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Local Public Agency _ _ —_ County Section Number <br /> 'City of Decatur '!Macon 09-00933-01-BR <br /> --_ _ _ —---—_-- -- ._.J[. .-- —------ R <br /> Exhibit D <br /> Qualification Based Selection(QBS)Checklist <br /> The LPA must complete Exhibit D.if the value meets or will exceed the threshold in 50 ILCS 510,QBS requirements must be followed. <br /> Under the threshold,QBS requirements do not apply.The threshold is adjusted annually.If the value is under the threshold with federal <br /> funds being used,federal small purchase guidelines must be followed. <br /> D Form Not Applicable(engineering services less than the threshold) <br /> Items 1-13 are required when using federal funds and QBS process is applicable.Items 14-16 are required when <br /> using State funds and the QBS process is applicable. <br /> No Yes <br /> 1 Do the written QBS policies and procedures discuss the initial administration(procurement,management ❑ <br /> and administration)concerning engineering and design related consultant services? <br /> 2 Do the written QBS policies and procedures follow the requirements as outlined in Section 5-5 and ❑ <br /> specifically Section 5-5.06(e)of the BLRS Manual? <br /> 3 Was the scope of services for this project clearly defined? ❑ <br /> 4 lWas public notice given for this project? ❑ <br /> If yes Due date of submittal'07/18118 i <br /> Method(s)used for advertisement and dates of advertisement <br /> Decatur Tribune 6-27-18 & 7-4-18 <br /> i <br /> 5 Do the written QBS policies and procedures cover conflicts of interest? ❑ <br /> 6 Do the written QBS policies and procedures use covered methods of verification for suspension and ❑ <br /> debarment? <br /> 7 Do the written QBS policies and procedures discuss the methods of evaluation? ❑ z <br /> Project Criteria Weighting <br /> - Project Understanding &Approach 25% <br /> - Firm's Experience 20% <br /> - Technical Project Management 10% <br /> - DBE Use 5% <br /> - Assigned Personnel 25% <br /> - Firm's Ability&Capacity 10% <br /> Proximity to the City 5% <br /> Add <br /> 8 JDo the written QBS policies and procedures discuss the method of selection? ❑ <br /> Selection committee Jtitkes for thisproject <br /> :Public Works Director, City Engineer, Asst. City Eng., Transportation Consultant, County <br /> !Engineer, ADM Representatives _ <br /> Top three consultants ranked for this project in order <br /> 1 AECOM <br /> 2 CMT <br /> 3 Hanson <br /> 9 Was an estimated cost of engineering for this project developed in-house prior to contract negotiation? ❑ R <br /> 10 Were negotiations for this project performed in accordance with federal requirements. ❑ N <br /> 11 Were acceptable costs for this project verified? ❑ 9 <br /> 12 Do the written QBS policies and procedures cover review and approving for payment,before forwarding the iJ Z <br /> request for reimbursement to IDOT for further review and approval? <br /> Completed 11/12/21 Page 10 of 11 BLR 05530(Rev.08/05/21) <br />