R2022-13 Resolution Authorizing an Engineering Services Agreement with WHKS and Co. and Appropriating Rebuild Illinois (RBI) Funds for the Grove Road Bridge over Sand Creek Arm of Lake Decatur, SN 058-6010, City Project 2019-34

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Local Public Agency County Section Number City of Decatur —IlMacon 19-00934-00-BR� Exhibit D' Qualification Based Selection(QBS)Checklist The LPA must complete Exhibit D. If the value meets or will exceed the threshold in 50 ILCS 510, QBS requirements must be followed. Under the threshold, QBS requirements do not apply.The threshold is adjusted annually. If the value is under the threshold with federal funds being used,federal small purchase guidelines must be followed. ❑ Form Not Applicable(engineering services less than the threshold) Items 1-13 are required when using federal funds and QBS process is applicable.Items 14-16 are required when usingState funds and the QBS process is applicable. P PP No Yes 1 Do the written QBS policies and procedures discuss the initial administration(procurement, management and administration)concerning engineering and design related consultant services? ❑ ❑ 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? 3 Was the scope of services for this project clearly defined? ❑ ❑ 4 lWas public notice given for this project? ❑ ❑ If yes Due date of submittal Methods used for advertisement and dates of advertisement 5 Do the written QBS policies and procedures cover conflicts of interest? ❑ ❑ 6 Do the written QBS policies and procedures use covered methods of verification for suspension and ❑ ❑ debarment? 7 Do the written QBS policies and procedures discuss the methods of evaluation? ❑ ❑ Project Criteria Weighting 8 Do the written QBS policies and procedures discuss the method of selection? ❑ ❑ Selection committee titles for this project Top three consultants ranked for this project in order 1 2 3 9 Was an estimated cost of engineering for this project developed in-house prior to contract negotiation? ❑ ❑ 10 Were negotiations for this project performed in accordance with federal requirements. ❑ ❑ 11 Were acceptable costs for this project verified? ❑ ❑ 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? Do the written QBS policies and procedures cover ongoing and finalizing administration of the project 13 (monitoring, evaluation,closing-out a contract, records retention, responsibility, remedies to violations or ❑ ❑ breaches to a contract,and resolution of disputes)? 14 QBS according to State requirements used? ❑ ON 15 Existing relationship used in lieu of QBS process? ® ❑ 16 LPA is a home rule community(Exempt from QBS). ® ❑ Completed 01/11/22 Page 10 of 10 BLR 05530(Rev.08/05/21)