REQUEST FOR PRE-QUALIFICATIONS (RFQ) - Build LACCD

Yes No16. Is it true that at no time within the last five (5) years has the Applicant or anApplicant Member refused to sign a Category 1 and 3 Public Contract awarded to it? Yes No17. Is it true that within the last five (5) years no claim or other demand been assertedagainst any bid bond, performance bond or labor and material payment bond posted by theApplicant or an Applicant Member in connection with a Category 1 and 3 Public Contract? Yes No18. Is it true that within the last five (5) years CAL OSHA has not cited and assessedpenalties against the Applicant or any Applicant Member for any “serious,” “willful” or “repeat”violations of its safety or health regulations in connection with a Public Works project? (NOTEto Applicant: If you have filed an appeal of a citation, and the Occupational Safety and HealthAppeals Board has not yet ruled on your appeal, you need not include information about it.) Yes No19. Is it true that the Applicant currently employs an individual with the followingCertification? BICSI Registered Communications Distribution Designer (RCDD). Yes No20. Is it true that the Applicant currently employs an individual with the followingcertification? BICSI (or other credentialed program) Certified Copper/Fiber Installer. Yes No21. Is it true that the Applicant currently holds, in good standing, manufacturerscertification/authorization to provide 20 year + extended warranty for at least one of theStructured Cabling Systems identified in Schedule A? Yes NoB. Past Project ExperienceThe following questions concern the Applicant’s general experience in public contracts.Failure or inability to provide the required number of past projects requested shall result indisqualification. In those instances where a question asks for further information that includes thename of a contact person, the Applicant is required to identify, whenever possible, the personavailable and most knowledgeable about the circumstances that are the subject of the question.If the Applicant is a Project Joint Venture, then answer on the basis of the experience of thePrincipal Managing Partner of the Project Joint Venture.List five (5) Category 1 and 3 Public Contracts remove $ amount that the Applicant (or, if theApplicant is a Project Joint Venture, its Principal Managing Partner) has completed in the past_________________________915 Wilshire Boulevard, Suite 810, Los Angeles, California 90017Exhibit 1: Prequalification Questionnaire: Page 10 of 13