R2020-120 Resolution Authorizing Supplement #1 to the Preliminary Engineering Services Agreement for Federal Participation between the City of Decatur and AECOM Technical Services, Inc.

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Exhibit C Federal Qualification Based Selection (QBS) Checklist Local Public Agency City of Decatur Section Number 09-00933-01-BR Project Number 6WGY(165) Job Number D97-009-19 The LPA must complete Exhibit C, if federal funds are used for this engineering agreement and the value will exceed$40,000. The LPA must follow federal small purchase procedures, if federal funds are used and the engineering agreement has a value less than$40,000. ❑ Form Not Applicable (engineering services less than $40,000) 1. Do the written QBS policies and procedures discuss the initial administration (procurement, management, and administration) concerning engineering and design related consultant services? ®Yes ❑ No 2. Do the written QBS policies and procedures follow the requirements as outlined in Section 5-5 and specifically Section 5-5.06(e)of the BLRS Manual? ®Yes ❑ No If no, IDOT's approval date: 3. Was the scope of services for this project clearly defined? ®Yes ❑ No 4. Was public notice given for this project? ®Yes ❑ No Due date of submittal: 07/18/2018 Method(s) used for advertisement and dates of advertisement: Decatur Tribune 6-27-18&7-4-18 5. Do the written QBS policies and procedures cover conflicts of interest? ®Yes ❑ No 6. Do the written QBS policies and procedures use covered methods of verification for suspension and debarment? ®Yes ❑ No 7. Do the written QBS policies and procedures discuss the method of evaluation? ®Yes ❑ No Criteria for this project Weighting Criteria for this project Weighting Prom Understanding &Approach 25% Assigned Personnel 25% Firm's Experience 20% Firm's Ability&Capacity 10% Technical Promect Management 10 % Proximity to the City 5% DBE Use 5% 8. Do the written QBS policies and procedures discuss the method of selection? ®Yes ❑ No Selection committee (titles)for this project: Public Works Director, City Engineer Asst City Eng Transportation Consultant, County Engineer ADM Representatives Top three consultants selected for this project in order: 1)AECOM 2) CMT 3) Hanson If less than 3 responses were received, IDOT's approval date: 9. Was an estimated cost of engineering for this project developed in-house prior to contract negotiation? ®Yes ❑ No 10. Were negotiations for this project performed in accordance with federal requirements? ®Yes ❑ No 11. Were acceptable costs for this project verified? ❑Yes ❑ No ® LPA will rely on IDOT review and approval of costs. 12. Do the written QBS policies and procedures cover review and approving for payment, before forwarding the request for reimbursement to IDOT for further review and approval? ®Yes ❑ No 13. Do the written QBS policies and procedures cover ongoing and finalizing administration of the project (monitoring, evaluation, closing-out a contract, record retention, responsibility, remedies to violations or breaches to a contract, and resolution of disputes)? ®Yes ❑ No Page 8 of 8 BLR 05610(Rev.05/31/19) Printed on 8/28/2020 11:48:36 AM