
CONTRACTORS WITH NO EMPLOYEES SHALL PROVIDE ITEMS A. & B. PER ABOVE REQUIREMENTS AND A
APPROVED NYS WORKER'S COMPENSATION BOARD FORM #CE-200(12-08). CONTRACTOR UNDERSTANDS
THAT PERMIT MAY NOT BE ISSUED IF FORM IS NOT SUBMITTED TO BUILDING DEPARTMENT.
Homeowner's Applications - All work to be performed by homeowner with no employees.
1. Homeowner shall provide proof of general liability insurance of $500,000 per occurrence.
2. Homeowner shall submit a completed NYS Workers' Compensation Board form #BP-1(9-07).*
(One completed #BP-1(9-07) satisfies both Workers' Compensation & Disability requirements.)
*NOTE: Effective 12/01/08 only the following completed forms approved by the State of New York Workers'
Compensation Board shall be accepted by the City of White Plains Building Department as proof of insurance
compliance.
WORKERS' COMPENSATION- #CE-200 (12-08) ; #C-105.2 or U-26.3; #SI-12
DISABILITY REQUIREMENTS -#CE-200(12-08) ; #DB-120.1 ; #DB-155
Any questions relating to these forms should be directed to the Board's Bureau of Compliance at 866-298-7830 or go
to their Official Website: www.wcb.ny.gov
http://www.cityofwhiteplains.com/
Insurance Compliance 10/14
Print Form
Prove It to Move It
New York State Workers' Compensation Board -- December, 2011 14
Form CE-200
Contractor Qualifications
For City of White Plains
Community Development Program
Neighborhood Housing Rehabilitation Program
Please complete the application using the fill-able PDF form. Print, sign and submit the original hard
copy either in person or by mail.
Part 1: COMPANY INFOMATION
Business Name: Business Phone #:
Owner's Name(s) Cell Phone Contact:
Business Address: E-mail:
NYS MWBE Certified: Yes
No
NYS SDVOB Certified: Yes
No
Part 2: CONSTRUCTION CAPABILITIES
Check all that apply:
General Contracting Masonry
Windows Insulation
Painting Glass
Carpentry Landscaping
Plumbing Electrical
Siding Fencing/Railing
Tree Work Asbestos Removal
Mold Removal (assessment) Mold Removal (remediation)
Paving (driveways, etc.) Roofing
Heating Garage Doors
Earthmoving Demolition
Flooring Chimney/Fireplaces
Excavation
Other
Part 3: FOR CORPORATIONS ONLY
Federal Tax ID #: EIN #:
State Incorporated: Date Incorporation:
Please Provide Names for Each of the Following:
President: Vice President:
Secretary: Treasurer:
Part 4: FOR PARTNERSHIPS ONLY
Type of Partnership: General Limited Association
Partner (1): Partner (2):
Address:
(For Partner 1)
Address:
(For Partner 2)
Part 5: GENERAL INFORMATION
State Tax ID #: Westchester County
Home Improvement
License #:
Years in Business: Annual Sales (last year):
Permanent
Employees:
PT Employees:
Geographic Limits of Operation:
If you authorize a person to act as a representative, please list their name(s) below:
If you authorized a person to act as a representative, please list their authorized actions below:
Sign Contracts
Represent the Company During Conferences
Other
List Contractor's Major Equipment Stock:
Please provide the name of your insurance carrier and attach a copy of your current insurance
certificate to this form
Name: Policy #:
Address:
Can the Company obtain
a performance bond?:
Yes No
If yes, please give the name of the agent and amount of bond
obtainable:
If yes, please give the name of the agent and amount of bond obtainable:
If this company has conducted business under another name, provide the name and address of
said business below:
Has this Company ever defaulted on any work awarded?
Yes No
If yes, please provide the date and details below:
Are there any lawsuits or liens pending against this Company for work performed?
Yes No
If yes, please provide details:
Has this Company or any partner/officer/director ever filed for bankruptcy?
Yes No
If yes, please provide details:
Has this Company, any partner/officer/director ever been indicted, tried or convicted of a
crime related to work performed?
Yes No
If yes, please state all relevant details below:
Please provide three (3) examples of projects completed and provide the owner's name, address
and phone number (these may be used as references):
Project (1):
Owner Name (1): Phone Number (1):
Address (1):
Project (2):
Owner Name (2): Phone Number (2):
Address (2):
Project (3):
Owner Name (3): Phone Number (3):
Address (3):
List at least two (2) building supply companies from which this Company has purchased over
$5,000 in materials from within the past year:
Supply Company (1):
Supply Company (2):
Supply Company (3):
Is this Company on the Equal Employment Opportunities Contractors Non-Compliance List?
Yes No
If yes, provide the date this Company was placed on the list:
List names and addresses of two (2) major sub-contractors used by this Company:
Sub Name (1):
Sub Address (1):
Sub Name (2):
Sub Address (2):
List languages spoken by contracting staff (for communicating with our non-English speaking
homeowners):
Language (1):
Language (2):
Language (3):
Contractor's Handbook & Qualifications Application
Page | 15
CONTRACTOR’S ACKNOWLEDGEMENT
The undersigned contracting firm agrees to be considered for placement on the housing rehabilitation
program’s contractor registry. I hereby authorize and request any person, firm or corporation to furnish
any and all information requested by the City of White Plains Community Development Neighborhood
Rehabilitation Program in verification of the information provided by Company in this Statement of
Qualifications.
I hereby acknowledge that I am responsible to provide a new certificate if there is a change in any
information. I understand that I am responsible to provide current insurance documents every 6
months whether the insurance is paid annually or not. I assure that I have read the attached Insurance
Review Guidelines.
I understand that all work will be performed by my company. I understand that if any portion of the
project requires sub-contracting due to a specialty trade requirement, such subcontracting must be
reviewed and approved by the CD Rehabilitation Officer. Furthermore, any and all subcontractors shall
provide all licenses and insurance requirements as stated above or the primary contractor can assume
these responsibilities on behalf of the subcontractor and shall submit new insurance documentation
naming the subcontractor as insured.
I hereby certify that the answers to the foregoing questions and all statements contained herein are
true and correct to the best of my, as a Company’s representative, knowledge and belief.
The firm will comply with the following conditions on all rehabilitation work performed on properties
financed by the program:
1. To use applicable contract forms and documents as approved by the Rehabilitation Officer or
program staff and made available for use and reference
2. If work performed by the contractor is found to be unsatisfactory by Rehabilitation Officer or
program staff or evidenced in contract relations between the contractor, homeowner, and
other parties are found to be unsatisfactory, program staff may remove the contracting firm’s
name from the contractor registry
3. All work shall be performed in accordance with the program’s housing rehabilitation standards
4. Comply with Insurance Policy Coverage requirements
5. Comply with Workers’ Compensation Compliance requirements
6. Westchester County Home Improvement Contractor Registration
7. The contractor will abide by the Equal Opportunity provisions of the Civil Rights Act
8. The contractor certifies that their license has not been revoked by any governing body
Construction Company/Contractor:
Phone #:
(please print)
Signature of Authorized
Representative:
Date:
Print Name:
Title:
APPLICATION CHECKLIST
Please complete the application using the fill-able PDF form. Print, sign and submit the original hard
copy either in person or by mail.
Please ensure all required items are included in your application
General Liability
Automotive Liability
Worker's Compensation
NY State Disability
Print and Sign Certificate of Attestation of Exemption (if applicable)
Print and Sign Contractor's Acknowledgement
Complete Contractor Qualifications Form
Print and Sign Statement of Qualifications Form
MWBE certificate (if applicable)
SDVOB certificate (if applicable)
New York State Mold License (if applicable)
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Completed 2 November 2020

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