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Local Public Agency Countv Section Number <br /> City of Decatur Macon 20-00022-00-BR <br /> Exhibit 0 <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,OBS 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 /> ❑ 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 lWas 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 <br /> Methods used for advertisement and dates of advertisement <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? ❑ ❑ <br /> Project Criteria Weighting <br /> Add <br /> FT-Do the written QBS policies and procedures discuss the method of selection? ❑ ❑ <br /> Selection committee titles for this project <br /> Top three consultants ranked for this project in order <br /> 1 <br /> 2 <br /> 3 <br /> 9 Was an estimated cost of engineering for this project developed in-house prior to contract negotiation? ❑ ❑ <br /> 10 Were negotiations for this project performed in accordance with federal requirements. ❑ ❑ <br /> 11 Were acceptable costs for this project verified? ❑ ❑ <br /> 12 Do the written QBS policies and procedures cover review and approving for payment,before forwarding 13 ❑ <br /> the request for reimbursement to IDOT for further review and approval? <br /> Do the written QBS policies and procedures cover ongoing and finalizing administration of the project <br /> 13 (monitoring,evaluation,closing-out a contract, records retention,responsibility,remedies to violations or ❑ ❑ <br /> breaches to a contract,and resolution of disputes)? <br /> 14 QBS according to State requirements used? ❑ <br /> 15 Existing relationship used in lieu of QBS process? ® ❑ <br /> 16 LPA is a home rule community(Exempt from QBS). ® ❑ <br /> Completed 01/11/22 Page 10 of 10 BLR 05530(Rev.08105/21) <br />