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Local Public Agency Prime Consultant(Firm)Name County Section Number <br /> Decatur AECOM Technical Services, Inc. Macon 09-00933-01-BR <br /> Exhibit C <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,OBS 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 OBS policies and procedures discuss the initial administration(procurement, management <br /> and administration)concerning engineering and design related consultant services? i. <br /> 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 /> Was the scope of services for this project clearly defined? ❑ El <br /> 4 Was public notice given for this project? El El <br /> If yes Due date of submittal 07(18118 <br /> Method(J used for advertisement and dates of advertisement <br /> Decatur Tribune 6-27-18& 7-4-18 <br /> 5 Do the written OBS policies and procedures cover conflicts of interest? 0 El <br /> u Do the written QBS policies and procedures use covered methods of verification for suspension and ❑ <br /> 6 El <br /> debarment? <br /> 7 Do the written QBS policies and procedures discuss the methods of evaluation? 0 <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%i <br /> Firm's Ability&CapacityI 10°/a <br /> Proximity to the City 5% <br /> 1 8 Do the written QBS policies and procedures discuss the method of selection? Tag-1 <br /> Selection committee jt!Ues)for this project _ <br /> r .. ---- - IIS <br /> Top three consultants ranked for this project in order <br /> _ <br /> 2 _ <br /> 3 <br /> 9 Was an estimated cost of engineering for this project developed in-house prior to contract negotiation? ❑ Xi <br /> 10 Were negotiations for this project performed in accordance with federal requirements. 1111 M <br /> 11 Were acceptable costs for this project verified? 0 11211 <br /> 12 Do the written QBS policies and procedures cover review and approving for payment,bebre forwarding then g <br /> request for reimbursement to IDOT for further review and approval? <br /> • <br /> Completed 08/28/23 Page 9 of 10 BLR 05530(Rev.07/08/22) <br />