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Layne - Bid Number 2014-25 (Full Proposal) Table of Contents Section A ....................................................... Letter of Interest Section B .................................... Evaluation of Qualifications ¾ Bidders Qualification Form Section C ............................................... Forms and Affidavits ¾ Affidavit 1 – Design Builder’s Affidavit ¾ Affidavit 2 – Debarment Disclosure ¾ Affidavit 3 – Criminal Record ¾ Affidavit 4 – Anti-Kickback Affidavit ¾ Affidavit 5 – Public Entity Crimes Form ¾ OSHA Acknowledgment ¾ Acknowledgment of Sub-Soil Conditions Section D ........................... Payment and Performance Bond ¾ Bonding Capacity Surety Letter Section E .................. Insurance Coverage Acknowledgment ¾ Certificate of Insurance Section F ......................... Safety Record – Past Performance ¾ Experience Modification Rate (EMR) Data ¾ OSHA’s Form 300 and 300A Section G ........................ Ability to Interface with the Village Layne and CPH have an extensive and solid history of working together on similar, successful, projects. In addition, each firm individually has detailed experience and more-than-qualified key personnel. This means we are able to join forces as highly knowledgeable, competent, and capable firms and come together as a single, comprehensive and multi-disciplinary team, ensuring the Village of Miami Shores will be provided with exceptional services. Layne and CPH worked on the Design-Build-Operate wastewater system project in Islamorada, Florida – a project currently worth $99 million. This project includes several wastewater pumping stations and over 90 miles of sanitary sewer mains. Specific project details include the following: x Four (4) Vacuum/Transfer Pump Stations. x One (1) Master Pump Station. x Seven (7) Ocean Channel Crossings using Horizontal Directional Drilling (HDD) in sizes ranging from 8” to 18”. x Vacuum/Low Pressure Collection System Consisting of Approximately 400,000 Linear Feet of 3” to 10” PVC Vacuum Sewers and 1-1/4” to 6” HDPE Low Pressure Force Mains. x Transmission System Consisting of Approximately 100,000 Linear Feet of 8” to 18” PVC and 6” to 20” HDPE Force Mains. x Service Connection for Approximately 5,000 Customers. x Installation of 400 Residential and Commercial Grinder Pump Stations. E-1 Grinder Pump Manufacturer. x Customer Service; System Startup, Commissioning, Operations, and Maintenance for 20 years. CPH areas of responsibility included the design and permitting of the vacuum collection system for the Island of Upper Matecumbe Key; vacuum pumping stations for the Islands of South Plantation Key, Upper Matecumbe Key and Lower Matecumbe Key; and low pressure force main collection systems for the Island of Windley Key and portions of Upper Matecumbe Key. CPH provided input data and documentation associated with areas of responsibility incorporated into the Preliminary Design Report for the overall project. This work included an analysis of flow data that incorporated FKEC water consumption information, review of existing package wastewater plants, and survey/analysis provided within the project solicitation documents in order to properly project anticipated wastewater flows for system design. Vacuum pump station designs have been based on vacuum equipment provided by AirVac. CPH provided design for two general use vacuum pumping stations and one vacuum pumping station that also incorporated a force main re-pumping station within the EVALUATION OF QUALIFICATIONS BB Comprehensive Team . . . . . . . . . . .. . . . . . . . . . . . . . . ; Capable to provide all aspects of the scope ; Key personnel with extensive experience ; Available staff and resources ; Established work history with subconsultants ; Extensive understanding and experience ; CBE firms structure. Architectural design of the buildings incorporates aspects of the respective individual site locations in order to blend within the neighborhood. All buildings are designed to withstand hurricane force winds of 150 mph and associated storm surge. Individual pumping stations include AirVac vacuum equipment sized for the specific basins being collected. The vacuum collection system for Upper Matecumbe Key incorporates connections for approximately 986 equivalent dwelling units (EDU). The system provides service along both sides of Overseas Highway in Upper Matecumbe using a conventional saw-tooth profile as generally recommended by AirVac. The project consists of 43,957 LF of PVC pipe ranging in size from 4-10”. The low pressure force main collection systems for Upper Matecumbe Key and Windley Key incorporates connections for approximately 1,755 (UMK) and 678 (WK) equivalent dwelling units (EDU). The systems provide service along both sides of Overseas Highway using a combination of conventional and trenchless technology. Combined the project consists of 37,410 LF of HDPE pipe ranging in size from 1 1/4-6”. CPH provided a complete system design including plan and profile drawings of each pipe run. CPH conducted system hydraulics calculations using Sewercad. CPH is providing limited CEI services for this portion of the project. Layne has additionally worked on a wastewater collection systems for Monroe County in South Florida and the City of Monticello in Indiana. The Cudjoe Regional Design-Build Wastewater Collection System for Monroe County involved the design, construction, outfitting, start-up, performance testing, warranty, and obtaining of governmental approvals for the Outer Islands of Cudjoe Regional Wastewater System. The FKAA Project will be designed and constructed to collect and pump wastewater from the outer islands (Lower Sugarloaf, Ramrod, Little Torch, and Big Pine) to the Cudjoe Wastewater Treatment Plant. The system will serve approximately 5,000 customers. The Rattlesnake Creek Wastewater Collection System for Monticello included the furnishing and installation of grinder pumps, horizontal directional drilled (HDD) force main, and booster stations. CPH has considerable similar experience in South Florida, including working on multiple Vacuum Pump Stations for the City of Key Largo and an Analysis and Redesign Wastewater Collection System for the City of Islamorada. Additionally, CPH has worked on numerous utility relocation projects with similar services throughout Florida, including projects on SR-50 in Orange County, on SR-46 Detour Road and SR-415 in the City of Sanford, and on SR-50 (from SR-429 to CR-545) in the City of Winter Garden. To further expand our qualifications, Layne will be including the Florida Pipeline Company (CBE) and Water Resource Technologies firms during the build process. As for design, CPH will include Brindley Pieters & Associates, GEOSOL, Marlin Engineering, and Tierra South Florida to be sure all requirements of the Village are met (all of which are certified CBE firms). Our team promises to work with the Village of Miami Shores as an extension of its staff; we are especially excited to be a part of this project and hope the following pages will showcase our experience and qualifications favorably. DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-1 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form STEP 1 - EVALUATION OF QUALIFICATIONS Section A –Project Information Bid No.: 2014-25 Project Name: Design-Build Services for the Central Business District Low Pressure Sewer System (LPSS) and Water Main Improvements Fi r m N o . Section B –Design-Builder’s Information Complete this section for the design-builder only; pursuant to Division 1, Section 1.7 of the RDBS “Teaming Restrictions”, design-builder may only participate on one (1) team when responding to this solicitation. 1 Design-Builder’s Name: FEIN: Business Address: Contact Person’s Name & Title: Addenda Received (Indicate number) Telephone Number: ( ) - Fax Number: ( ) - E-mail: General Contractor’s / Building Contractor’s License No. Fi r m N o . Section C (1) –Proposed Architecture & Engineering (A &E) Subconsultants (DESIGN TEAM) Complete this section for all proposed A & E subconsultants; pursuant to Division 1, Section 1.7 of the RDBS “Teaming Restrictions”. A & E Subconsultant’s Name FEIN: 2 3 4 5 6 7 8 9 Layne Heavy Civil,Inc.20-3512785 1117NW55thSt.,FortLauderdale,FL33309 WesleySelf,P.E.,DBIAAlternativeDeliveryManager 2054478787 7709694363 wesley.self@layne.com CGC1509783 CPH,Inc.59-2068806 --SubtoCPH-BrindleyPieters&Associates,Inc.(BPA)59-3057983 --SubtoCPH-GEOSOL,Inc.65-0997886 --SubtoCPH-MarlinEngineering,Inc.65-0279601 --SubtoCPH-TierraSouthFlorida,Inc.20-0282450 DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-2 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form 10 11 12 13 14 15 Section C (2) -A&E Technical Certification Requirements (DESIGN TEAM) Fill in this section by indicating which firm on the team, using the numbers shown in Sections C(1), will provide services in the technical categories required in the RDBS; you may list more than one firm per category, if applicable. A&E Technical Category Lead A & E Consultant A & E Subconsultant 6.01 Water and Sanitary Sewer Systems -Water Distribution and Sanitary SewageCollection and Transmission Systems (LEAD A/E CONSULTANT FOR DESIGN TEAM) 16.00 General Civil Engineering (LEAD A/E CONSULTANT FOR DESIGN TEAM) 9.01 Soils, Foundations and Materials Testing – Drilling, Subsurface Investigations and Seismographic Services 9.02 Soils, Foundations and Materials Testing -Geotechnical and Materials Engineering Services 9.03 Soils, Foundations and Materials Testing - Concrete and Asphalt Testing Services 9.04 Soils, Foundations and Materials Testing - Non-Destructive Testing and Inspections 10.05 Environmental Engineering -Contamination Assessment and Monitoring 11.00General Structural Engineering 15.01Surveying and Mapping – Land Surveying 15.03Surveying and Mapping – Underground Utility Location 17.00 Engineering Construction Management 2 2 4 4 6 6 4 3 2 5 2 DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-3 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Fi r m N o . Section D –Proposed Non-A & E Subconsultants and/or Subcontractors Complete this section for all proposed non-A & E subconsultants and/or subcontractors who will perform Work with readily identifiable scopes of services and subcontractors as referenced in Section 2.1 – Experience and Qualifications of the RDBS. The following must be provided below: firm name, address, phone number (including area code), contact person, assigned services and FEIN. Non A & E Subconsultant’s/Subcontractor’s Name FEIN: a Firm Name: Address: Phone Number: ( ) - Contact Person: Assigned Services: b Firm Name: Address: Phone Number: ( ) - Contact Person: Assigned Services: c Firm Name: Address: Phone Number: ( ) - Contact Person: Assigned Services: d Firm Name: Address: Phone Number: ( ) - Contact Person: Assigned Services: WaterResourceTechnologies 11221St.JohnsIndustrialParkwayNorth,Jacksonville,FL32246 9049280700 MarkAlexander 20-5809756 Eonegrinderequipment,controlpanels,hi-tidetelemetrysystems,installationsupport andstartupservicesforlowpressuresewerserviceareas 3052818746 45-5582-1469310SW69thSt.,Miami,FL33173 FloridaPipelineCompany RudyIbarra,President MOT,PermitCoordination,andUtilityLocation DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-4 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section E –Table of Organization Please attach the following documents: 1)Table of Organization 2)RESUMES FOR KEY PERSONNEL 3)General Contractors or Building Contractors License for Design-Builder Pleaseseeattached: 00420E1TableofOrganization 00420E2Resumes 00420E3Licensing DOCUMENT00420 BIDDERSQUALIFICATIONFORM Section F – ExperienceandQualification / Preference / ReferenceForm Thisformmustbesubmittedbyeachteammember(Design-Builder,A/ESub-consultant,Non-A/ESub-consultant,Sub- contractors)asapplicable.Applicableteammembersmustlistprevioussimilartypeprojectinwhichithasperformedwork. ThereferenceprovidedbelowshouldbeforoneprojectandmustcomplywiththerequirementslistedinSection2.1 – ExperienceandQualificationsandSection 2.5,FormatandContentsoftheRDBS. NameofFirm(Design-Builder/A/ESub-consultant/Non-A/ESub-consultant/Sub-contractor): Layne HeavyCivil,Inc. ReferenceProjectName/Address:Design-BuildOperateWastewaterSystem – Islamorada, FL Name(s)androle(s)ofkeypersonnelworkingonthisreferenceproject:Wes Self, PE, DBIA –Design-Build Manager; Richard Crow, PE – Construction Manager; Les Archer, PE, DBIA – Project Executive ReferenceProjectDescription: Design-Build-Operate ScopeofServicesProvided:Project Management, Design, Permitting, Construction, Customer Outreach, Project Startup & Commissioning, Customer Service, System Operations & Maintenance. ProfessionalFees $ ProjectStartDate: : / ProjectCompletionDate: / ConstructionStartDate:9/2012 ConstructionCompletionDate: anticipated 6/1/2015 A:ProjectConstructionCost: $105,041,960 B: Professional Fees: $N/A TotalProjectCost(A+B):$105,041,960 ReferenceCompanyName: Islamorada,Village of IslandsReferenceName:TedBlackburn,Mayor ReferencePhoneNumber (305) 664-6400 FaxNumber (305) 664-6464 E-mail:ted.blackburn@islamorada.fl.us ThisprojectreferencecomplieswiththeExperienceandQualification(s)and/orPreference(s)requiredunderSection2.1, ExperienceandQualifications YesNo PleasedenotewhichExperience/Qualification(s)and/orPreference(s)thatismetwiththisprojectreference: Low pressure sanitary sewer system Includes sanitary sewer grinder pump stations. Includes minimum of 3,000 LF of force main with minimum inside diameter of 8 Design-Buildermayusethespacebelowtoexpandonthescopeofservicesprovidedforthisproject: Thecentralwastewatersystem consists of a collectionsystemand a transmission system.Thecollectionsystem utilizes a combinationofvacuumand low pressuresewersto collectwastewaterfromapproximately5,000 residentialandcommercialcustomerson thefourislands. TheTransmissionsystemtransports thewastewater fromfourvacuum/transferpump stations to a master pump station locatedin northPlantation Key.Themaster pump station transportsallof thewastewaterto aregional wastewatertreatment plant in KeyLargo,whereit is treatedanddisposedunder anintergovernmentalagreementbetweenthe KeyLargoWastewaterTreatment Districtand theVillage. CONTINUED NEXT PAGE MIAMISHORESVILLAGE00420-5 RDBSforCentralBusinessDistrictLPSSandWaterMainImprovementsBiddersQualificationForm Specificprojectdetails include the following: 1.Four(4) Vacuum/TransferPump Stations. 2.One(1) MasterPump Station. 3.Seven (7) Ocean Channel Crossings using Horizontal DirectionalDrilling (HDD)in sizes ranging from 8” to 18”. 4.Vacuum/Low Pressure CollectionSystemConsisting of Approximately 400,000 LinearFeetof 3”to10”PVC VacuumSewers and 1-1/4” to 6” HDPELowPressure Force Mains. 5.TransmissionSystemConsistingof Approximately 100,000 LinearFeetof 8” to 18” PVC and6” to 20” HDPEForce Mains. 6.Service Connection for Approximately 5,000 Customers. 7.Installationof 400 ResidentialandCommercialGrinderPump Stations. E-1 Grinder Pump Manufacturer. 8.Customer Service;System Startup, Commissioning, Operations, and Maintenance for 20 years. MIAMISHORESVILLAGE00420-5 RDBSforCentralBusinessDistrictLPSSandWaterMainImprovementsBiddersQualificationForm DOCUMENT00420 BIDDERSQUALIFICATIONFORM Section F – ExperienceandQualification / Preference / ReferenceForm Thisformmustbesubmittedbyeachteammember(Design-Builder,A/ESub-consultant,Non-A/ESub-consultant,Sub- contractors)asapplicable.Applicableteammembersmustlistprevioussimilartypeprojectinwhichithasperformedwork. ThereferenceprovidedbelowshouldbeforoneprojectandmustcomplywiththerequirementslistedinSection2.1 – ExperienceandQualificationsandSection2.5,FormatandContentsoftheRDBS. NameofFirm(Design-Builder/A/ESub-consultant/Non-A/ESub-consultant/Sub-contractor): Layne Heavy Civil, Inc. ReferenceProjectName/Address:Cudjoe Regional Design-Build Wastewater CollectionSystem – Monroe County, FL Name(s)androle(s)ofkeypersonnelworkingonthisreferenceproject:N/A ReferenceProjectDescription:Wastewater Collection System ScopeofServicesProvided:Project Management, Design, Permitting, Construction, Customer Outreach, Project Startup & Commissioning, Customer Service ProfessionalFees $ ProjectStartDate: : / ProjectCompletionDate:/ ConstructionStartDate:01/2013 ConstructionCompletionDate:04/2017 (anticipated) A:ProjectConstructionCost: $65,195,176 B:ProfessionalFees: $3,800,000 TotalProjectCost(A+B): $98,995,176 ReferenceCompanyName:Florida Keys Aqueduct Authority ReferenceName:Thomas Walker, PE, BCEE Director of Engineering ReferencePhoneNumber (305)295-2140 FaxNumber (305)295-2188 E-mail:twalker@fkaa.com ThisprojectreferencecomplieswiththeExperienceandQualification(s)and/orPreference(s)requiredunderSection 2.1,ExperienceandQualifications YesNo N/A PleasedenotewhichExperience/Qualification(s)and/orPreference(s)thatismetwiththisprojectreference: Low pressure sanitary sewer system Includes sanitary pump station. Includes minimum of 3,000 LF of force main with minimum inside diameter of 8” Design-Buildermayusethespacebelowtoexpandonthescopeofservicesprovidedforthisproject: The purpose of this project is to design, construct, outfit, start-up, performance test, warranty, and obtain governmental approvals for the Outer Islands of Cudjoe Regional Wastewater System. The FKAA Project will be designed and constructed to collect and pump wastewater from the outer islands (Lower Sugarloaf, Ramrod, Little Torch, and Big Pine) to the Cudjoe Wastewater Treatment Plant. The system will serve approximately 5,000 customers. Collection System construction includes: 2”-6” HDPE Force Main 350,000 lf 8” PVC Gravity Sewer 250,000 lf 70 Neighborhood Lift Stations 1350 Residential Grinder Pumps Transmission System construction includes: 6”-10” DIP Transmission Main 4,485 lf 8”-10” HDPE Transmission Main 18,070 lf 8”-14” PVC Transmission Main 33,545 lf Pump Station Lower Sugarloaf Key – Duplex 51 HP Pump Station Ramrod Key – Triplex 115 HP Pump Station Big Pine Key 1 –Duplex 57 HP Pump Station Big Pine Key 2 –Duplex 16 HP Niles Channel Ocean Crossing – 5,217 lf of18" DR7 HDPE directional bore MIAMISHORESVILLAGE00420-5 RDBSforCentralBusinessDistrictLPSSandWaterMainImprovementsBiddersQualificationForm DOCUMENT00420 BIDDERSQUALIFICATIONFORM Section F – ExperienceandQualification / Preference / ReferenceForm Thisformmustbesubmittedbyeachteammember(Design-Builder,A/ESub-consultant,Non-A/ESub-consultant,Sub- contractors)asapplicable.Applicableteammembersmustlistprevioussimilartypeprojectinwhichithasperformedwork. ThereferenceprovidedbelowshouldbeforoneprojectandmustcomplywiththerequirementslistedinSection2.1 – ExperienceandQualificationsandSection 2.5,FormatandContentsoftheRDBS. NameofFirm(Design-Builder/A/ESub-consultant/Non-A/ESub-consultant/Sub-contractor): Layne Heavy Civil, Inc. ReferenceProjectName/Address:Phase III - Contract 1 & Contract 3B –Rattlesnake Creek Wastewater Collection System Monticello, IN Name(s)androle(s)ofkeypersonnelworkingonthisreferenceproject: N/A ReferenceProjectDescription:Wastewater Collection System ScopeofServicesProvided:Construction, Construction Supervision, Project Management ProfessionalFees $ ProjectStartDate:ProjectCompletionDate: ConstructionStartDate: 08/2007 ConstructionCompletionDate: 05/2009 A:ProjectConstructionCost:$11,554,561 B:ProfessionalFees: $N/A TotalProjectCost(A+B): $11,554,561 ReferenceCompanyName: Twin Lakes Regional Sewer District ReferenceName:Mike Darter ReferencePhoneNumber (219) 253-1105 - FaxNumber ( ) - E-mail: ThisprojectreferencecomplieswiththeExperienceandQualification(s)and/orPreference(s)requiredunderSection2.1, ExperienceandQualifications YesNo N/A PleasedenotewhichExperience/Qualification(s)and/orPreference(s)thatismetwiththisprojectreference: Low pressure sanitary sewer system Includes sanitary pump station. Includes minimum of 3,000 LF of force main with minimum inside diameter of 8”. Design-Buildermayusethespacebelowtoexpandonthescopeofservicesprovidedforthisproject: Project consists of but is not limited to the furnishing and installation of grinder pumps, horizontal directional drilled (HDD) force main, and booster stations. 12" HDPE Force main 16,299/LF 12” HDPE HDD Force Main 4,269/LF 10” HDPE HDD Force Main 16,357/LF 6" HDPE Force main 11,773/LF 1 ¼’’ – 6” HDPE HDD Force Main 201,493/LF 4" HDPE Force main 8,108/LF 3" HDPE Force main 21,508/LF 2" HDPE Force main 14,295/LF 1-1/2" HDPE Force main 5,198/LF 1-1/4" HDPE Force main 46,519/LF Grinder Pump Units 1,267/EA Booster Pump Stations 5/EA MIAMISHORESVILLAGE00420-5 RDBSforCentralBusiness DistrictLPSSandWaterMainImprovementsBiddersQualificationForm DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) CPHhasprovidedimprovementstoover13milesofthewaterdistributionsystemandwastewater collectionandtransmissionsystemwithintheSR-50Corridor,oneofthebusiestroadsinCentral Florida–whichisbeingexpandedfrom4-lanesto6-lanes.Theutilityimprovementsincludebuilding newfacilitiesaswellastheremovaloffacilitiesinconflictwiththeFDOTroadwaydesign. TheutilityimprovementswereconstructedaspartoftheconstructionoftheFDOTSR-50projects underajointagreementbetweenOrangeCountyandFDOT.TheconstructiondocumentsmeetFDOT planpreparationstandards,FDOTroadwaydesignscheduleandwerecoordinatedwiththeFDOTroad designandotherutilities.Theprojectincludedtheinstallationofapproximately5.5milesof8,12,16, 20and24-inchdiameterwatermainand7.7milesof4,8,12,16,20and30-inchdiameterforcemain alongSR-50fromWestSR-436toOldCheneyRoad(theproject).Connectionofexistingservicesand lateralmainswererequiredwhilemaintainingservicetocustomers. CPH,Inc. SR50UtilityRelocation-OrangeCounty,FL DavidMahler,JamesMorris,DavidGierach Waterdistributionandwastewatercollectionandtransmissionsystem Seebelow. 300,000 2007 2008 2008 2009 17million 300,000 17,300,000 Orange County Mr. JoseE.Hernandez,P.E.,EngineerIII 4072549718 4072549610 X Jose.Hernandez2@ocfl.net ForceMain WaterMain DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) -144 CPHareasofresponsibilityincludedthedesignandpermittingofthevacuumcollectionsystemfortheIslandofUpperMatecumbeKey;vacuum pumpingstationsfortheIslandsofSouthPlantationKey,UpperMatecumbeKeyandLowerMatecumbeKey;andlowpressureforcemain collectionsystemsfortheIslandofWindleyKeyandportionsofUpperMatecumbeKey.CPHprovidedinputdataanddocumentationassociated withareasofresponsibilityincorporatedintothePreliminaryDesignReportfortheoverallproject.Thisworkincludedananalysisofflowdatathat incorporatedFKECwaterconsumptioninformation,reviewofexistingpackagewastewaterplants,andsurvey/analysisprovidedwithintheproject solicitationdocumentsinordertoproperlyprojectanticipatedwastewaterflowsforsystemdesign. VacuumpumpstationdesignshavebeenbasedonvacuumequipmentprovidedbyAirVac.CPHprovideddesignfortwogeneralusevacuum pumpingstationsandonevacuumpumpingstationthatalsoincorporatedaforcemainre-pumpingstationwithinthestructure.Architectural designofthebuildingsincorporatesaspectsoftherespectiveindividualsitelocationsinordertoblendwithintheneighborhood.Allbuildingsare designedtowithstandhurricaneforcewindsof150mphandassociatedstormsurge.IndividualpumpingstationsincludeAirVacvacuum equipmentsizedforthespecificbasinsbeingcollected.ThevacuumcollectionsystemforUpperMatecumbeKeyincorporatesconnectionsfor approximately986equivalentdwellingunits(EDU).ThesystemprovidesservicealongbothsidesofOverseasHighwayinUpperMatecumbe usingaconventionalsaw-toothprofileasgenerallyrecommendedbyAirVac.Theprojectconsistsof43,957LFofPVCpiperanginginsizefrom 4-10”. ThelowpressureforcemaincollectionsystemsforUpperMatecumbeKeyandWindleyKeyincorporatesconnectionsforapproximately1,755 (UMK)and678(WK)equivalentdwellingunits(EDU).ThesystemsprovideservicealongbothsidesofOverseasHighwayusingacombinationof conventionalandtrenchlesstechnology.Combinedtheprojectconsistsof37,410LFofHDPEpiperanginginsizefrom11/4-6”.CPHprovideda completesystemdesignincludingplanandprofiledrawingsofeachpiperun.CPHconductedsystemhydraulicscalculationsusingSewercad. CPHisprovidinglimitedCEIservicesforthisportionoftheproject. CPH,Inc. WastewaterCollectionandTransmissionDBOProject-Islamorada,FL GeraldCox,DavidGierach,ThomasGalloway Wastewatercollectionandtransmission Seebelow. 1,735,000 082012 2013 012014 UnderConstruction 98million 1,735,000 99,435,000 Islamorada Mr. GregTindle 7709694040 X greg.tindle@islamorada DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : /Project Completion Date: / Construction Start Date: /Construction Completion Date: A: Project Construction Cost: $B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ()-Fax Number ()-E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) Theprojectconsistedofrelocatingapproximately4700-LFofexistingsewer,reclaimed watermain,andpotablewatermainonairportpropertysouthofSR46andalongSR415. Constructionincludedjackandbore20”steelcasingunderSR415andcoordinationwith FDOTassociatedwithitsroadwaywideningprojects.CPHperformedsurveying, environmentalservices,design,permitting,bidding,andconstructionphaseservicesfor theprojectandassistedtheCitywithStateRevolvingLoanFund(SRF)programfunding. CPH,Inc. SR46DetourRdandSR415UtilityRelocations-Sanford,FL KatriinaBowman,DavidGierach,RoccoNasso Sewer,ReclaimedWaterMainandPotableWaterMainRelocation Seebelow. 166,145 122011 112012 022012 11/2012 166,145 Sanford Mr. PaulMoore,P.E.,UtilityDirector 4076885106 4073305679 X moorep@sanfordfl.gov ForceMain WaterMain DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) 8BUFS.BJO Thisprojectincludedthedesignof10,100l.f.of24-inchforcemainalongUniversalBoulevardandPointPlazaAve.,acrossInternational DriveandInterstate-4,withaconnectionacrossTurkeyLakeRoad.Approximately2,300l.f.of24-inchforcemainwereinstalledby directionaldrilland330l.f.of42-inchjackandborewereneededtofacilitatethisinstallation.Thelocationofthisprojectisadjacenttothe hightourismareasincludingtheOrangeCountyConventionCenterandalongbusyInternationalDriveandcrossingFDOTlimited right-of-wayledtomanydesignandpermittingchallengesthatweremetbyCPH’sdesignteam.Theprojectwasdividedintotwo segmentswhichweredesignedandbidseparately. CPHprovidedaPreliminaryDesignReportwhichaddressedpermittingrequirements,right-of-wayusageissues,surveyandgeotechnical requirements,costestimatesandreviewedvariouspipelineinstallationtechnologiestobestrecommendthealignmentforthenew 24-inchforcemain.BasedonthePreliminaryDesignReportCPHprovidedplanandprofiledrawingsforbothsectionsoftheproject. DuringtheseservicesCPHassistedtheCountywithcoordinatingtheconstructioninfrontoftheOrangeCountyConventionCenterand helpedreducedimpactstothedailyoperationoftheCenter.CPHdesignedthemostcosteffectivealignmentbyavoidingpotential expensiveopencutsofnewCountyroadwayandtominimizeimpactstoheavylandscapingalongtheroute.Additionalexistingutilities werelocatedduringthedesignandthealignmentwasbestselectedtoreducethepotentialforconflictsduringconstruction. SpecialpermittinghadtobecoordinatedwithmultipleagenciesincludingFDOT,FDEP,OrangeCounty,CityofOrlando,andthe ConventionCenter.CPHsuccessfullypermittedthisprojectthroughthecoordinationofalloftheseagencies.CPHperformedpost designservicesincludingparttimeinspectionservices,shopdrawingreview,presidedatprogressmeetings,assistedwithright-of-way permitcoordination,providedsubstantialcompletionandfinalinspections,reviewofchangeorders,andpreparedtheprojectrecord drawings. CPH,Inc. InternationalDriveandUniversalBoulevardForceMain-Orlando,FL DavidA.Gierach,DavidMahler,JamesMorris FDOTForcemaindesign Seebelow. 233,000 072005 112009 11/2012 2.8million 233,000 3,033,000 Orange County Mrs.ElizabethO'Reilly 4072549900 4072549799 X Elizabeth.oreilly@ocfl.net DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) 8BUFS.BJO 'PSDF.BJO Theprojectconsistedofdesign,permittingandconstructionadministrationservicestorelocatewatermainsandforcemains,includingthe incorporationofanewgravitysewercollectionsystemintotheFDOTwideningplansforSR-50fromSR-429toCR-545.Thedesignincluded approximately11,900l.f.ofgravitysewermainsranginginsizefrom8-inchto24-inch,connectionsfromotherforcemainsystemstothegravity sewersystemandnewsanitarylateralconnectionstothegravityseweronSR-50.Theprojectalsoinvolvedthedesignoftheinstallationor relocationfor5,000l.f.of16-inch,9,250l.f.of12-inch,5,775l.f.of8-inchwatermains;6,400l.f.of12-inchand1,300l.f.of6-inchforcemains. CPHhadtoreviewandevaluatetheoriginaldesignfortheCity,whichwasbasedontheoldroadwideningplans,andcomparetheseplanstothe City’sutilitymaps.WeincorporatedtheoriginaldesignintothenewFDOTplanstoassesstheconstructabilityoftheproject.Duetothefactthat theoriginaldesigncouldnotbeconstructedandmeettheintentofwhattheCitywastryingtoaccomplish,CPHvalueengineeredtheprojectand developedanewpreliminarylayoututilizingasmuchoftheCity’sexistinginfrastructure.ThispreliminarylayoutwasprovidedtotheCitytoobtain approvalofthelayoutinordertoproceedwiththefinaldesign.CPHprovidedconstructiondrawingsforthewatermainandforcemain relocations,andforthenewgravitysewersystem.CPHworkedwithCitystafftodevelopprobableconstructioncosts,basedonthepreviously agreeduponcontractbetweentheCityandtheirselectedcontractor. CPHwasresponsibletocompletingandobtainingtheFDOTpermit.Inordertofasttrackthepermit,CPHbroketheprojectinto2phases,tomeet theFDOTconstructionschedule.CPHwasabletoaccomplishthistaskbyworkingwiththeFDOTstaffandtheirroadwaydesignengineers.CPH wasresponsiblefordevelopingtheUtilityWorkSchedule,andincorporatingtheCity’sproposedconstructionscheduleintotheroadway contractorsproposedschedule.CPHwasalsoresponsibleforobtainingtheFDEPwaterandwastewaterconstructionpermits.CPHperformed limitedC/Aservicesforthisproject.TheCityprovidedday-to-dayinspections.Servicesincludedattendingweeklyprogressandutilitycoordination meetings,periodicobservationofconstructionoftheproject,provideengineeringadviceduringconstruction,andpreparerecorddrawingsand appropriatecertificationsofcompletion. CPH,Inc. SR-50UtilityRelocationsfromSR-429toCR-545(AvalonRoad)-WinterGarden,FL DavidGierach,DavidMahler,JamesMorris,ThomasGalloway relocatewatermainsandforcemains;newgravitysewercollectionsystem Seebelow. 435,000 012009 042010 012010 02/2011 5.5million 435,000 5,935,000 Winter Garden Mr.DonaldR.Cochran,DirectorofPublicServices 4076564111 4078772363 X dcochran@cwgdn.com DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) 'PSDF.BJO ThisprojectconsistsofthedesignoftheNorthernandSouthernForcemainfromMM92+/-toMM106+/-.Theoriginaldesignwasforallpiping tobePVCexceptforthedirectionaldrills(HDPE)andtheaerialbridgecrossingthatwasductileiron.Thepipelinesizevariesfrom4-inchto 18-inchalongtheUS-1corridor.Thisprojectincludesaninnovativedesignelement.Anabandoned30-inchwatermainexistedwithintheUS-1 corridor.KLWTDwasabletoobtaintherightstoutilizethispipeastheircorridorfortheforcemain.Thereforenodiggingwasinvolvedinorderto installthenewforcemain.Sincethisdidnotallowfor“normalaccess”,HDPEwasusedinlieuofPVCwithintheoldwatermain.Thelinehas supportsatintervalstokeepthenewlinefromrubbingontheoldlinemuchlikeaboreandjack.Utilizingtheoldwatermain(withtheinstallation ofasliplinepipe)minimizedtheimpactofconstructionontrafficwithintheUS-1corridor. Theprojectconsistsof4,503l.f.of4-inchPVC,4,156l.f.of6-inchPVC,19,846l.f.of8-inchPVC,11,750l.f.of10”PVC,573l.f.of10-inchHDPE (slipline),13,198l.f.of12-inchHDPE(slipline),6,231l.f.of14-inchHDPE(slipline),9,825l.f.of16”PVC,and11,085l.f.of18-inchHDPE (slipline)forcemain.WeprovidedsurveyofthefullrightofwayofUS-1andsoilsworkalongthealignment. CPHprovidedpreliminaryengineeringtodeterminecapacityandtheproposedconnectionpointsalongthesystem.Bytheuseofwatermeter data,landusemapsandaerials,CPHdeterminedthedemandofeachresidential,commercialandpublicentitythatwouldtieintothesystem. TheflowdataalongwiththebasindatawasusedtodevelopaSewerCadmodeltodeterminepumpstationrequirementsandtheassociatedline sizesbasedona24-hoursimulation.CPHprovidedfinaldesignoftheforcemainsystemalongtheUS-1corridor,includingthedesignutilizingthe bridgeatAdam’sCutforthepipelinesupport. CPHpreparedthepermitapplicationsandsubmittalrequirementsforFDEP,theWaterManagementDistrict(trenchdewatering)andtheFDOT RightofWayUtilizationPermitandtheFDOTpermitsforroadwaycrossingsandtheutilizationofthebridgedecktosupportthepipelinewiththe FDOTBridgeStructuralDepartment. CPH,Inc. NorthernForcemainandSouthernForcemain-KeyLargo,FL GeraldCox,DavidMahler,ThomasGalloway,DavidGierach Vacuumpumpstationdesign Seebelow. 496,188 102005 102006 10/2008 9.42mill 496,188 9,916,188 Key Largo Ms.MargaretBlank,GeneralManager 3054514019 X DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) 4BOUJBSZ4FXFS 1VNQ4UBUJPO CPHiscurrentlyprovidingservicesasEngineer-of-RecordfortheFountainSquareSanitarySewer PumpStation,incompliancewithMiami-DadeWaterandSewerstandards.Theprojectwillbe conveyedtoMD-WASDuponcompletedofconstruction.Thisprojectispartofthe350,000squarefoot FountainSquareMixed-UseProject. CPH,Inc. FountainSquareSanitarySewerPumpStation ToddH.Hendrix,P.E.,CGC SanitarySewerPumpStation Seebelow. 600,000 UnderConstruction 15million 600,000 15,600,000 Key Largo Regency/Master Development,Mr.BobShapiro 3054915500 X DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : /Project Completion Date: / Construction Start Date: /Construction Completion Date: A: Project Construction Cost: $B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ()-Fax Number ()-E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) Thisprojectinvolvedthedesignandconstructionmanagementofdrainageandutilityinfrastructure improvementsalongwithanairfieldtaxiwayandroadwayimprovements.Thisprojectwasbuiltto provideinfrastructureneedstoproposedandfuturedevelopmentsinthenorthwestquadrantofthe OrlandoInternationalAirport.Theprojectincludednewdrainagefacilities,utilities,relocationofexisting utilities,liftstationdesignandcomprehensiveplanningforsewersystemexpansionandfutureflows fromAirportprojectsdischargingtotheproject’sliftstation. BPAprovidedthedesignof3,100feetof20"ductileironwatermain;designof3,800feetofgravity sanitarysewermain;designof2,000feetof10"sanitarysewerforcemain;designofsanitarysewerlift station;anddesignoftelecomductbank.BPAalsoprovidedthedesignofroadwayturnlanesand signalmodifications;drainagedesignandpermittingthroughWaterManagementDistrict;signageand pavementmarkingdesign;designofanewtaxiwayand132’longDBL7’x4’boxculvertcrossingfor aircraftattaxiway;andextensivelandscapedesign.APreliminaryEngineeringReportwithanalysisof allproposedimprovementswaspreparedalongwithcostestimates,andconstructionschedules Subconsultant-BrindleyPieters&Associates,Inc. SiteandInfrastructureImprovements/TradeportDr,OIA RandyAugat,ProjectManager Designdrainage,utilityinfrastructure,watermains,sewermains,androadways CivilEngineeringandConstructionAdministration 267,339 0401 0103 02/02 01/03 2.3M 267,339 2,567,339 GOAA TuanNguyen,PE 4078254662 4078253531 tnguyen@goaa.org X DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : /Project Completion Date: / Construction Start Date: /Construction Completion Date: A: Project Construction Cost: $B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ()-Fax Number ()-E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) TheprojectincludestheconstructionofanewPVCsanitarysewerforcemainandtheconversionoftheexistingDIPforce maintoareclaimedwatermain.Theprojectalsoincludesconnectionstoexistingforcemainsservingdevelopmentson InternationalDriveandWorldCenterDrive.Theprojectincludestheconstructionofapproximately4,000linearfeetof20-inch forcemain,2,000linearfeetof24-inchforcemain,and7,100linearfeetof30-inchforcemainintheexistingpavementalong thewestsideofInternationalDriveandthenorthsideofWorldCenterDrive.Theprojectalsoincludestheconversiontoa reclaimedwatermainofapproximately12,100linearfeetofexisting20-inch,24-inch,and30-inchDIPforcemain. Additionalitemsinthescopeofservicesincludetheinstallationofthesanitarysewerforcemainsystemwithconnectionsto existingforcemainsystems,includingdiverting,pumpingandtransferringtheexistingsanitaryflowsduringconstructionofthe newmainsandremovaland/orabandoninginplaceportionsoftheexistingsmallermainsconnectedtotheexisting20-inch, 24-inch,and30-inchforcemains;convertingtheexistingsanitarysewerforcemaintoa20-inchreclaimedwatermainand connectingtoexistingreclaimedwatermains;by-passpipingandlinestops;pavementremovalandresurfacing,roadway stripingandpavementmarkings;testingofinstalledsystems;restorationandsiteclean-up;andplacingPumpStation#3624 outofserviceandassociateddemolition. BPAprovidedtheforcemaindesign,utilityplans,roadwayplans,maintenanceoftrafficplans,costestimates,project schedules,permitting,andcoordinationwithFDOTandOOCEAformaintenanceoftraffic. Subconsultant-BrindleyPieters&Associates,Inc. InternationalDriveForceMainImprovements,OrangeCountyFL RandyAugat,ProjectManager ForcemainsandconversionofexistingDIPforcemaintoareclaimedwatermain. CivilEngineeringandConstructionAdministration 852,936 0610 0613 0813 01/14 9M 852,936 9,852,936 OrangeCo.ElizabethO'Reilly 4072549734 4079241673 elizabeth.oreilly@ocfl.net X DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) TheworkbeingperformedbyMarlinconsistsof,butisnotlimitedto: Photogrammetriccontrol. Themonumentationandremonumentationofpropertyboundaries&subdivisions. Themeasurementandpreparationofplansshowingexistingimprovementsafterconstruction. UndergroundutilityandImprovementslocation. Thelayoutofproposedimprovements. Thepreparationofdescriptionsforuseinlegalinstrumentsofconveyanceofrealpropertyandpropertyrights. Thepreparationofsubdivisionplanningmapsandrecordplats. Thedeterminationof,notthedesignof,gradesandelevationsofroadsandlandinconnectionwithsubdivisionsofland. Thecreation&prepetuationofalignmentsrelatedtothemaps,recordplats,fieldnotes,records,reports,propertydescriptions,plandand drawingsthatrepresentthem. Thisworkalsoincludestheprovisionoftopographic,hydrographic,andgeodeticsurveying,andmappingservices. Therewere5taskworkordersforthisproject: #1SunkistPinelandPark(sw64st&sw84av) #2MICEarlingtonHeightParcel129,132,133Survey #3GroveHomesSiteSurvey #4MunneSubdivisionSurvey #5HammocksPoliceStaBoundary&TopoSurvey MARLINENGINEERING,INC. GeneralLand&EngineeringSurveyServices(ContractE06-PW-01) RamonSoria,P.E.,PrincipalIncharge,LazaroFleitas,P.S.M,Senior ProjectSurveyer,OmarCarcamo,SurveyTech,ElisaAzcona,CADDTech 15.03 Survey&Mapping-LandSurveying 571,428 12007 22007 MiamiDade CountyPublic Works LuisLacau 3053755774 3053753070 lzl@miamidade.gov X DOCUMENT 00420 BIDDERS QUALIFICATION FORM MIAMI SHORES VILLAGE00420-5 RDBS for Central Business District LPSS and Water Main ImprovementsBidders Qualification Form Section F –Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub- contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience andQualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Reference Project Name/Address: Name(s) and role(s) of key personnel working on this reference project: Reference Project Description: Scope of Services Provided: Professional Fees $ Project Start Date: : / Project Completion Date: / Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B:Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Reference Name: Reference Phone Number ( ) - Fax Number ( ) - E-mail: This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) TheworkbeingperformedbyMarlinconsistsof,butisnotlimitedto: Photogrammetriccontrol. Themonumentationandremonumentationofpropertyboundaries&subdivisions. Themeasurementandpreparationofplansshowingexistingimprovementsafterconstruction. UndergroundutilityandImprovementslocation. Thelayoutofproposedimprovements. Thepreparationofdescriptionsforuseinlegalinstrumentsofconveyanceofrealpropertyandpropertyrights. Thepreparationofsubdivisionplanningmapsandrecordplats. Thedeterminationof,notthedesignof,gradesandelevationsofroadsandlandinconnectionwithsubdivisionsofland. Thecreation&prepetuationofalignmentsrelatedtothemaps,recordplats,fieldnotes,records,reports,propertydescriptions,plandand drawingsthatrepresentthem. Thisworkalsoincludestheprovisionoftopographic,hydrographic,andgeodeticsurveying,andmappingservices. Therewere6taskworkordersforthisproject: #1SurveyServicesforWater&SewerER47798 #2SurveyServicesforJacksonHospitalTreeSurvey #3SurveyServicesforJacksonMem.ClinicHomestead #4SurveyServicesforTopo28300SW152Ave #5SurveyServicesforSW157Ave #6SurveyServicesforBirdRd&Turnpike MARLINENGINEERING,INC. GeneralLand&EngineeringSurveyServices(ContractE03-PW-04) RamonSoria,P.E.,PrincipalIncharge,LazaroFleitas,P.S.M,Senior ProjectSurveyer,OmarCarcamo,SurveyTech,ElisaAzcona,CADDTech 15.03 Survey&Mapping-LandSurveying 256,410 52004 52006 MiamiDade CountyPublic Works LuisLacau 3053755774 3053753070 lzl@miamidade.gov X Section F – Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub-contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience and Qualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Tierra South Florida, Inc. Reference Project Name/Address: Force Main Route II, North Bay Village, FL Name(s) and role(s) of key personnel working on this reference project: Raj Krishnasamy, P.E. - Project Manager (Geo) Reference Project Description: Force Main Route II Scope of Services Provided: Performed a geotechnical study for the Force Main Route II in City of North Bay Village, Florida (traversing for a length of 13,000 linear feet, along NE 80th street, NE 79th Street, Adventure Avenue, North Treasure Drive to the pump station on Galleon Street). The purpose of this study was to explore the subsurface conditions at the site to enable an evaluation of acceptable construction and site development considerations. Field work included 13 Standard Penetration Test (SPT) borings to depth ranging from 20 to 100 feet below grade. Provided geotechnical report summarizing subsurface conditions and groundwater information. TSF also provided geotechnical recommendations regarding excavations, lateral earth pressures, and other construction considerations. Professional Fees $ 27,492.00 Project Start Date: : 1/2009 Project Completion Date: 3/2009 Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B: Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Kimley-Horn & Associates, Inc. Reference Name: Gary Ratay, P.E. Reference Phone Number (954) 535- 5100 Fax Number (561) 863-8175 E-mail: gary.ratay@kimley-horn.com This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes X No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: 9.01, 9.02 Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) ISD FORM 8DB – Rev 04/01/14 Section F – Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub-contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience and Qualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Tierra South Florida, Inc. Reference Project Name/Address: Regional Force Main, Boynton Beach, Florida Name(s) and role(s) of key personnel working on this reference project: Raj Krishnasamy, P.E. - Project Manager (Geo) Reference Project Description: Regional Force Main Scope of Services Provided: Performed a geotechnical study for the proposed Regional Force Main in Boynton Beach, Florida (approximately 24,000 linear feet of force main from Ocean Avenue to Regional Wastewater Treatment Plant). Maximum diameter of the force main was about 24 inch. Field work included Standard Penetration Test (SPT) borings along the proposed force main alignment, at the canal crossings, for the directional drilling, and for the proposed lift station. Provided geotechnical report summarizing subsurface conditions and groundwater information. Also provided geotechnical recommendations regarding open cut excavations, trench backfill, lift station foundation design, and deep foundation for aerial canal crossings. The project was completed on time and within budget in 2008. Professional Fees $ 22,149.00 Project Start Date: : 3/2008 Project Completion Date: 4/2008 Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ B: Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Wantman Group, Inc. Reference Name: David K. Brobst, P.E. Reference Phone Number (561) 687-2220 Fax Number (561) 687-1110 E-mail: david.brobst@wantmangroup.com This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes X No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: 9.01, 9.02 Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) ISD FORM 8DB – Rev 04/01/14 Section F – Experience and Qualification / Preference / Reference Form This form must be submitted by each team member (Design-Builder, A/E Sub-consultant, Non-A/E Sub-consultant, Sub-contractors) as applicable. Applicable team members must list previous similar type project in which it has performed work. The reference provided below should be for one project and must comply with the requirements listed in Section 2.1 – Experience and Qualifications and Section 2.5, Format and Contents of the RDBS. Name of Firm (Design-Builder/A/E Sub-consultant/Non-A/E Sub-consultant/Sub-contractor): Tierra South Florida, Inc. Reference Project Name/Address: Neighborhood Improvements - Utility Analysis Zone (UAZ) 124, Broward County, FL Name(s) and role(s) of key personnel working on this reference project: Raj Krishnasamy, P.E. - Project Manager (Geo and CMTS) Reference Project Description: Neighborhood Improvements - UAZ 124 Scope of Services Provided: Performed geotechnical and material testing services for the Phase 1 of the water and sewer improvements for the neighborhood. The UAZ 124 project is located between Florida Turnpike, State Road 7, Commercial Boulevard and N.W. 39th Street. This area is primarily residential, built in the 1950’s and early 1960’s. The area was developed with sanitary sewer system, and an inadequate water distribution system. The infrastructure improvements to the existing neighborhood included new water, sanitary sewer systems. TSF’s field explorations were conducted along the shoulders or on the existing subdivision streets in Broward County, Florida. Field work included drilling 30 Standard Penetration Test (SPT) borings. Provided geotechnical discussion of subsurface and groundwater conditions and provided recommendations for excavations, dewatering, and lateral earth pressure for below grade structures. Construction materials testing included soil sample pick-up, transporting to our laboratory for proctor and LBR testing. TSF staff performed density tests during utility backfill, subgrade and base construction. TSF also tested sidewalks and driveways along the residential neighborhood. Concrete samples were taken during placement of concrete in sidewalks and driveways. The project was completed in time and within budget. Professional Fees $ 77,865.00 Project Start Date: : 6/2007 Project Completion Date: 3/2012 Construction Start Date: / Construction Completion Date: A: Project Construction Cost: $ $10,838,436.00 B: Professional Fees: $ Total Project Cost (A+B): $ Reference Company Name: Craven Thompson & Associates, Inc. Reference Name: Thomas McDonald, P.E. Reference Phone Number (954) 739-6400 Fax Number (954) 739-6409 E-mail: tmcdonald@craventhompson.com This project reference complies with the Experience and Qualification(s) and/or Preference(s) required under Section 2.1, Experience and Qualifications Yes X No N/A Please denote which Experience/Qualification(s) and/or Preference (s) that is met with this project reference: 9.01, 9.02, and 9.04 Design-Builder may use the space below to expand on the scope of services provided for this project: (Additional sheets of paper may be used to include information) ISD FORM 8DB – Rev 04/01/14 LAYNE HEAVY CIVIL, INC. 1117 NW 55TH ST FORT LAUDERDALE, FL 33309 205.447.8787 Layne Heavy Civil, Inc., (Layne) (f/k/a Reynolds, Inc.): Design-Builder, General Contractor, Lead contract entity. Layne is a subsidiary of the publicly traded company Layne Christensen Company (LAYNE) (NASDAQ:LAYN). Layne is a global water management, construction and drilling company. We provide responsible solutions for water, mineral and energy challenges. Layne is recognized today as one of the nation’s leading water resource contractors, offering innovative project design and construction. With over 4,500 permanent employees operating in more than 80 integrated offices and project sites worldwide, Layne is well positioned to serve municipalities and industries globally. Layne typically grosses over $1 billion annually and is an industry leader in water supply, pipeline and treatment plant construction. Layne is ranked 53rd in the top 400 construction firms in the United States by Engineering News Record (ENR) and has constructed more than 1,000 treatment plants and installed over 10 million linear feet of pipeline. Layne has installed more Eone grinders than anyone else in the country. The Layne Heavy Civil division currently grosses approximately $300 million annually, employs close to 1,000 people, and owns an equipment fleet valued in excess of $30 million. Over the last 5 decades, Layne Heavy Civil has constructed more than 200 treatment plants and installed more than 7.5 million feet of pipeline. Layne has successfully performed multiple projects involving deep shafts, tunneling and microtunneling, and large diameter pipelines. Layne’s philosophy of responsible growth guides us to consistently do the right thing for our people, the environment, our company and the clients we serve every day. We strive to leave the individuals and places we touch better off for their interaction with us, and our culture includes an unwavering commitment to the four core values that define us: Safety, Sustainability, Integrity and Excellence. Many of our projects are contracted with repeat customers because of previous excellent performance. These results are achieved because we employ skilled, dedicated and experienced individuals at all levels of the company who produce first-rate results. environment, our company and the clients we serve every day. We strive to leave the individuals and places we touch better off for their interaction with us, and our culture includes an unwavering commitment to the four core values that define us: Safety, Sustainability, Integrity and Excellence. Many of our projects are contracted with repeat customers because of previous excellent performance. These results are achieved because we employ skilled,dedicated and experienced individuals at all levels of the company who produce first -rate results. 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Water, Sewer & Storm Systems Replacement Area 1: City of Gulfport, MS - CRPSleWe PuQLFLSDl LQIrDVWruFWure reSlDFePeQW QeFeVVLWDWeG b\ WKe eIIeFWV RI +urrLFDQe .DWrLQD. 7Ke SrRMeFW LQFluGeV WKe reSlDFePeQW RI DSSrR[LPDWel\ 2,500 /) RI QeZ JrDYLW\ VeZer, 2,000 /) RI QeZ ZDWer lLQe, 1,500 /) RI QeZ VWRrP lLQe, DV Zell DV D QeZ VeZer lLIW VWDWLRQ DQG IRrFe PDLQ. 2,20 /) – (´ 8´ 39& :DWer, ,15 /) – (8´ 12´ ',3 :DWer MDLQ, 2, /) - (8´-18´ 39& *rDYLW\ 6eZer, 1,000 /) - (8´-10´ ',3 *rDYLW\ 6eZer, ,0 /) – (15´ – ´ 5&3 JrDYLW\ VWRrP VeZer, ,181 /) – (18´[11´ – ´[5´ A5&3, 0 (A – 6DQLWDr\ MDQKRleV. &RPSleWeG 2011, &RQWrDFW APQW 11,1,5. Water System Extension-Annexed Area: City of Waveland, MS - 3rRYLGe DSSrR[LPDWel\ 1,200 SRWeQWLDl QeZ FuVWRPerV ZLWK FLW\ ZDWer VerYLFe. 7Ke SrRMeFW FRQVLVWV RI DSSrR[LPDWel\ 18,500 /) RI QeZ ZDWer PDLQ FRQVLVWLQJ RI , 8, 10, DQG 12 39&, ',3, DQG +'3( SLSe. &RPSleWeG 2011 Albuquerque, NM AWlDQWD, *A %DWRQ 5RuJe, /A %LJ 3LQe .e\, )/ &RluPbuV, 2+ 'DllDV, 7; 'eQYer, &2 )RrW /DuGerGDle, )/ ,VlDPRrDGD, )/ -DFNVRQYLlle, )/ NDVKYLlle, 7N 2rleDQV, ,N 4uDNerWRZQ, 3A GENERAL CONTRACTOR LAYNE HEAVY CIVIL – LICENSES & CERTIFICATES CPH, INC. 1992 SW 1ST STREET MIAMI, FL 33135 305.274.4805 CPH has been serving the needs of numerous Florida communities since the 1960’s. The firm has grown to over 220 employees and 16 offices nationwide. Our team has consistently ranked among Engineering News-Record’s Top 500 Design Firms. Our capacities in Florida include nearly 200 staff members with a local office in Miami, allowing us the accessibility to perform services for the Village of Miami Shores. Our extensive history of providing solutions for Florida communities has prepared our team to successfully deliver services for projects both large and small. CPH has been delivering sewer system and water main planning, design, and construction services to local governmental agencies for more than 33 years. We are exceedingly proud of our long-term relationships with our clients. In fact, 90% of our business is providing services for existing clients. We strive to provide excellent client service and maintain our distinguishing qualifications, including: x Comprehensive local resource and experience supported by a highly-skilled, multi-disciplinary staff able to provide the Village of Miami Shores with a single-source solution for a broad range of projects. x Local, Regional and National utility experience and understanding that is essential to successfully complete projects on time and within budget. x A commitment to client satisfaction and, as an employee-owned firm, our personnel have a vested interest in ensuring the Village of Miami Shores is invariably satisfied with our services. Years of Service With Proposer: 27 Years Years of Experience: 31 Years Academic Credentials B.S. in Environmental Engineering, University of Florida Licenses Professional Engineer – FL (No. 38642) General Contractor License – FL (No. 060789) Expertise: x Master Water/Wastewater/Reclaimed Water Plans x Major Wastewater Treatment Plants, Water Reclamation Facilities, Wastewater Collection Systems, and Reclaimed Water Systems x Planning, Design and Engineering Services during construction for water, wastewater, and reclaimed water type projects x Process Design/Analysis x Design and Construction of water supply, treatment and distribution systems x Advanced Treatment Standards x Sludge Handling/Disposal Systems x Stormwater Management Other Utility Projects: x Lake Mary WTP x Halifax R.O. Plant x Manalapan RO Water Treatment Plant x Oviedo WTP x Sanford North Sludge Management System x Sanford South Sludge Management System x Palm Coast Sludge Management System x MaxWest Sludge Systems x St. Lucie West Services District Membrane Softening/Reverse Osmosis Plant x Sanford Aux WTP Islamorada Village Wide Wastewater System, Design, Build, Operate (DBO)/Islamorada x CPH areas of responsibility included the design and permitting of the vacuum collection system for the Island of Upper Matecumbe Key; vacuum pumping stations for the Islands of South Plantation Key, Upper Matecumbe Key and Lower Matecumbe Key; and low pressure force main collection systems for the Island of Windley Key and portions of Upper Matecumbe Key. x Combined the project consists of 37,410 LF of HDPE pipe ranging in size from 1 1/4-6”. CPH provided a complete system design including plan and profile drawings of each pipe run. CPH conducted system hydraulics calculations using Sewercad. CPH is providing limited CEI services for this portion of the project. Analysis and Redesign / Phase I Collection System- Northern Plantation Key x Providing engineering services to Islamorada, Village of Islands, for an analysis and subsequent redesign of three specific vacuum collection mains that are not performing to specification in the Phase I Vacuum Collection System in Islamorada. x CPH was tasked with analyzing the existing vacuum mains within the subject areas which included calculating static and friction losses within the collection system, verification of existing vacuum main profiles where possible, collection of vacuum loss trending data, and an analysis of flow and ancillary functions that contribute to the operation of the vacuum system. Northern Forcemain and Southern Forcemain Project/Key Largo Wastewater Treatment District x Consists of the design of the Northern and Southern Forcemain from MM 92 +/- to MM 106 +/-. x The original design was for all piping to be PVC except for the directional drills (HDPE) and the aerial bridge crossing that was ductile iron. The pipeline size varies from 4-inch to 18-inch along the US-1 corridor. x This project includes an innovative design element. x An abandoned 30-inch water main existed within the US-1 corridor. KLWTD was able to obtain the rights to utilize this pipe as their corridor for the forcemain. David A. Gierach, P.E., CGC/Design Principal-in-Charge Mr. Gierach serves CPH as President. He oversees all planning, design and engineering services for roadway, water, wastewater, and reclaimed water projects. He has extensive experience in the design of major water/wastewater treatment plants, water supply, water reclamation facilities, wastewater collection systems, control and SCADA systems, and reclaimed water systems, and he has provided such services to clients including the Cities of Palm Coast, Sanford, Lake Mary, Casselberry, Winter Springs, Orlando, the U.S. Navy and Volusia County for numerous projects. Todd H. Hendrix, P.E., CGC /Design Manager Mr. Hendrix serves the firm of CPH in the capacity of Branch Manager for their Miami Office. He oversees a diverse staff that manages site development for commercial, residential, and municipal projects. Mr. Hendrix joined CPH in 1998. His municipal experience includes project coordination, design, and permitting of various potable water systems, wastewater systems, and stormwater management systems. He has experience in the areas of design and permitting of water supply wells, ground storage and treatment facilities, and high service pumping and distribution systems. Years of Service With Proposer: 16 Years Years of Experience: 16 Years Academic Credentials M.S. in Environmental Engineering, Florida International University, 1998 B.S. in Biological Science, Florida International University, 1996 Licenses Professional Engineer – FL (No. 66794), PR & ME General Contractor License – FL (No. 1518490) Expertise: x Land Development Coordination x Commercial, Industrial, and Residential Site Development. x Water and Wastewater Planning and Design. x Stormwater Management and Design. x Environmental Permitting and Compliance. x Project Budgeting, Scheduling, and Quality Control Analysis and Redesign / Phase I Collection System- Northern Plantation Key x Providing engineering services to Islamorada, Village of Islands, for an analysis and subsequent redesign of three specific vacuum collection mains that are not performing to specification in the Phase I Vacuum Collection System in Islamorada. x CPH was tasked with analyzing the existing vacuum mains within the subject areas which included calculating static and friction losses within the collection system, verification of existing vacuum main profiles where possible, collection of vacuum loss trending data, and an analysis of flow and ancillary functions that contribute to the operation of the vacuum system. Islamorada Village Wide Wastewater System, Design, Build, Operate (DBO)/Islamorada x CPH areas of responsibility included the design and permitting of the vacuum collection system for the Island of Upper Matecumbe Key; vacuum pumping stations for the Islands of South Plantation Key, Upper Matecumbe Key and Lower Matecumbe Key; and low pressure force main collection systems for the Island of Windley Key and portions of Upper Matecumbe Key. x Combined the project consists of 37,410 LF of HDPE pipe ranging in size from 1 1/4-6”. CPH provided a complete system design including plan and profile drawings of each pipe run. CPH conducted system hydraulics calculations using Sewercad. CPH is providing limited CEI services for this portion of the project. Jackson Memorial Hospital- Pedestrian Plaza x Civil Engineering Service x Construction of Jackson Memorial Hospital the County’s medical campus x The project included the coordination of landscape and hardscape improvements for the construction of the hospital’s new park. Shoppes at the Fountains- Plantation, FL x CPH provided survey, civil, architectural, and traffic engineering services x Demolition of approximately 200,000 sq. ft. of existing retail space for the construction of new anchor tenants including Kohl's, Dick's Sporting Goods, and Jo-Ann's Fabrics lddf Gerald M. Cox, CGC, CUC/Lead Designer Gerald Cox serves CPH in the capacity of Design and Construction Manager and has been with CPH since 2001. Mr. Cox has been involved with water, wastewater, and reclaimed water planning design and construction. Mr. Cox has 38 years of experience working for private, municipal utilities and governmental agencies. His most recent project involved the analysis and redesign of existing Vacuum Sewer Systems for the Villages of Islamorada in the Florida Keys. On this project Mr. Cox provided the system analysis and lead the redesign effort. Years of Service With Proposer: 12 Years Years of Experience: 38 Years Academic Credentials B.S. in Building Construction, University of Florida, 1976 Licenses Certified General Contractor – FL (No. 010771) Certified Utility Contractor – FL (No. 051667) Expertise: x Water Supply Wellfields (Well Outfitting and Raw Water Transmission Mains x Lift Station Design and Rehabilitation x Utility Adjustment Plans x Construction Documents and Administration x Water Distribution Design Northern Forcemain and Southern Forcemain Project/Key Largo Wastewater Treatment District x Consists of the design of the Northern and Southern Forcemain from MM 92 +/- to MM 106 +/-. x The original design was for all piping to be PVC except for the directional drills (HDPE) and the aerial bridge crossing that was ductile iron. The pipeline size varies from 4-inch to 18-inch along the US-1 corridor. x This project includes an innovative design element. x An abandoned 30-inch water main existed within the US-1 corridor. KLWTD was able to obtain the rights to utilize this pipe as their corridor for the forcemain. Analysis and Redesign / Phase I Collection System- Northern Plantation Key x Providing engineering services to Islamorada, Village of Islands, for an analysis and subsequent redesign of three specific vacuum collection mains that are not performing to specification in the Phase I Vacuum Collection System in Islamorada. x CPH was tasked with analyzing the existing vacuum mains within the subject areas which included calculating static and friction losses within the collection system, verification of existing vacuum main profiles where possible, collection of vacuum loss trending data, and an analysis of flow and ancillary functions that contribute to the operation of the vacuum system. Sanford Vacuum Sewer Collection System x Provided planning, design, permitting and construction engineering inspection services during the construction of an innovative vacuum sewer collection system resulting in the separation of the existing combined sewer/stormwater collection system. x In addition to the vacuum sewer collection system, the project included construction of three gravity sewer lift stations and force mains; one vacuum sewer pump station; and construction of the vacuum sewer service laterals. x This unique vacuum system was selected due to the need to install replacement sanitary sewers within confined and narrow 14-ft.-wide alleys also housing storm sewers, water mains and gas lines. x The system included one vacuum station with six vacuum mains serving the basin; 45,000 feet of 4-inch to 8-inch PVC vacuum mains with solvent welded connections; and approximately 1,200 residential and commercial connections with 434 vacuum pits and nine buffer tanks. Project Name Length Type Sanford Reclaimed Water System 16 Miles 8” – 18” Reclaimed Water Main Capital Improvements Program, Palm Bay 2.1 Miles 6” – 8” Water Main South Patrick and Indian Harbour Beach FM Interconnect 4.75 Miles 24” Ductile Iron Force Main Palm Coast WTP No. 3 Well Field System 23 Miles 8 – 24” Raw Water Main North Courtenay Parkway FM Interconnect 2.1 Miles 20” RCCP Hillsborough County Reclaimed Water Mains 10+ Miles 12” – 30” Reclaimed Water Main City of Cocoa SR3 Water Main Replacement 5+ Miles 6” – 8” Water Main PAFB Water Main Replacement 5+ Miles 4” – 8” Water Main Orange County Winter Garden / Vineland Road 3+ Miles 20” Water Main City of Oviedo – Well Field 2+ Miles 16” – 20” Raw Water Main Casselberry – Old Winter Park Drive 2 Miles 6” – 12” Water Main Sanford Vacuum Sewers 8.5 Miles 4” – 8” Vacuum Main Key Largo Vacuum Sewer System 15+ Miles 4” – 10” Vacuum Main Key Largo Force Mains 10 + Miles 8” – 16” Force Main Islamorada Vacuum System 8.3 Miles 4” – 10” Vacuum Main Islamorada Low Pressure Force Main 6+ Miles 1 ¼” – 6” Low Pressure Force Main Palm Coast Well Field x Provided design, permitting and construction administrative services for shallow aquifer wells for the City of Palm Coast. x The wells fields furnish raw water to the City’s Water Plant 3 a Low Pressure Reverse Osmosis Facility. x Design included drilling test wells to determine potential yields within the well field, modeling the well field potential, and developing a raw water well location plan. Palm Coast Water Treatment Plant No. 3 x The new water system consists of the following components: 3.0 MGD Low Pressure Reverse Osmosis skids (RO 1.5 MGD), well field system to supply raw water to the Water Treatment Plant, concentrate treatment & disposal system, finished water distribution system to connect to existing distribution system. Cigar Lake x Performed design, permitting and construction services for a reclaimed water pump station for the City of Palm Coast. The pump station consists of a 40’ x 76’ building including a pump room, an electrical room, and a chemical feed room. x Included in the pump room are three horizontal split case centrifugal pumps, tumble disk filter system, an air compressor, and a vacuum system for the pump priming. x The electrical room houses all the VFD units, switch board, and control panels. x The pump stations ultimate capacity is designed for 10 MGD ADF. Sanford Reclaimed Water System x Contractor overseeing construction of a regional reclaimed system that interconnects two Cities and a County through 16 miles of 8” to 18” reclaimed water mains. Islamorada Village Wide Wastewater System, Design, Build, Operate (DBO)/Islamorada x CPH areas of responsibility included the design and permitting of the vacuum collection system for the Island of Upper Matecumbe Key; vacuum pumping stations for the Islands of South Plantation Key, Upper Matecumbe Key and Lower Matecumbe Key; and low pressure force main collection systems for the Island of Windley Key and portions of Upper Matecumbe Key. x Combined the project consists of 37,410 LF of HDPE pipe ranging in size from 1 1/4-6”. CPH provided a complete system design including plan and profile drawings of each pipe run. CPH conducted system hydraulics calculations using Sewercad. CPH is providing limited CEI services for this portion of the project. N. Katriina Bowman, P.E., CCS/Project Engineer Ms. Bowman has been an engineer with CPH since 1989. She has extensive utility design and permitting experience, including prediction of flows, pipe sizing, horizontal and vertical layout; pressure system modeling, lift station design, preparation of utility adjustment plans, and preparation of FDEP State Revolving Fund Loan program loan applications. Ms. Bowman also has experience with the preparation of Traffic Control Plans and has experience overseeing Construction Engineering and Inspection (CEI) over numerous utility construction projects. Her technical experience includes constructability reviews, writing and reviewing Change Orders, issuing contract interpretations, and processing of Contractor payment applications. She has also prepared bid documents, construction cost estimates, and has written technical specifications for a number of projects. Her CCS Certification demonstrates knowledge of construction contract types, Agreements and Conditions of the contract, changes in the work, Bidding Documents and Requirements, and specification writing. Years of Service With Proposer: 24 Years Years of Experience: 26 Years Academic Credentials M.S. in Civil Engineering, Clemson University B.S. in Civil Engineering, Clemson University Licenses Professional Engineer - FL (No. 45155) Certified Construction Specifier – Construction Specifications Institute (CSI) Qualified Stormwater Management Inspector (FDEP) Advanced Maintenance of Traffic Qualification (FDOT) Expertise: x Water Supply Wellfields (Well Outfitting and Raw Water Transmission Mains x Lift Station Design and Rehabilitation x Utility Adjustment Plans x Construction Documents and Administration x Water Distribution Design Titusville - Area IV Well Outfitting and Raw Water Transmission Main (Phase 1) x Provided design, permitting, bidding and construction phase services for the project. x Project construction included the drilling of 5 production wells, 3 saline water monitoring wells, outfitting of 6 production wells, and construction of approximately 72,000 LF of new raw water transmission main (16”-20” diameter pipeline) from the City’s Mourning Dove Water Treatment Plant to the Area IV Wellfield. Pipe Bursting of Potable Water Mains Using Pre-Chlorinated Pipe, City of Sanford x Project consisted of bursting approximately 17,500 LF of 4” water main and approximately 23,000 LF of 6” water main within 4 different residential neighborhoods in Sanford x Federal economic stimulus project funded under the State Revolving Fund Loan program administered through the Florida Department of Environmental Protection (FDEP) using American Recovery and Reinvestment Act (ARRA) fund x Reviewed payment applications, prepared change orders, and prepared disbursement requests for the SRF funding Lake Harriet Water Transmission Main, Seminole County x Provided design, permitting, bidding and CEI x Construction of over 6,100-ft of new 8” potable water transmission main in existing neighborhoods north and south of SR 436. x The project provided new water services to over 60 existing residences that were on private wells. x Project included the construction of approximately 12,600 LF of fiber optic conduit and installation of over 30 pull boxes. x Permitting was through FDEP (2 separate permits due to the 2 separate public water systems) and FDOT (jack and bore and directional drill construction across SR 436). Project Name Length Water Main Palm Coast WTP No. 3 Well Field System 23 Miles 8 – 24” Raw Water Main Old Kings Road South RWM Construction 15,000 feet (RWM) 20 to 24” (RWM) Fire Hydrant Upgrades – Regency Oaks Apartments 5,300 feet (WM) 5,000 Ft. 6 to 10” (WM) Airport LS and Force Main Improvements and Beardall Ave. Water main and Force Main Extension 11,600 ft. (10-inch FM) 1900 ft. sanitary sewer 260 Ft. 12” (WM) Palmetto Ave., Valencia Ct. and Woodfield Dr. RWM Extensions 4,700 ft. (4” RWM) 2,000 ft. (6” WM) 4,300 ft. (1- to 2” Service Lines) 4,700 Ft. (4” RWM) 2,000 ft. (6- Inch WM) Titusville - Area IV Well Outfitting and Raw Water Transmission Main (Phase 1) 71,690 FL 16”-20” Pipe Bursting of Potable Water Mains Using Pre-Chlorinated Pipe, City of Sanford 17,500 LF 23,000 LF 4” water main 6” water main Lake Harriet Water Transmission Main, Seminole County 6,100-ft 8” potable water transmission main Midway Utilities Replacement - Phase 1, Seminole County 9600-ft 4"-10" water main Red Cleveland Blvd. Water Main Looping at the Orlando Sanford International Airport 3980-ft 8”-10” potable water transmission main Old Kings Road North and South RWM Construction, City of Palm Coast x This project consisted of the construction of approximately 39,100 feet of 16”-30" RWM along existing FPL easements east and west of I-95 and west of Old Kings Road. x Jack and bore construction included approximately 1800-ft of 30”-36” steel casing. x CPH’s services included design, permitting through FDOT and CEI services. Additionally, CPH assisted the City with securing funding and preparing and submitting cost share reimbursement requests for this project through SJRWMD (district water supply plan funding). Midway Utilities Replacement - Phase 1, Seminole County x Provided design, permitting, bidding and CEI services x The Project consists of the Construction of approximately 9600-ft of new 4"-10" water main, water services, and fire hydrants within the Midway residential community located east of Sanford. x The construction includes the abandonment in place (via grouting) of existing 6” water main and directional drill construction, and the installation of a new Master Meter Assembly. The project includes replacing existing water services between the new mains and existing water meters. Red Cleveland Blvd. Water Main Looping at the Orlando Sanford International Airport, City of Sanford x Provided design, permitting, bidding and CEI services x The project construction included construction of approximately 3980-ft of new 8”-10” potable water transmission main along the west side of Red Cleveland Blvd. and Control Tower Rd. between Marquette Ave. and the existing water main located approx. 1000-ft north of Airport Blvd., east of the Orlando Sanford International Airport terminal. x The project included coordination with the airport and FAA due to existing infrastructure in the construction areas. Rocco R. Nasso, P.E./Project Engineer Mr. Nasso serves the firm of CPH as a Project Manager and Engineer. He has extensive experience with water and wastewater transmission systems, collection systems, and pumping systems design and construction. Mr. Nasso’s design experience includes stormwater calculations and modeling (ICPR and Hydraflow), transmission main design and modeling (WaterCAD), route analysis and planning, pump sizing, and lift station design. Other duties include the preparation, construction coordination with contractors in the build out phase and processing of permits through various regulatory and municipal agencies. Years of Service With Proposer: 13 Years Years of Experience: 13 Years Academic Credentials B.S. in Civil Engineering, University of Central Florida, 2001 A.A., Seminole Community College Licenses Professional Engineer - FL (No. 64727) Qualified Stormwater Management Inspector (FDEP) Advanced Maintenance of Traffic Certification OSHA Construction Safety and Health Certification Expertise: x Water and Wastewater Design and Modeling x Utility Distribution Systems x Stormwater Design x Construction Administration x Construction Inspection x Permitting Pipe Bursting of Potable Water Mains Using Pre-Chlorinated Pipe, City of Sanford x Project consisted of bursting approximately 17,500 LF of 4” water main and approximately 23,000 LF of 6” water main within 4 different residential neighborhoods in Sanford x Federal economic stimulus project funded under the State Revolving Fund Loan program administered through the Florida Department of Environmental Protection (FDEP) using American Recovery and Reinvestment Act (ARRA) fund x Reviewed payment applications, prepared change orders, and prepared disbursement requests for the SRF funding Area IV Well Outfitting and Raw Water Transmission Main (Phase 1), City of Titusville x Provided design, permitting, bidding and construction phase services for the project. x Approximately 71,690 linear feet of 16”-20” raw water transmission main, extending from the Mourning Dove Water Treatment Plant in Titusville to Well 407 located in the Area IV wellfield U.S. 17-92 at I-4 Utility Relocations x Consisting of relocation of 20” reclaimed water main 24th Place Sewer Replacement x Replacement of 8” and 12” sanitary sewer x Work included preparation of an MOT plan, a bore and jack crossing of U.S. 17-92 and open cutting the outside travel lane of U.S. 17-92 to install a conflict structure East Lake Mary Blvd. Segment IIB Utility Construction x Over 20,000-ft of 6”-12” force main x 1400-ft of 20” force main x 1700 linear feet of 8” water main x 18300-ft of 12” water main x 10,400-ft of 24” reclaimed water main along the East Lake Mary Boulevard roadway construction project from the Airport Entrance Road to SR 46 Orlando-Sanford International Airport x Lift Stations and Force Main including construction of 2 New Lift Stations x Demolition of lift stations and an abandoned WWTP Project Name Length Water Main Lake Harriet Water Main 6000 LF 8” Water Main Airport Blvd Phase III Relocations 9000 LF 5500 LF 6”-20” sewer and FM, 3500 LF 8”-20” WM, Marquette Avenue Utility design and Construction 16000 LF 8000 LF 12”- 20” FM, 8500 LF 6”-16” WM SR 46 Phase II Water Main 5500 LF 16” WM Narcissus Ave Force Main and Sewer 11000 LF 8”-12” sewer and FM CR 46 A Utility Relocations 7500 LF 4”-24” WM St Johns Parkway Utilities 13000 LF 2700 LF 8” FM, 4900 LF 16” WM, 5100 LF 12” RWM Airport Blvd Phase II Utilities 13000 LF 5000 LF 6”-18” FM, 8000 LF 8”- 18” WM Fire Hydrant Upgrades – Regency Oaks Apartments 5,300 feet (WM) 5,000 Ft. 6 to 10” (WM) Airport LS and Force Main Improvements and Beardall Ave. Water main and Force Main Extension 11,600 ft. (10-inch FM) 1900 ft. sanitary sewer 260 Ft. 12” (WM) Palmetto Ave., Valencia Ct. and Woodfield Dr. RWM Extensions 4,700 ft. (4” RWM) 2,000 ft. (6” WM) 4,300 ft. (1- to 2” Service Lines) 4,700 Ft. (4” RWM) 2,000 ft. (6- Inch WM) Titusville - Area IV Well Outfitting and Raw Water Transmission Main (Phase 1) 71,690 FL 16”-20” Lake Harriet Water Transmission Main x Provided design, permitting, bidding and CEI x Construction of over 6,100-ft of new 8” potable water transmission main in existing neighborhoods north and south of SR 436. x Project included the construction of approximately 12,600 LF of fiber optic conduit and installation of over 30 pull boxes. x Permitting was through FDEP (2 separate permits due to the 2 separate public water systems) and FDOT (jack and bore and directional drill construction across SR 436). CR 46-A Reclaimed Watermain x Consisted of the construction of approximately 9,450 LF of new 20" reclaimed watermain and the removal of approximately 3,380 LF of existing 12" and 14" reclaimed watermain. x The reclaimed watermain design and construction phase services were conducted by CPH and included design of a base RWM size (20”) and alternate size (16”), coordination with the Tri-party members (Lake Mary and Sanford) relating to the reimbursement of costs to Seminole County, and coordination with the County’s roadway construction contractor during construction. Lake Jessup Bridge RWM Relocation Design-Build x Prepared engineering plans for the construction of 4,000 LF of 24” reclaimed watermain along existing SR 46 and hanging from new FDOT bridge in Seminole County. Seminole County Regional Water Treatment Facility at Yankee Lake x Construction of a raw water pump station and intake structure to be located on the St. Johns River x Installation of offsite large diameter piping, conduits for electric power and fiber optic cable from the raw water pump station to the treatment facility site x Offsite piping included the opencut installation of approximately 40,000 LF of dual 42” HDPE raw water pipline with 36” ductile iron pig stations. x Onsite yard piping consisted of approximately 12,000 LF of process piping ranging from 4” to 36” diameter. Jason L. James/Project Engineer Jason James serves the firm of CPH in the capacity of Project Engineer. He is responsible for design and engineering infrastructure, grading, drainage, potable water, sanitary sewer systems, as well as the preparation and processing of permits through various regulatory agencies. Years of Service With Proposer: 8 Years Years of Experience: 8 Years Academic Credentials B.S. in Civil Engineering, University of Central Florida, 2005 Licenses Engineer-in-Training – FL, 2005 Expertise: x Commercial land development x General Site Planning x Utilities Design x Permitting Relevant Project Experience: x CVS Pharmacy – Big Pine Key – 2011 x CVS Pharmacy – Stock Island – 2011 x Church of Jesus Christ Latter-day Saints – Marathon – 2010 x CVS Pharmacy – Key West - 2010 x Church of Jesus Christ Latter-day Saints – Key West – 2009 x Panda Express – Homestead – 2006 x McDonald’s Restaurant – North Miami - 2009 Northern Forcemain and Southern Forcemain Project/Key Largo Wastewater Treatment District x Consists of the design of the Northern and Southern Forcemain from MM 92 +/- to MM 106 +/-. x The original design was for all piping to be PVC except for the directional drills (HDPE) and the aerial bridge crossing that was ductile iron. The pipeline size varies from 4-inch to 18-inch along the US-1 corridor. x This project includes an innovative design element. x An abandoned 30-inch water main existed within the US-1 corridor. KLWTD was able to obtain the rights to utilize this pipe as their corridor for the forcemain. Shoppes at the Fountains- Plantation, FL x CPH provided survey, civil, architectural, and traffic engineering services x Demolition of approximately 200,000 sq. ft. of existing retail space for the construction of new anchor tenants including Kohl's, Dick's Sporting Goods, and Jo-Ann's Fabrics x New streetscape retail was designed to transform the center into a new and exciting shopping destination TGK Booking Center- Miami-Dade County x CPH provided civil, architectural, and surveying services x Performed a design study to create a centralized booking area in the existing Turner Guilford Knight Correctional Center x Created separate entrances for law enforcement officers (LEOs) and inmates x Provided a conceptual plan that converted an existing covered parking garage into a secured bus drop-off area for the inmates x Created a concept plan for a Sally Port and secured parking area for the LEOs x Prepared construction documents for the project x The construction documents included plans for demolition, grading, site dimensioning, structural and electrical work CVS Pharmacy - Monroe County x Involved the opinion of probable cost x Utility coordination x Preliminary design x Overall preliminary planning for sites located on the islands of Key West, Stock Island, and Big Pine Key David E. Mahler, P.E./Pump Station Engineer Mr. Mahler serves the firm of CPH as Senior Vice President and Branch Manager of the Orlando Office. Mr. Mahler is a Project Manager/Project Engineer for municipal and private clients. Mr. Mahler has been involved with treatment facility improvements, SCADA systems, collection and distribution system design, and modeling as well as utility line extension and relocation projects for both municipal and private clients. In addition, Mr. Mahler specializes in relocation of existing utilities associated with roadway projects. He has also been involved with land development and roadway design and permitting for private clients. Years of Service With Proposer: 15 Years Years of Experience: 24 Years Academic Credentials B.S. in Environmental Engineering, University of Central Florida Licenses Professional Engineer - FL (No. 50041) Expertise: x Water Supply, Treatment, Pumping, Storage and Distribution x Wastewater Collection, Treatment and Pumping x Reclaimed Water Storage, Pumping and Distribution x Utility System Relocations x Utility Systems Modeling x Land Development Clients: x Orange County x Haines City x City of Lake Alfred x FL Department of Corrections x City of Winter Springs x City of Eustis x City of Orlando x City of Oviedo x City of Winter Garden x City of Ocoee x Volusia County School Board x Lake County School Board x Town of Oakland S.R. 50 Utility Relocation Project x 13 miles of water distribution system and wastewater collection and transmission system relocations and installations within the S.R. 50 Corridor x FDOT/JPA contract x New facilities as well as relocations and removal x 5.5 miles of 8, 12, 16, 20 and 24” diameter water main x 7.7 miles of 4, 8, 12, 16, 20 and 30” diameter forcemain x 2.84 miles of gravity collection mains x Triplex Master Pump Station S.R. 426 Utility Relocation Project x FDOT widening project for 1.2 miles of S.R. 426 x Relocation of the City’s 10” watermain with a 16” watermain x Additional 12” watermain designed to provide interconnect to another city x 4,000 feet of gravity sewer collection system with sewer lines ranging from 8” to 15” x New master lift station designed to accommodate existing and future flows from the area. x Installed 1,300 feet of 10” forcemain including a 270 foot directional drill Key Largo Wastewater Treatment District, Northern Forcemain Project x Design of the northern forcemain from MM 100.5 +/- to MM 106 +/- x All piping was PVC except for the directional drills that were HDPE and the aerial bridge crossing that was ductile iron. x The pipeline size varies from 8-inch to 10-inch along the US 1 corridor. SR-50 Utility Relocations from SR-429 to CR-545 (Avalon Road) x Design, permitting and construction administration services to relocate water mains and force mains, including the incorporation of a new gravity sewer collection system into the FDOT widening plans for SR- 50 from SR-429 to CR-545. x Included approximately 11,900 l.f. of gravity sewer mains ranging in size from 8-inch to 24-inch, connections from other force main systems to the gravity sewer system and new sanitary lateral connections to the gravity sewer on SR-50. x Design of the installation or relocation for 5,000 l.f. of 16-inch, 9,250 l.f. of 12-inch, 5,775 l.f. of 8-inch water mains; 6,400 l.f. of 12-inch and 1,300 l.f. of 6-inch force mains. James R. Morris, Jr., P.E./Project Engineer James “Jay” Morris Jr. works as a Project Manager in our Environmental Engineering Department, and has experience with water and wastewater transmission systems, wastewater collection systems , and pumping systems in both design and construction administration. His areas of expertise also includes preparation of water and wastewater master plans, writing and organizing technical specifications and project manuals, client management, and utility coordination,. In addition to water and wastewater projects, he has also been responsible for construction administration on vertical construction projects. Years of Service With Proposer: 9 Years Years of Experience: 14 Years Academic Credentials B.S. in Environmental Engineering, University of Central Florida Licenses Professional Engineer – FL (No. 62384) Commercial Pilot License (No. 266577109) Expertise: x Water, Reclaimed Water, and Wastewater Transmission Systems Design x Water, Wastewater and Solid Waste Master Plans x Construction Administration x Utility Coordination x Pumping Facilities Professional Activities: x Florida Water Environment Association: Central Florida Steering Committee Member 2000-current. x Past Chair -2009 S.R. 50 Utility Relocation Project x 13 miles of water distribution system and wastewater collection and transmission system relocations and installations within the S.R. 50 Corridor x FDOT/JPA contract x New facilities as well as relocations and removal x 5.5 miles of 8, 12, 16, 20 and 24” diameter water main x 7.7 miles of 4, 8, 12, 16, 20 and 30” diameter forcemain x 2.84 miles of gravity collection mains x Triplex Master Pump Station SR-50 Utility Relocations from SR-429 to CR-545 (Avalon Road) x Design, permitting and construction administration services to relocate water mains and force mains, including the incorporation of a new gravity sewer collection system into the FDOT widening plans for SR-50 from SR-429 to CR-545. x Approximately 11,900 l.f. of gravity sewer mains ranging in size from 8-inch to 24-inch, connections from other force main systems to the gravity sewer system and new sanitary lateral connections to the gravity sewer on SR-50. x Design of the installation or relocation for 5,000 l.f. of 16-inch, 9,250 l.f. of 12-inch, 5,775 l.f. of 8-inch water mains; 6,400 l.f. of 12-inch and 1,300 l.f. of 6-inch force mains. Key Largo Wastewater Treatment District, Northern Forcemain Project x Design of the northern forcemain from MM 100.5 +/- to MM 106 +/- x All piping was PVC except for the directional drills that were HDPE and the aerial bridge crossing that was ductile iron. x The pipeline size varies from 8-inch to 10-inch along the US 1 corridor. International Drive and Universal Boulevard Force Main x Design of 10,100 l.f. of 24-inch force main along Universal Boulevard and Point Plaza Ave., across International Drive and Interstate-4, with a connection across Turkey Lake Road. x Approximately 2,300 l.f. of 24-inch force main were installed by directional drill and 330 l.f. of 42-inch jack and bore were needed to facilitate this installation. Thomas J. Galloway, PSM/Director of Surveying and Mapping Mr. Galloway has over 24 years of experience in the surveying and mapping profession, and has a Bachelor of Science of Surveying and Mapping from the University of Florida. His experience ranges from working in the field and office on small to large development projects, to serving as Party Chief/Survey CADD Technician, Project Manager and Survey Manager. Mr. Galloway has served as Principal and Director of the Surveying Division of the firm since its establishment in 2001. He has overseen the department’s growth from two survey crews to managing the current seven survey crews. Additionally Mr. Galloway has been personally involved in over 2,500 surveys while at CPH. Years of Service With Proposer: 13 Years Years of Experience: 24 Years Academic Credentials B.S. in Surveying and Mapping, University of Florida, 1992 Licenses Professional Surveyor & Mapper - FL (No. LS6549) Professional Land Surveyor – PR (No. 23387) & AL (No. 31338-S) Professional Land Surveyor - DC (No. LS906192) Certification NCEES Council #1291 Expertise: x Surveying and Management x Highway Projects x Land Development/Commercial and Private Projects x Municipal Projects Other Relevant Experience: x Seminole County x Pollo Tropical x Hibiscus Homes x KB Homes x City of Winter Springs x Orange County Utilities x Florida Power & Light x McDonald’s Corporation x City of Tampa x City of Punta Gorda x Jackson Memorial Hospital x Toho Water Authority x Habitat for Humanity x Lowe’s Home Centers SR-50 Utility Relocations from SR-429 to CR-545 (Avalon Road) x Design, permitting and construction administration services to relocate water mains and force mains, including the incorporation of a new gravity sewer collection system into the FDOT widening plans for SR-50 from SR-429 to CR-545. x Approximately 11,900 l.f. of gravity sewer mains ranging in size from 8-inch to 24-inch, connections from other force main systems to the gravity sewer system and new sanitary lateral connections to the gravity sewer on SR-50. x Design of the installation or relocation for 5,000 l.f. of 16-inch, 9,250 l.f. of 12-inch, 5,775 l.f. of 8-inch water mains; 6,400 l.f. of 12-inch and 1,300 l.f. of 6-inch force mains. Islamorada Village Wide Wastewater System, Design, Build, Operate (DBO)/Islamorada x CPH areas of responsibility included the design and permitting of the vacuum collection system for the Island of Upper Matecumbe Key; vacuum pumping stations for the Islands of South Plantation Key, Upper Matecumbe Key and Lower Matecumbe Key; and low pressure force main collection systems for the Island of Windley Key and portions of Upper Matecumbe Key. x Combined the project consists of 37,410 LF of HDPE pipe ranging in size from 1 1/4-6”. CPH provided a complete system design including plan and profile drawings of each pipe run. CPH conducted system hydraulics calculations using Sewercad. CPH is providing limited CEI services for this portion of the project. Boos Development Group - – Boundary, Topographic and As-built Surveys, Construction Layout, Sketch and Descriptions, Wetlands and Platting x Multiple CVS sites throughout the State of Florida x Multiple CVS sites throughout Puerto Rico U.S. Navy - Vertical control and sanitary sewer design build survey on the Island of Guam Florida Department of Agriculture – Boundary and Topographic Survey and High Definition Laser Scanning x Immokalee Farmers Market TES SURVEYORS AND MAPPERS PROFESSIONAL ENGINEERS ARCHITECTURE LANDSCAPE ARCHITECTS TEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEESSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTEEEEEEEEEEEEEEEEEEESSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS CPH – LICENSES & CERTIFICATES BRINDLEY PIETERS & ASSOCIATES, INC. 815 NORTHWEST 57TH AVENUE, SUITE 335 MIAMI, FLORIDA 33126 305.266.1235 Founded in 1991, BPA has more than twenty-one years experience in providing design, program and construction management services to municipal, state and federal clients in the utility, civil, structural, airport and transportation engineering fields. BPA’s staff consists of professional engineers, technicians and support staff. The firm and staff have experience in providing services which include studies, design, relocation coordination, permitting and construction phase services for water, wastewater and reclaimed water utility projects as well as general civil engineering projects such as roadways, park facilities, stormwater drainage projects, preparation of building site plans and permitting. Specifically, our firm and staff have provided utility engineering services for water main, force main and reclaimed water main design and construction, facility site design and lift station rehabilitation projects for clients including Orange County Utilities, the City of Orlando, Orlando Utilities Commission, the Greater Orlando Aviation Authority and Sarasota County Environmental Services. Projects completed for City and County clients range from utility relocations at airport facilities and residential neighborhoods to the design for miles of water main, force main and reuse water main constructed within public rights-of-way, water storage facilities, wells, odor control systems and site development at treatment facilities. Additionally, BPA is currently providing continuing engineering services to FDOT District 5 for utility relocation coordination. These utility relocation services include coordinating design reviews of JPA utility plans; coordinating and reviewing Utility Work Schedules; reviewing utility reimbursements; and reviewing utility relocation cost estimates. and reviewing Utility Work Schedules; reviewing utility reimbursements; and reviewing utility relocation cost estimates. RANDY AUGAT Senior Project Manager Mr. Augat has more than twenty-six years experience in utility and storm sewer design, airport, roadway, site planning, environmental permitting, project management, and construction administration. He has served as Project Manager for design projects ranging from rehabilitation of existing residential neighborhood water and sewer systems, new residential subdivisions, public schools, parks, and redevelopment streetscapes to commercial developments, roadway widening and international airport expansions. EXPERIENCE 26 Years EDUCATION PROJECTS B.A. Florida State University Master Pump Station Improvements, Group 5, Orange County FL Project Manager. Preparation of conceptual site plans, preliminary design report, and cost estimates for rehabilitation/removal/relocation alternatives at five pump stations illustrating improvements proposed in each alternative. CONSERV II Water Reclamation Facility, Orlando FL. Project Manager overseeing data collection; preparation of site and grading plans; stormwater pond design and DEP permitting; roadway widening, turn lanes, auxiliary lanes; signing and pavement markings; and construction administration. Project was the replacement of existing master pump station, addition of flow equalization facilities, and addition of a hauled waste receiving and separation facility. CONSERV II Digester Gas Holding Tank, Orlando FL. Project Manager. Conducted a condition assessment of structural components at the exterior of the digester tank cover and at the interior of the sludge storage/gas holding tank. Responsible for providing a report on the structural condition of the tank and covers. A preliminary cost estimate was prepared for the repair work identified in the Condition Assessment. Northwest Water Reclamation Facility Phase II Expansion, Orange County FL Project Manager. Erosion and sedimentation control plans and details and specifications, Facility is located on a 700-acre site and is an advanced secondary wastewater treatment plant with effluent reuse. Northwest Water Reclamation Facility Operations Building Wind Retrofit, Orange County FL. Project Manager. Oversaw the design of the structural wind protection enhancements for the Operations Building. The design upgraded and provided protection for the doors and windows to resist hurricanes and to provide windborne debris missile impact resistance for the facility. Eastern and Southern Service Area Odor Control Systems, Orange County FL, Project Manager. Construction documents for installation of odor control systems at 13 existing pump stations. Site plans indicated pump station arrangement and odor control system layout, electrical controls, piping, fittings, existing utility locations, and property boundary information. Southern Regional Water Supply Facility, Orange County FL. Project Manager. Site planning, grading, stormwater system design, utility systems design, and stormwater ERP permitting for a 150-acre new deep well/water treatment plant. Western Regional Water Supply Facility-Plant Expansion, Orange County Utilities Department. Project Manager. Design, permitting and construction administration for the new treatment plant site and well service roads. Project included roadway and parking lot design, drainage system, sanitary sewer force main and lift station, water main design and permitting. Eastern Regional Water Supply Facility, Orange County Utilities Department. Project Manager. Site development for water plant expansion, which included roadway, well sites, building and storage tank additions, fencing, security, and permitting through FDEP, County and SJRWMD. Lake Lucerne Stormwater System, Phase 2, Orlando FL. Project Manager. Modifications to an existing FDEP permitted stormwater management system to provide additional treatment and floc removal. Oversaw the preparation of plans and specifications for the nutrient separating baffle box which tied into the existing outfall into Lake Lucerne. PROFESSIONAL AFFILIATION American Society of Civil Engineers American Society of Highway Engineers American Water Works Association RANDY AUGAT Senior Project Manager Page 2 PROJECTS International Drive Force Main (Little Lake Bryan Parkway South to Pump Station 3597 on World Center Drive) Orange County FL. Project Manager. Design of 8,100 LF of replacement 30-inch force main. Design included the sliplining and conversion of the existing 30-inch force main to a reclaimed water main along with permitting and transferring existing force mains from lift stations to the new force main. Orlando Utilities Commission Project Renew, Orlando FL. Project Manager. Design for 3-mile section of transmission main. Project consists of an annual average flow 8.55 MGD pumping station and 14 miles of 24-inch DIP reclaimed water transmission main. Project is mostly routed along existing public right-of-way and easements. Meadow Woods Water Supply Facility, Orange County FL. Project Manager. Oversaw the civil and structural engineering services required to complete the modifications to the Meadow Woods Water Supply Facility that was decommissioned as a water supply facility and the two existing wells retrofitted with new pumps and connected to a new raw water transmission main so that the raw water from these wells can be conveyed to the new Southern Regional Water Supply Facility for treatment. The existing Meadow Woods potable water storage and pumping facilities will be converted into a reclaimed water storage and re-pump facility. Gore Street Stormwater Improvements, Orlando FL. Project Manager. Responsible for preparation of the maintenance of traffic plan and permitting for the construction of a new stormwater system along Gore Street between Bahama Drive and Huntington Place. Lake Adair Stormwater Improvements, Orlando FL. Project Manager. Responsible for the preparation of the maintenance of traffic plan and permitting for the replacement of the culverts that connect Lake Adair and Lake Concord and for the closure of Edgewater Drive. Marks Street/Pasadena Place Utility Improvements, Orlando FL. Project Manager. Design, permitting and construction for improvements to the sanitary sewer system and stormwater improvements. The sanitary sewer component of the project involved the installation of 4,700 feet of sanitary sewer system improvements. Oversaw the preparation of the Preliminary Design Report for stormwater improvements along Marks Street and Pasadena Place. Dahlia Drive Sanitary Sewer System Replacement, Orlando FL. Project Manager. Installation of 4,000 linear feet of 15-inch diameter gravity sanitary sewer and seventeen sanitary manholes. Oversaw the preparation of stormwater pollution prevention plans and maintenance of traffic/detour plans; preparation of the Stormwater Pollution Prevention Plan; and Notice of Intent to use the NPDES FDEP Generic Permit. Iron Bridge Water Treatment Plant, Orlando Utilities Commission. Project Manager for the design, permitting and construction administration for the site design of a chlorine storage facilities at an existing water treatment plant. Project included site plan, truck docks and loading areas, and drainage design and permitting. Eastern and Southern Service Area Odor Control Systems, Orange County FL, Project Manager. Construction documents for installation of odor control systems at 13 existing pump stations. Site plans indicated pump station arrangement and odor control system layout, electrical controls, piping, fittings, existing utility locations, and property boundary information. Hiawassee Road Force Main, Orange County FL. Project Manager. Design of 3,000 LF of replacement 30-inch force main along a 6-lane County road and included permitting, transferring existing force main connections to the new force main. Lift Station 3, Orlando FL. Project Manager. Structural design and analysis for the new wet well and pump station building. Also provided the civil/site design for the expanded pump station site as well as the Environmental Resource permitting. TREVOR ADAMS, P.E., LEED AP Structural Engineer Mr. Adams’ experience is in structural engineering for commercial, industrial, and residential structures along with arenas, convention centers, airport terminals, parking structures, schools, and bus terminals. His areas of expertise in structural systems include reinforced concrete, steel, wood, precast, post tensioned concrete, pan joist floors, tilt up concrete, piled foundations, sheetpiling, and wind and earthquake resistant design. His experience also includes project management, preparation and review of plans, contract documents, quality control, schedules, budgets, construction management, and design/build delivery. EXPERIENCE 27 Years PROFESSIONAL LICENSE PROJECTS Professional Engineer Florida #46305 Georgia #PE028417 Jamaica #01:06/0158 Water Treatment Plant Number 2 Improvements, Palm Beach County FL. Structural Engineer. Plant build-out to increase capacity from 10.5 mgd to 14.5 mgd. Structural design included concrete foundation pads for new filtration tanks, concrete backwash sump pits, collector flume and splitter box assembly including steel tower supports, and inspection walkway platforms over flume/splitter and precipitator tanks. Lake Nona Pump Station, Orlando FL. Structural Engineer responsible for the design, specifications and construction phase services for the reinforced concrete building. Bennett Road Force Main and Pump Station, Orlando FL. Structural Engineer. Expansion of the existing wastewater bypass facility to include addition of 25’ wet wells for new submersible pumps. The structure required modifications for aeration channel area, existing influent/effluent chambers and removal and replacement of existing roof. Western Regional Water Treatment Plant Corrosion Control Facilities, Orange County FL. Structural Engineer. Preparation of construction documents for containment structures for 5 sodium hydroxide tanks with foundation concrete pads. Also responsible for design foundations, site adaptation including grading and determination of the location of the structures. Southern Regional Water Supply Facility, Orange County FL. Structural Engineer. Design of high service pump building, which houses 5 pumps, emergency generators, and electrical rooms. The masonry clad structure supports a metal roof with an independent steel frame for a 7.5 ton overhead traveling crane. Design included deep concrete pits and encasing for pipes and pumps. Other structures included a guardhouse, diesel fuel, and liquid oxygen storage tank supports. Adams Drive Culvert, Atlanta GA. Structural Engineer. Performed structural analysis and design of the Adams Drive replacement culvert. The project consisted of replacing in-kind the existing quadruple 10’ x 9’ cast in place concrete 90’ culvert with a new cast in place structure. The design included wingwalls and inlet and outlet aprons. Southwest Water Mains, Atlanta GA Project Engineer. Design of structural elements associated with the six-mile segment of 54-inch pipeline. Performed preliminary design of a pipeline bridge over Norfolk Southern Railroad track. Also performed design of large cast in place vault structures to house valves and other appurtenances. Northwest Water Reclamation Facility Operations Building Wind Retrofit, Orange County FL. Structural Engineer. Design of the wind protection enhancements for the Operations Building. The design upgraded and provided protection for the doors and windows to resist hurricanes of 140 mph wind speeds (Category 3 on the Saffir Simpson/NOAA Scale) and to provide windborne debris missile impact resistance for the facility. Northwest Water Reclamation Facility Phase III Expansion, Orange County FL. Structural Engineer. Structural design of cast in place concrete oxidation ditches for 5 stage BNR basin. Design included 200’ x 250’ reinforced concrete mat foundation; 23’ high walls, and flow splitter box and flow channels. Also provided design for supports for aeration piping on walls and metal walkways/platforms to support mixers. Existing oxidation ditches were expanded and new construction required design to limit differential settlement by various methods including soil preloading, stabilization, and special design and detailing of interface joints. EDUCATION M.Eng. Cornell University (Structural) 1986 B.S.C.E. University of the West Indies (Civil) 1982 CERTIFICATION LEED AP PROFESSIONAL AFFILIATION American Society of Civil Engineers American Concrete Institute WESLEY BARNES, P.E. Principal Civil Engineer Mr. Barnes has over thirty-eight years of civil engineering experience specializing in private and public works projects. His projects include highway planning and design, rail corridor studies, rapid transit system design, aviation design, stormwater drainage system design and permitting, erosion and sedimentation control design, wastewater treatment facility design, site development and environmental permitting and compliance. Mr. Barnes’ management responsibilities include preparing and maintaining project budgets and schedules, providing project and staff coordination, and client liaison. EXPERIENCE 38 Years PROFESSIONAL LICENSE PROJECTS Professional Engineer Florida #58326 Georgia #12125 City of Atlanta, Stockade CSO Sewer Separation. Project Manager. Design for the separation of 56,000 LF of combined sewer into separate storm and sanitary systems. Oversaw staff involved in the checking of as-built survey drawings against available data.. Provided hydrological and hydraulic analyses for the separated storm and sanitary sewers, sizing of pipelines, development of plan and profile drawings, cost estimates and specifications. Project included obtaining permits from City of Atlanta Land Disturbance permit, EPD Sewer Extension permit, GDOT Utility Encroachment permit and railroad permits. City of Atlanta Annual Contract for Architectural/Engineering Services, Atlanta GA. Deputy Contract Manager. Responsibilities include preparation of project proposals, budgets, presentations, staff assignments, and QA/QC. Projects include Virginia Highlands Water Main Replacements, Koweta Road Pump Station, Water System Leakage Audit and Void Detection for the City’s Water Distribution System, Southwest Main Improvements, Hemphill Water Pump Station Upgrade, and Location of Utilities throughout the City. Marsh Creek Pump Station, Fulton County GA. Project Director. Design to upgrade the raw sewage pump station to a capacity of 6 mgd, with ultimate expansion capability of 10 mgd. The project included demolition of the existing wastewater reclamation center and regarding of the existing site. The facility is fully automated for remote operation with standby generator capable of operating the facility during power outages. Utoy Creek Combined Sewer Separation, Atlanta Department of Public Works. Project Director responsible for developing the budget and overseeing the design of the separation of a system of combined sewers into separate storm and sanitary systems. Responsible to the client for ensuring proper allocation of resources to the project, quality control, fee negotiation and subcontract agreements with subconsultants. Facilitated client, community and agency liaisons. Butler Street Sewer Tunnel, Atlanta GA. Project Manager. Civil and structural preparation of contract plans and specifications for approximately 3,000 feet of 14' diameter tunnel in urban area involving varying soils conditions, presence of ground water and intersections with existing major sewers. Responsibilities included interface and coordination of joint venture staff, geotechnical consultant and tunnel consultants, and establishment and management of budget. Veteran's Sewer Upgrade, Atlanta GA. Project Manager. Preparation of construction plans and specifications for the design of over eight miles of sanitary sewer upgrade. Project involved removal and replacement of existing sewer, through private as well as public rights-of-way, including easement acquisition, subconsultant procurement and coordination. Proctor Sandy Creek Trunk Replacement, Atlanta GA. Project Director. Design for the replacement of sanitary sewer outfalls in the Proctor Creek and Sandy Creek sewer service areas. Project involved replacement and rehabilitation of several segments of the sewer system. The portions of the sanitary sewer system designed included trunk lines that make up the Terrell Creek Outfall in the Terrell Creek watershed and segments of the Sandy Creek Outfall trunk line. Both outfalls are tributary to the Lower Proctor Creek Trunk which conveys sewage to the Utoy Creek Water Reclamation Facility for treatment. EDUCATION B.S., Civil Engineering Howard University 1973 PROFESSIONAL AFFILIATION American Society of Civil Engineers American Railway Engineering and Maintenance of Way Association WESLEY BARNES, P.E. Principal Civil Engineer PAGE 2 PROJECTS Nancy Creek Force Main Sewer, Atlanta GA. Project Engineer. Study and design of a relief sewer for the Nancy Creek trunk system. Responsibilities included developing population data from census and projections for the design year, performed flow calculations, and sizing of pipes. Also performed head loss calculations, developed system curves and selected pumps. Responsibilities also included route selection, part of which was along congested city streets and presentations at public meetings. South Delta Sewers, Atlanta GA. Project Manager. Design of five construction packages for the relocation/upgrade of this major trunk sewer, from private residences in Atlanta's historic Cabbagetown area, into public right-of-way. Responsibilities included development of Scope of Services for client, as well as interface with major private and franchised utility agencies. Cabbagetown Sewer Relocations, Atlanta GA. Project Engineer. Relocation of major combined sewer throughout the Cabbagetown area of Atlanta. Because of the size of the project, the design was broken into three phases, which were designed and let in phases. The design involved the computation of storm water flows, addition of sanitary flows based upon population census, sizing of pipes and the relocation of the existing sewer from private property to City right-of-way to facilitate future maintenance and release the encumbrance of private properties. Project also involved replumbing of many private residences to facilitate connection to the new sewer. Medical Center Rail Extension, Memphis TN. Project Manager. Design of the rail extension and relocation of existing storm sewers, installation of new drainage inlets and pipes, relocation of the Gayaso Bayou, a major drainage culvert that crossed the project, and conducting a drainage study. Entrenchment Creek Wastewater Treatment Plant Upgrade, Atlanta GA. Project Engineer. Responsibilities included layout of facilities, design of roadways, site grading, drainage and utilities. Riverside Pump Station, Fulton County GA. Project Manager. Preparation of structural plans and specifications for this pump station, which had depth up to 60 feet below grade. Project was done on a fast track to meet client's schedule. Also supervised resident engineer, field inspectors, and administrative staff on this $7,000,000 facility and associated interceptor sewer and force main. Chattahoochee to Northside Waterline, Atlanta GA. Project Manager. Preparation of contract plans and specifications for over 5 miles of 24-inch waterline including major highway, railroad and stream crossing. Project consisted of preliminary phase, route study, agency coordination, cost estimates and design development report. City of Atlanta Valve and Hydrant Assessment and Repairs. Project Manager. Overseeing the staff involved in locating by GPS methods approximately 48,000 valves and 24,000 hydrants in the City of Atlanta’s water system. The condition of each facility is assessed and recorded and input into the City’s Maximo program. Soundings are also taken to determine the presence of leakage in the system Chattahoochee III Sewer Pump Station, Atlanta GA. Project Manager. Civil and structural design for the preparation of contract plans and specifications, subconsultant coordination, budget, and schedule Brookwood Tunnel and Surface Improvements, Metropolitan Atlanta Rapid Transit Authority. Senior Civil Engineer. Design of street improvements, storm drainage system upgrade, and relocation of utilities. Checked track alignment and profile using MARTA's COGO program and designed track drainage. Coney Island, Wastewater Treatment, Coney Island NY. Participated in 40-hour value engineering program on the final design of the project for civil services. PROFESSIONAL ENGINEERS BRINDLEY PIETERS & ASSOCIATES – LICENSES & CERTIFICATES GEOSOL, INC. 5795-A NW 151ST STREET MIAMI LAKES, FL 33014 PHONE 305.828.4367 Geosol, Inc. (GEOSOL) is a small professional firm that was established in the year 2000. The firm has grown from 2 to 12 employees and provides geotechnical engineering and testing services, including subsurface exploration studies, laboratory testing, engineering, consulting, and design of foundation systems. The firm has a reputation for providing high quality, creative and cost effective geotechnical engineering solutions primarily for clients in the public sector. GEOSOL has become very actively involved in the public service arena and is already participating as a Soils, Foundations and Materials Testing sub-consultant for 100’s of projects for various South Florida municipalities including Miami-Dade County Agencies (Water & Sewer, Roadways, Aviation, Transit, DERM, and Housing), FDOT and Tri-County Commuter Rail Authority. GEOSOL engineers have over 50 years of geotechnical engineering combined experience and knowledge of the local ground conditions. Mr. Oracio Riccobono has served as Senior Geotechnical Engineer and Geotechnical Consultant for a variety of water supply, water resources, and water maintenance facilities projects. He has over 28 years of experience in the field of geotechnical engineering including planning and performance of field investigations. His experience includes interpretation of subsurface conditions, planning and execution of laboratory testing programs, geotechnical analysis and design of foundation elements of structures, management of geotechnical projects and preparation of numerous geotechnical baseline reports (GBR) providing conclusions and recommendations. He has recently executed several major water resource projects for MDWASD. ORACIO RICCOBONO, PE POSITION Senior Geotechnical Engineer EDUCATION Master in Business Administration, Florida International University, 2000 M.S., Civil Engineering, (Geotechnical), Louisiana State University, 1987 B.S., Civil Engineering, Louisiana State University, 1985 REGISTRATIONS Registered Professional Engineer, Florida, 1995 (Florida PE # 49324) PROFESSIONAL AFFILIATIONS American Society of Civil Engineers and Florida Engineering Society SUMMARY OF CAPABILITIES Shallow Foundation Design Deep Foundation Engineering Geotechnical Instrumentation In-Situ Testing Soil Mixing and Stabilization Roadway/Bridge Geotechnical Studies Pavement Design Wave Equation Analysis Slope Stability Evaluations Engineered Materials Testing and Inspection PROFESSIONAL EXPERIENCE Mr. Riccobono has over 28 years of experience and served as senior geotechnical engineer and geotechnical consultant for a variety of water supply, water resources, and water maintenance facilities projects. He is experienced in the field of geotechnical engineering including planning and performance of field investigations. Experience includes interpretation of subsurface conditions, planning and execution of laboratory testing programs, geotechnical analysis and design of foundation elements of structures, management of geotechnical projects and preparation of numerous geotechnical reports providing conclusions and recommendations. Most recently, he has executed and served as project geotechnical manager for the following MDWSD projects: South District Wastewater Treatment Plant Water Reclamation Facility; Miami-Dade County, FL - Project Geotechnical Engineer responsible for planning and executing the field exploration and laboratory testing programs, interpreting the test results, performing geotechnical analyses for the design of a 23 million gallon per day (MGD) advanced water treatment plant and proposed pipeline network as a way to implement reliable and cost-effective alternative sources of water. Reverse Osmosis Water Treatment Plant Facility, City of Hialeah, FL - Project Geotechnical Engineer responsible for planning and executing the field exploration and laboratory testing programs, interpreting the test results, performing geotechnical analyses for the design of a 5 MGD reverse osmosis water treatment plant and proposed pipeline network. Recycled Storm Water Treatment Plant Facility, City of Doral, FL - Project Geotechnical Engineer responsible for planning and executing the field exploration and laboratory testing programs, interpreting the test results, performing geotechnical analyses for the design of a 2 MGD recycled storm water treatment plant and proposed pipeline network. Central District Wastewater Treatment Plant Water Reclamation Facility Improvements; Miami-Dade County, FL - Project Geotechnical Engineer responsible for planning and executing the field exploration and laboratory testing programs, interpreting the test results, performing geotechnical analyses and design for the design of a 1 MGD Water Reclamation Facility (WRF) at the CDWWT to provide reclaimed water to the Village of Key Biscayne (Village) and the Department of Park and Recreation (DPR) for irrigation use of sports fields, marinas, and other green areas on Key Biscayne. 54-In. Dia. Sanitary Sewage Force Main from Miami Beach to CDWWTP; Miami-Dade County, FL - Project Geotechnical Engineer responsible for geotechnical investigation along the tunnel alignments for preparation of Criteria Package for Design-Build of project. Services included performance of test borings, rock coring and packer testing to determine the hydraulic conductivity (k) values of the subsurface rock formation near the elevation of the proposed tunnel alignment. 20-In. Dia. Water Main from Port Island to Fisher Island; Miami-Dade County, FL - Project Geotechnical Engineer responsible for geotechnical investigation along the tunnel alignments for preparation of Criteria Package for Design-Build of project, including the performance of test borings, rock coring and report preparation along tunnel alignment. Miami-Dade County Water and Sewer Department, Design-Build of 8,000 Feet of 54-Inch Diameter Sewer Force Main; DERM 01-WASD-NLE East - Project Geotechnical Engineer responsible for planning and executing the field exploration and laboratory testing programs, interpreting the test results, performing geotechnical analyses and design. Prepared the geotechnical report. The project involved the design / build for the installation of a 54 - inch diameter pre-cast pre-stressed concrete sewer force main east of the Opa-Locka Airport, in Opa- Locka, Florida. Miami-Dade County Water and Sewer Department, Design-Build of 9,100 Feet of 54-Inch Diameter Sewer Force Main; DERM 01-WASD-NLE West - Project Geotechnical Engineer responsible for planning and executing the field exploration and laboratory testing programs, interpreting the test results, performing geotechnical analyses, design and preparing the geotechnical report. The installation of the pipe required excavation and support of the existing subsurface materials for the installation of a 54 - inch diameter pre-cast pre-stressed concrete sewer force main across the southeast section of Opa-Locka Airport, in Opa-Locka, Florida. The project included a 300-foot long sub-aqueous crossing near 57th Avenue. ADNAN ISMAIL, P.E. POSITION Project Geotechnical Engineer EDUCATION M.S., Civil Engineering, Florida International University, 2013 B.S., Civil Engineering, Florida International University, 2007 PROFESSIONAL AFFILIATIONS American Society of Civil Engineers and Florida Engineering Society SUMMARY OF CAPABILITIES Shallow Foundation Design Deep Foundation Engineering Geotechnical Instrumentation In-Situ Testing Soil Mixing and Stabilization Roadway/BridgeGeotechnical Studies Pavement Design Wave Equation Analysis Slope Stability Evaluations Engineered Materials Testing and Inspection FDOT’s CTQP Drilled Shaft Inspector FDOT’s CTQP Pile Driving Inspector FDOT’s CTQP Augercast Pile Inspector PROFESSIONAL EXPERIENCE Mr. Ismail has over 8 years of experience and has served as project geotechnical engineer for a variety of water supply, water resources, and water maintenance facilities projects. He has 8 years of experience in the field of geotechnical engineering including planning and performance of field investigations. Experience includes interpretation of subsurface conditions, planning and execution of laboratory testing programs, geotechnical analysis and design of foundation elements of structures, management of geotechnical projects and preparation of numerous geotechnical reports providing conclusions and recommendations. Most recently, he has executed and served as project geotechnical engineer for the following MDWSD, Miami-Dade County projects: 54-In. Dia. Sanitary Sewage Force Main from Miami Beach to CDWWTP; Miami-Dade County, FL - Assisted in the planning and execution of the field exploration and laboratory testing programs, interpretation of the test results and performance of geotechnical analyses for preparation of Criteria Package for Design-Build and preparation of the geotechnical report. 20-In. Dia. Water Main from Port Island to Fisher Island; Miami-Dade County, FL - Project Geotechnical Engineer responsible for geotechnical investigation along the tunnel alignments for preparation of Criteria Package for Design-Build of project, including the performance of test borings, rock coring and report preparation along tunnel alignment. Miami-Dade County Water and Sewer Department, Design-Build of 54-Inch Diameter Sewer Force Main; DERM 01-WASD-NLE East – Assisted in the planning and execution of the field exploration and laboratory testing programs, interpretation of the test results, performance of geotechnical analyses and design. Assisted in the preparation of the geotechnical report. The project involved the design / build for the installation of a 54 - inch diameter pre-cast pre- stressed concrete sewer force main east of the Opa-Locka Airport, in Opa-Locka, Florida. The length of the proposed force main is approximately 8,000 feet. The installation of the pipe required excavation and support of the existing subsurface materials. Miami-Dade County Water and Sewer Department, Design-Build of 54-Inch Diameter Sewer Force Main; DERM 01-WASD-NLE West - Assisted in the planning and execution of the field exploration and laboratory testing programs, interpretation of the test results, performance of geotechnical analyses and design. Assisted in the preparation of the geotechnical report. The project involved the design / build for the installation of a 54 - inch diameter pre-cast pre- stressed concrete sewer force main east of the Opa-Locka Airport, in Opa-Locka, Florida. The length of the proposed force main is approximately 9,100 feet. The alignment of the pipe starts at the Opa-Locka Airport southern boundary near LeJeune Road (NW 42nd Avenue) then travels west to a point west of 57th Avenue and the Red Road Canal. The project included a 300-foot long sub-aqueous crossing near 57th Avenue. 24 and 36-Inch Diameter Finished Water Transmission Mains for South Miami-Heights Water Treatment Plant, SW 212th, SW 213th, SW 218th, and SW 219th Streets and SW 117th Court, SW 119th Avenue, SW 122nd Avenue and SW 124th Ct. - Assisted in the planning and execution of the field exploration and laboratory testing programs, interpretation of the test results, performance of geotechnical analyses and design. Assisted in the preparation of the geotechnical report. Miami-Dade County Water and Sewer Department, Design of 30-Inch Diameter Water Main under Miami River Canal At SW 2nd Street - Assisted in the planning and execution of the field exploration and laboratory testing programs, interpretation of the test results, performance of geotechnical analyses and design. Assisted in the preparation of the geotechnical report. Miami-Dade County Water and Sewer Department, Design of Pipeline Replacement for Needs Assessment Program (Several Projects) - Assisted in the planning and execution of the field exploration and laboratory testing programs, interpretation of the test results, performance of geotechnical analyses and design. Assisted in the preparation of the geotechnical report. PROFESSIONAL ENGINEERS GEOSOL – LICENSES & CERTIFICATES MARLIN ENGINEERING DORAL 2191 NW 97 AVENUE MIAMI, FL 33172 305.477.7575 Marlin Engineering Inc., a full service multidisciplinary engineering company, was founded in 1991 by Ramon Soria, P.E. and Sergio Alfonso, Jr., P.E in Doral, Florida on a solid base of transparency, ethics and professionalism. It employs highly technical professionals including: civil engineers, traffic engineers, drainage engineers, planners, surveyors, estimators, specification writers, GIS technicians, construction engineering inspectors, certified bridge inspectors, ADA specialists, environmental scientists, rail engineers, certified rail inspectors, and administrative professionals. Marlin Engineering serves the entire state of Florida assisting public and private clients in their efforts to improve, expand and modernize existing transportation facilities. Our offices are located in Doral, Tampa, and Tallahassee. As a local company, we feel deeply committed to provide our local municipalities with safe transportation solutions that balance the needs of all modes of transportation; such as: bicyclists, pedestrians, persons with disabilities, transit riders, freight, and passenger vehicles, among others. Our firm has grown throughout the years to becoming a “one stop shop” for all of our clients. We offer a variety of services such as traffic data collection, traffic analysis, traffic calming, GIS mapping, safety studies, pavement deficiency analysis, surveying, roadway design, drainage analysis and design, utility coordination, subsurface utility exploration, inlet/ pipe cleaning and televising, bridge inspection, underwater inspection, construction management, construction inspection, PD&E studies, multi-modal concept and development studies, and a full range of rail services to name a few. MARLIN ENGINEERING, INC. | 2191 NW 97th Avenue, Doral, Florida 33172 | P 305.477.7575 Page 1 ElisaAzcona PROJECT ROLE |SurveyCADD Technician EDUCATION Bachelor of Science in Architecture|Universidad Central Santa Clara, Cuba | 1991 CERTIFICATIONS Intermediate Maintenance of Traffic AREAS OF EXPERTISE Survey & Mapping YEARS OF EXPERIENCE 15Years SUMMARYOF EXPERIENCE Ms. Azcona has over 15 years of experience doing roadway, boundary and development related surveys. She is experienced with the use of a variety of surveying software including Auto CADD, Land Development, CAICE, MicroStation, and is familiar with the processing of the EFB and TDS data collectors. She also has experience in the design of community developments, small projects involving site plans, and topographical surveys. WORK HISTORY MAARLIN ENNGINEERING,IINC..,Doral, Florida June2008to Present |Survey CADD Technician Survey Services for West Lakes BCDE |Town of Miami Lakes |CADD Technician The scope of work included the following: Establishing control points, establishing elevations, providing drainage as-builts, full Topography Survey/ Digital Terrain Model (DTM). Also establishing job and instate plane coordinates. (Completed 2012) Reference: Hiram Siaba (305) 364-6100 TMB Peninsula Aviation Leasehold Survey –Kendall-Tamiami Executive Airport | Miami-Dade County Aviation Department | CADD Technician Ms. Azcona is responsible for NGS points recovery, section corners recovery, state plane coordinate in NAD 83/07, establish vertical and horizontal control points, topography survey, establish leasehold boundary survey, and legal description. (Ongoing) Reference: Hector Infanzon, Sr. (305) 876-7060 Greenways Biscayne Trail Segments C from North Canal Drive to Black Point Park along L-31E Canal | Miami-Dade County Park and Recreation Department | CADD Technician Ms. Azcona established vertical and horizontal controls as well as baseline survey, showed record right of way line, topography survey, check sections, and DTMS. (Completed 2012) Reference: Adelfa Martinez (305) 755-7815 Ad Barnes Park Improvement | Miami-Dade County Park and Recreation Department | CADD Technician The scope of work included boundary survey, topography survey, and tree survey. (Completed 2012) Reference: Adelfa Martinez (305) 755-7815 Park Trail Improvements PSA | Miami DadeParks & Recreation | CADD Technician This project entailed Baseline of Survey, Right of way Lines, Topography Survey, Bench Marks, Network Control, and Cross sections (Completed 2012) Project Manager: David Livingstone, (305) 755-7824 MARLIN ENGINEERING, INC. | 2191 NW 97th Avenue, Doral, Florida 33172 | P 305.477.7575 Page 2 ElisaAzcona PROJECT ROLE |SurveyCADD Technician SUE at RickenBacker Causeway & Miami Seaquarium | Miami Dade Public Works | CADD Technician This project entailed the use of vacuum to excavate for the purpose of physically measuring vertical location, as type of material and depth of utility. Two soft digs would be performed to discover and establish an existing FPL line. (Completed 2011) Project Manager: Yuly Hernandez (305) 375-4384 MARLIN ENGINEERING, INC. | 2191 NW 97th Avenue, Doral, Florida 33172 | P 305.477.7575 OmarCarcamo PROJECT ROLE |Senior Survey Intern/Utility Coordinator EDUCATION Bachelor of Science Construction Management|Florida International University|Miami, FL | 2013 CERTIFICATIONS Intermediate Maintenance of Traffic AREAS OF EXPERTISE Survey & Mapping YEARS OF EXPERIENCE 19Years SUMMARYOF EXPERIENCE Mr. Carcamo has over 19years of experience in the Land Surveying industry. Thisincludesa strong background inhorizontal and vertical control surveying, topographic, hydrographic, as-built, and boundary surveys,andconstruction layout.Mr. Carcamo has worked for a variety of city, county and state agencies, as well as private clients. He is experienced with the latest Topcon Total Stations,Topcon Hiper Pro (GPS) surveying equipment,and levels in the market today. He possesses technical knowledge of Auto CADD 2011, Microstation XM/V7, CAICE, Microsoft Office Suite, andhas completed 30 hours of OSHA training. WORK HISTORY MAARLIN ENNGINEERING,IINC..,Doral, Florida May2003to Present |Survey Crew Chief/ CADD Technician Survey Services for West Lakes BCDE |Town of Miami Lakes |Survey Technician The scope of work included the following: Establishing control points, establishing elevations, providing drainage as-builts, full Topography Survey/ Digital Terrain Model (DTM). Also establishing job and instate plane coordinates. (Completed 2012) Reference: Hiram Siaba (305) 364-6100 TMB Peninsula Aviation Leasehold Survey –Kendall-Tamiami Executive Airport | Miami-Dade County Aviation Department | Survey Technician Mr. Carcamo is responsible for NGS points recovery, section corners recovery, state plane coordinate in NAD 83/07, establish vertical and horizontal control points, topography survey, establish leasehold boundary survey, and legal description. (Ongoing) Reference: Hector Infanzon, Sr. (305) 876-7060 Greenways Biscayne Trail Segments C from North Canal Drive to Black Point Park along L-31E Canal | Miami-Dade County Park and Recreation Department | Survey Technician Mr. Carcamo established vertical and horizontal controls as well as baseline survey, showed record right of way line, topography survey, check sections, and DTM. (Completed 2012) Reference: Adelfa Martinez (305) 755-7815 Ad Barnes Park Improvement | Miami-Dade County Park and Recreation Department | Survey Technician The scope of work included boundary survey, topography survey, and tree survey. (Completed 2012) Reference: Adelfa Martinez (305) 755-7815 Park Trail Improvements PSA | Miami Dade Parks & Recreation | Survey Technician This project entailed Baseline of Survey, Right of way Lines, Topography Survey, Bench Marks, Network Control, and Cross sections (Completed 2012) Project Manager: David Livingstone, (305) 755-7824 MARLIN ENGINEERING, INC. | 2191 NW 97th Avenue, Doral, Florida 33172 | P 305.477.7575 OmarCarcamo PROJECT ROLE |Senior Survey Intern/Utility Coordinator SUE at RickenBacker Causeway & Miami Seaquarium | Miami Dade Public Works | Survey Technician This project entailed the use of vacuum to excavate for the purpose of physically measuring vertical location, as type of material and depth of utility. Two soft digs would be performed to discover and establish an existing FPL line. (Completed 2011) Project Manager: Yuly Hernandez (305) 375-4384 Wynwood Neighborhood Service Center (2902 NW 2nd Ave)| Miami Dade County General Services Administration | Survey Technician This project entailed Horizontal Control, Vertical Control, Baseline of Survey, Right of way Lines, Property Cornes, topographic, Cross-sectional, Spots Elevation, Drainage Survey, Sanitary Sewer Survey, and Survey Tree. (2010 -2010) Project Manager: Jorge Zaldivar (305) 375-1115 Groves Homes, Scattered Sites / Property Surveys of various single family units | Miami Dade Housing Agency | Survey Technician Mr. Carcamowas the Survey Technicianfor thisproject. This project entailed Boundary Surveys. (2008 -2008) Project Manager: Jorge Zaldivar (305) 644-5214 SUE at RickenBacker Causeway & Miami Seaquarium | Miami Dade Public Works | Survey Technician Mr. Carcamowas the Survey Technicianfor thisproject. This entailed the use of vacuum to excavate for the purpose of physically measuring vertical location, as type of material and depth of utility. Two soft digs would be performed to discover and establish an existing FPL line. (2011-2011) Project Manager: Yuly Hernandez (305) 375-4384 MIC (Set Parcel Corners and delineate lines)|Miami Dade Transit | Survey Technician Mr. Carcamowas the Survey Technicianfor thisproject. Thisentailed the establishment of Boundary and topographic survey. (2008 -2008). Project Manager: Carol A. Wilson. (786) 469-5278 Land Surveying Services along SW 157 Ave from SW 152 St to 184 St. | Miami Dade Highway Division | Survey Technician Mr. Carcamowas the Survey Technicianfor thisproject. Thisentailedsetting network control using RTK GPS methods, Bench Run, Topography (Topo) within Right of Way +25’ beyond, Cross sections at 50’ intervals, Side street X-sections R/W TOR/W +20’, Profiles at side streets from SW 157 Ave centerline out to 100’, Right of Way Lines, and final deliverables were turned in electronically with a CADD drawing. (2006 -2006) Project Manager: Yanek Fernandez, E.I. (305) 375-3016 Sunkist Pineland Park (SW 64 St & SW 84Ave)| Miami Dade County | Survey Technician Mr. Carcamowas the Survey Technicianfor thisproject. Thisentailed Boundary Survey, Topographic Information, Tree Information, and Utility Information (2007 -2008) Project Manager: Diana Cornely, (305) 755-7907 MARLIN ENGINEERING, INC. | 2191 NW 97th Avenue, Doral, Florida 33172 | P 305.477.7575 Page 1 LazaroFleitas, PSM PROJECT ROLE |Senior Surveyor & Mapper/ SUE Project Manager EDUCATION Irrigation and Drainage Engineer|Higher Institute of Agriculture Science |Havana, Cuba | 1989|Topography Middle Technician|Alvaro Reynoso Polytechnic Institute|Havana, Cuba |1980 CERTIFICATIONS Professional Surveyor & Mapper –Florida 6518 –2006 AREAS OF EXPERTISE Survey & Mapping YEARS OF EXPERIENCE 26Years SUMMARYOF EXPERIENCE Mr. Fleitas has extensive experience in all types of surveying projects including Boundary Survey, Topographic Survey, Sectional Survey, Construction layout, As-Built Survey, Land Development Survey, Right of Way Survey, Specific Purpose Survey, preparation of Control Survey and Right of Way maps. His responsibilities include Project Manager, client relations, proposals, service negotiations and performing the necessary quality control to ensure client needs are met. WORK HISTORY MAARLIN ENNGINEERING,IINC..,Doral, Florida Februrary2007to Present |Senior Surveyor & Mapper/ SUE Project Manager TMB Peninsula Aviation Leasehold Survey –Kendall-Tamiami Executive Airport | Miami-Dade County Aviation Department | SUE Surveyor Mr. Fleitas is responsible for NGS points recovery, section corners recovery, state plane coordinate in NAD 83/07, establish vertical and horizontal control points, topography survey, establish leasehold boundary survey, and legal description.(Ongoing) Reference: Hector Infanzon, Sr. (305) 876-7060 Greenways Biscayne Trail Segments C from North Canal Drive to Black Point Park along L-31E Canal | Miami-Dade County Park and Recreation Department | SUE Surveyor Mr. Fleitas established vertical and horizontal controls as well as baseline survey, showed record right of way line, topography survey, check sections, and DTMS.(2011 –2012) Reference:Adelfa Martinez (305) 755-7815 Ad Barnes Park Improvement | Miami-Dade County Park and Recreation Department | SUE Surveyor Mr. Fleitas was responsible for boundary survey, topography survey, and tree survey.(2011 –2012) Reference: Adelfa Martinez (305) 755-7815 Park Trail Improvements PSA | Miami Dade Parks & Recreation | SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities. This project entailed Baseline of Survey, Right of way Lines, Topography Survey, Bench Marks, Network Control, and Cross sections(2011 - 2012) Project Manager: David Livingstone, (305) 755-7824 Wynwood Neighborhood Service Center (2902 NW 2nd Ave)|Miami Dade County General Services Administration|SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities. This project entailed Horizontal Control, Vertical Control, Baseline of Survey, Right of way Lines, Property Cornes, topographic, Cross-sectional, Spots Elevation, Drainage Survey, Sanitary Sewer Survey, and Survey Tree.(2010-2010) Project Manager: Jorge Zaldivar(305) 375-1115 MARLIN ENGINEERING, INC. | 2191 NW 97th Avenue, Doral, Florida 33172 | P 305.477.7575 Page 2 LazaroFleitas, PSM PROJECT ROLE |Senior Surveyor & Mapper/ SUE Project Manager Groves Homes, Scattered Sites / Property Surveys of various single family units |Miami Dade Housing Agency|SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities.This project entailed Boundary Surveys.(2008-2008) Project Manager: Jorge Zaldivar(305) 644-5214 SUE at RickenBacker Causeway & Miami Seaquarium |Miami Dade Public Works|SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities.This project entailed the use of vacuum to excavate for the purpose of physically measuring vertical location, as type of material and depth of utility. Two soft digs would be performed to discover and establish an existing FPL line. (2011-2011) Project Manager: Yuly Hernandez(305) 375-4384 MIC (Set Parcel Corners and delineate lines)|Miami Dade Transit|SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities.This project entailed the establishmentof Boundary and topographic survey.(2008-2008) Project Manager: Carol A. Wilson. (786) 469-5278 Land Surveying Services along SW 157 Ave from SW 152St to 184 St.|Miami Dade Highway Division|SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities.This project entailed setting network control using RTK GPS methods, Bench Run, Topography (Topo) within Right of Way +25’ beyond, Cross sections at 50’ intervals, Side street X-sections R/W TOR/W +20’, Profiles at side streets from SW 157 Ave centerline out to 100’, Right of Way Lines, and final deliverables were turned in electronically with a CADD drawing.(2006-2006) Project Manager: Yanek Fernandez, E.I.(305) 375-3016 Sunkist Pineland Park (SW 64 St & SW 84 Ave)|Miami Dade County|SUE Surveyor Mr. Fleitas was the Survey Project Manager responsible for the direction of all survey activities.This project entailed Boundary Survey, Topographic Information, Tree Information, and Utility Information (2007 -2008) Project Manager: Diana Cornely, (305) 755-7907 WORK HISTORY FLORIDADEPARTMENTOFTRANSPORTATION,DISTRICT6..,Miami, Florida January2000to February 2007|Professional Land Surveyor Supervisor II/ Assistant Location Surveyor |January 2005 –February 2007 Managed and monitoredConsultants and in-house Right of Way and Location Surveyingcrew’s performance and use of equipment. Supervised survey crew’s production and attendance ensuring that all work was in compliance with DOT and minimum technical standards, safety procedures were followed, andfield work met production schedules. Managed data collection to coordinate and review field work, maps, existing baselines, surveys, field books, and bench run. Revised consultant’s documentation including manpower estimates. Coordinated technical information required for project completion with consultants schedule to assure department production. Collected and distributed work for consultants ensuring that work load is balanced in order to finish tasks in a timely manner. SupervisedDistrict in-house crewsGPS (Global Positioning System) work. Prepared scope of services and assisted in budget programming, prepared extensions and supplemental agreements, evaluated and graded consultants and prepared letters of authorization. Participated in the consultant selection process. Certified Right of Way staking, topographic drawings, digital terrain modeling (DTM) information, and survey sketches. SURVEYORS AND MAPPERS PROFESSIONAL ENGINEERS MARLIN ENGINEERING – LICENSES & CERTIFICATES TIERRA SOUTH FLORIDA, INC. 2765 VISTA PARKWAY, SUITE 10 WEST PALM BEACH, FL 33411 561.635.7677 Tierra South Florida, Inc. (TSF) is a full service consulting geotechnical engineering, construction materials testing and inspections engineering firm with capabilities to provide test borings, engineering analyses and reports, AutoCAD and Microstation plan sheets, laboratory soils testing, and construction materials testing. TSF was incorporated in the State of Florida in 2003. Our professional team has been working together since 2000 and is committed to providing quality, responsive service establishing a reputation for sound approaches and professional competence in a wide range of technically demanding areas. Our services also include threshold/special inspection and roofing inspection services. TSF is a certified Small Business Enterprise (SBE) and Disadvantaged Business Enterprise (DBE) with the Florida Department of Transportation. TSF is also a certified Minority Business Enterprise (MBE) with the State of Florida’s Office of Supplier Diversity. Our main office is located in West Palm Beach, Florida with operational satellite offices in Fort Lauderdale and Hialeah Gardens, Florida. Our staff includes principal engineers with more than 25 years of experience in geotechnical, construction, laboratory and field materials testing and inspection services. We feature Masters Degree level or higher educational background amongst our Registered Professional Engineers and maintain licenses in the State of Florida. TSF’s principals have served as geotechnical engineering consultants to a large variety of clients, both public and private, in the course of our experience. These clients include architects, engineers, contractors, developers, utilities, institutions, schools, military, municipalities, and private enterprise covering commercial and residential entities. Our collective project experience is broad based covering: airport construction, pavement design of municipal airports, buildings, highways, bridges, communication towers, dams and levees, sinkhole remediation, ground improvement projects, water supply projects, landfills, slope stabilities analyses, and distressed structure/foundation studies. municipal airports, buildings, highways, bridges, communication towers, dams and levees, sinkhole remediation, ground improvement projects, water supply projects, landfills, slope stabilities analyses, and distressed structure/foundation studies. PROFESSIONAL EXPERIENCE As President and Principal Engineer for Tierra South Florida, Inc., Mr. Krishnasamy oversees the geotechnical engineering, construction materials testing, and inspection services operations. Mr. Krishnasamy was the Project Manager for a $1.2 billion multimedia super corridor project that included universities, commercial buildings, and residential roadways. He was also Principal Geotechnical Engineer for a $780 million elevated highway, where he established Rock Founding Rationale for deep foundation systems. He was also Principal Geotechnical Engineer for a $450 million highway that included land reclamation and soil stabilization. Mr. Krishnasamy has been involved in hundreds of projects of diversified complexity consisting of residential, commercial, educational, and wastewater treatment facilities, sports arenas, landfills, airports, roadways and land reclamation. KEY PROJECT EXPERIENCE Design-Build Rehabilitation of West Bridge and Bear Cut Bridge on Rickenbacker Causeway, Miami-Dade County, Florida (2013) Provided geotechnical services for the bridge widening. The project includes constructing French drains on the east and west sides of the bridge. Field work completed includes 44 Standard Penetration Test (SPT) boring, 6 BoreHole Permeability (BHP) tests, and rock corings. Performed pile capacity analysis and prepared soil parameters and provided geotechnical engineering recommendations. Additionally performed studies to determine the length and pile capacity of the existing bridge (unknown foundation study). Force Main Route II, North Bay Village, Florida (2009) Performed a geotechnical study for the proposed Force Main Route (13,000 linear feet). Provided geotechnical report summarizing subsurface conditions and groundwater information. Also provided geotechnical recommendations regarding excavations, lateral earth pressures, and other construction considerations. 48-inch Force Main Crossing at Oleta River, Miami-Dade County, Florida (2004) Performed a geotechnical study to provide geotechnical recommendations for pile foundation. The force main was to be supported by 18-inch square prestressed concrete piles with a spacing of approximately 30 feet. Axial and lateral pile analysis were performed. Provided geotechnical recommendations regarding pile foundation analysis, concrete pile installation, test pile program, as well as general subsurface/groundwater conditions. Regional Force Main, Boynton Beach, Florida (2008) Performed a geotechnical study for the proposed Regional Force Main in Boynton Beach, Florida (approximately 24,000 linear feet of force main from Ocean Avenue to Regional Wastewater Treatment Plant). Maximum diameter of the force main was about 24 inch. Provided geotechnical report summarizing subsurface conditions and groundwater information. Also provided geotechnical recommendations regarding open cut excavations, trench backfill, lift station foundation design, and deep foundation for aerial canal crossings. Royal Poinciana Alternate Crossing - 24” Watermain and 24” Forcemain Subaqueous Pipeline Installations, West Palm Beach, Florida (2010) Performed a geotechnical exploration for the proposed Water Main Route in West Palm Beach, Florida. The project consists of a 24-inch water main which traverses across Flagler Drive and the Intracoastal Waterway, to the Town of Palm Beach. Scope of services for this study included the drilling of 2 Standard Penetration Test (SPT) boring to a depth of 30 feet below existing ground surface, and 2 SPT borings to a depth of 75 feet in the Intracoastal Waterway. Performed rock cores and unconfined compressive strength tests on rock cores. Provided a geotechnical report summarizing subsurface conditions and groundwater information. Evaluated Rock Quality Designation (RQD) and rock strength characteristics, and provided geotechnical recommendations regarding excavations, trench backfill, and lateral earth pressures for soil stabilization. The project included canal crossing, jack & bore, and directional bore operations. RAJ KRISHNASAMY, P.E. President, Principal Geotechnical Engineer 26 Years Professional Experience EDUCATION MS in Geotechnical Engineering, University of Memphis 1995 BS in Civil Engineering, Christian Brothers University 1987 Diploma/1984/Electronic Engineering, Malaysian Air Force Institute PROFESSIONAL ORGANIZATION AND REGISTRATION Professional Engineer: Florida, 53567 Certified OSHA Supervisor Certified Environmental Consultant KEY PROJECT EXPERIENCE (Con’t.) Pine Island Road-Southbound Lanes Existing 36-inch Force Main and Gas Main Evaluation, Broward County, Florida (2009 - 2010) Performed a geotechnical engineering study for the Pine Island Road-Southbound lanes existing 36-inch force main and gas main evaluation. Field work included excavating 13 test pits along the existing force main alignment and 21 test pits along the existing gas main alignment. Provided the designer with options on how to install the roadway over the pipe with a potential for minimal coverage and confirmed that existing shallow subsurface soils encountered in the test pits were suitable for supporting the proposed roadway construction after proper subgrade preparation. In addition, conducted a series of laboratory tests to better classify the type of existing backfill soils. UAZ - 310 Water Main Replacement, Broward County, Florida (2011) Performed geotechnical engineering study for the replacement of existing water main in the City of Dania Beach and Hollywood. Field work included 20 Standard Penetration Test borings. Provided geotechnical recommendations regarding subsurface/groundwater conditions, excavations, trench backfill, and lateral earth pressures. Homestead Air Reserve Park Sanitary Sewer Improvements, Miami, Florida (2014) Performed a geotechnical engineering study for the proposed sanitary sewer improvements at the Homestead Air Reserve Park located at the southeast corner of SW 268th Street and SW 127th Avenue. The improvements include of the construction of a sanitary sewer system consisting of gravity mains, a pump station, and a force main. Field work included three Standard Penetration Test (SPT) borings to a depth of 20 feet, and one SPT boring to a depth of 30 feet below existing ground surface. TSF provided summary of general soil and groundwater conditions. Also provided soil parameters to be utilized during design as well as geotechnical recommendations for utilities. The project was completed on time and within budget in 2014. ABBREVIATED MIAMI-DADE COUNTY EXPERIENCE Miami-Dade County - Water & Sewer Department WASD-12451 SW 82nd Avenue (Material Testing - 2012) WASD-US1 4B and 170 Street (Material Testing - 2012) 11800 SW 208th Street (Material Testing - 2010) SW 119th Ave.& SW 216th St. (Material Testing - 2009) NE 77 Street between NE 6 Ct & NE 8 Ave (Material Testing - 2009) SW 62 Ave & SW 24 St (Material Testing - 2009) SW 9th Street & SW 12 Avenue (Material Testing - 2008) 3280 Bird Avenue (Material Testing - 2008) SW296 Street & SW 162 Avenue (Material Testing - 2008) Miami-Dade County - Public Works and Waste Management Department SW 115 Avenue & SW 185 Street, SW 220 Street between SW 103 and SW 102 Ave., SW 176 Terrace and SW 142 Court (Geotechnical - 2013) NW 71 St, NW 1 Ave, SW 157 - MD Proj# 20100725 CDBG-R (Material Testing - 2012) SW 5th Street & SW 32nd Ave. - Drainage Improvements (Geotechnical - 2011) NW 67th Street Drainage Improvement Project (Geotechnical - 2011) Caribbean Blvd. Drainage (Geotechnical - 2011) 10450 NW 19th Ave Drainage Improvements (Geotechnical - 2010) Midway Addition Drainage Project (Geotechnical - 2010) Bird Road between 149th Ave & 152nd Ave. (Material Testing - 2010) SW 62nd Avenue between SW 24th St & SW 16th St. (Material Testing - 2010) NW 95th Street between NW 2nd Ave to NW 6th Ave (Material Testing - 2010) NW 17th – 22nd Avenue and NW 54th – 62nd Street Floral Park Drainage Improvement (Geotechnical - 2010) SW 162nd Ave & SW 47th St (Material Testing - 2010) Drainage Improvements Site #1-NE 207th Street from Highland Lake Boulevard to NE 22nd Place and Site #2- Tropical Estates (Geotechnical - 2010) Drainage Improvements SW 137th Avenue between SW 56th Street and SW 76nd Street (Geotechnical - 2010) SW 114 Ct & SW 118 Street (Material Testing - 2009) 82 Ave NW & 3rd Street (Material Testing - 2009) SW 85 Street & SW 84th Ave (Material Testing - 2009) SW 95 Ave & SW 9 Terrace (Material Testing - 2009) NE 19 Ave & 196 St Terrace (Material Testing - 2009) NW 65th Street & NW 18 Ave (Material Testing - 2009) SW 82nd Ave & SW 2nd Street (Material Testing - 2009) SW 143rd Ct & SW 172nd Lane (Material Testing - 2009) SW 62nd Ave between SW 24 Street & SW 16 St (Material Testing - 2009) Drainage Improvement NE 18th Place & NE 214 Terrace (Material Testing - 2009) PROFESSIONAL ENGINEERS TIERRA SOUTH FLORIDA – LICENSES & CERTIFICATES WATER RESOURCE TECHNOLOGIES 11221 ST. JOHNS INDUSTRIAL PARKWAY NORTH JACKSONVILLE, FL 32246 904.928.0700 Water Resource Technologies is headquartered in Jacksonville, Florida and is a company that is dedicated to protecting the environment and serving the needs of its customers with top-notch customer service. Not only is the company passionate about building sewer systems, but also strives to provide a solution that adds value to every customer involved – from the home owner to the contractor to the municipal operator – Water Resource Technologies strives to exceed your expectations. The company is managed by Mark Alexander, its president. WRT brings over a 175 years in experience with sewer solutions to the table. With the RIGHT products to meet the customer’s needs, WRT also provides design assistance which includes preliminary system design with the use of AutoCAD and hydraulic analysis capabilities. The company also prides itself on a factory certified service department. Technicians are factory-certified and bring extensive field experience to the job site. With extensive knowledge and vendor support, WRT can tackle any situation. The company has provided low pressure systems to FKAA, Islamorada, Monroe County, Key Largo and other Keys customers on numerous projects. WRT will provide packaged Eone grinder equipment, control panels, hi-tide telemetry systems, installation support and startup services for low pressure sewer service areas. WRT has developed a robust and sustainable grinder system design for coastal applications. FLORIDA PIPELINE COMPANY 9310 SW 69TH STREET MIAMI, FL 33173 305.281-8746 Florida Pipeline Company (FLPC) is a certified CSBE firm and a Construction Subcontractor focusing on: Water, Sewer, and Storm Water. Florida Pipeline Company was started in Miami-Dade County Florida on June of 2012 and is a local developing business enterprise (LDB) and a certified level 1 CSBE company. The president and owner of the company is a state certified Underground Utility and Excavation Contractor as well as a local Pipeline Engineering Contractor. Mr. Rodolfo Ibarra is also a Professional Engineer with over 30 years of engineering experience, including design, construction administration, permitting and conveyance of water distribution and sewage collection systems throughout the State of Florida. FLPC is currently working on projects in downtown Miami in close proximity to this project. FLPC is keenly aware of the permitting involved in this area and impacts to local homes and business. FLPC currently has over 20 different MOT’s going on at the same time in the same area. FLPC currently has significant FDOT CTQP certifications including: MOT Advanced & Intermediate Certification, QC Manager, Final Estimates I &II, Asphalt I & II, and Earthwork. FLPC will provide Permit Coordination, Material, M.O.T. and Utility Location services as a subcontractor to Layne. FORMS AND AFFIDAVITS CC PAYMENT AND PERFORMANCE BOND DD Layne will comply with the insurance requirements as denoted per Division 1, Section 1.5 and Document 00430, Insurance Advisory Form. Please see the Certificate of Insurance on the following page. INSURANCE COVERAGE ACKNOWLEDGMENT EE SAFETY RECORD – PAST PERFORMANCE FF Experience Modification Rate (EMR) Data Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) 40 4 - 1 0 4 2 - 0 7 7/ 2 3 Jo b S i t e EE w a s s t r u c k b y s h o p v a c b e i n g lo w e r e d w h i l e h e w a s d e s c e n d i n g w e l l 1 16 59 1 52 2 - 1 0 4 2 - 1 1 11 / 1 1 wa l k i n g sl i p p e d a n d f a l l w e t g r a v e l 1 21 03 1 - 3 1 8 0 - 0 2 1/ 2 8 no t s e l e c t e d EE w a s w o r k i n g o n a s t r u c t u r e , f e l l a n d fr a c t u r i n g c o l l a r b o n e 12 0 6 3 1 41 9 - 3 1 2 0 - 0 3 8/ 1 be l o w g r o u n d EE t r i e d t o c a t c h t h e w a t e r b o t t l e , i t h i t hi m o n t h e t i p o f h i s R t i n d e x f i n g e r . 1 1 83 1 02 5 - 3 1 1 0 - 0 1 1/ 2 4 no t s e l e c t e d EE w a s d r i v i n g d u m p t r u c k o n j o b s i t e , ba c k e d i n t o a h o l e a n d r o l l e d i t o v e r , su s t a i n e d m u l t i p l e s c r a t c h e s a n d ba c k / n e c k s t r a i n 1 1 8 0 1 44 0 - 3 1 6 5 - 0 5 6/ 2 0 st e p p i n g o n t o a t r a u c k ' s st e p EE s t e p p e d o n t o a t r u c k ' s s t e p , b o o t sl i p p e d t w i s t i n g h i s L t k n e e . 1 49 78 1 53 5 - 3 1 3 2 - 0 6 12 / 3 ch a i n b r o k e a n d s t r u c k E E a c r o s s f a c e 1 24 1 55 4 - 3 1 6 5 - 0 6 12 / 1 7 pi n c h e d l e f t i n d e x f i n g e r o n m e t a l t e n c h sh o r i n g 14 5 1 38 7 - 1 0 4 2 - 0 6 7/ 1 5 no t s e l e c t e d Wh i l e n a i l i n g w o o d e n f o r m s E E g r a z e d R i n d e x f i n g e r o n e d g e of r e b a r , c a u s i n g la c e r a t i o n 17 1 20 7 - 3 1 3 0 - 0 1 4/ 2 5 no t s e l e c t e d B a c k p a i n f r o m b e n d i n g o v e r t o u s e s a w 1 1 2 1 Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder Poisoning Hearing Loss Da y s a w a y fr o m w o r k Ca s e N o . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 3 Cl a s s i f y t h e c a s e Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e o n e t y p e o f il l n e s s : La y n e C h r i s t e n s e n C o m p a n y - - H e a v y C i v i l D i v i s i o n Te x a s CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : Respiratory Condition Re m a i n e d a t w o r k Injury Jo b t r a n s f e r or r e s t r i c t i o n De a t h Lo g o f W o r k - R e l a t e d I n j u r i e s a n d I l l n W h e r e t h e e v e n t o c c u r r e d ( e . g . Lo a d i n g d o c k n o r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , p a r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t di r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d de g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ot h e r r e c o r d - ab l e c a s e s (m o . / d a y ) Id e n t i f y t h e De s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s On j o b tr a n s f e r o r re s t r i c t i o n (d a y s ) At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e co n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e in f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y an d h e a l t h p u r p o s e s . Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i ll n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k a c t iv i t y o r j o b t r a n s f e r , d a y s aw a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - r e l a t e d i n j u r i e s a n d il l n e s s e s t h a t a r e d i a g n o s e d b y a ph y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d w o r k - r e l a t e d i n j u r i e s a n d il l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a li s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . F e e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n ju r y a n d il l n e s s i n c i d e n t re p o r t ( O S H A F o r m 3 0 1 ) o r e q u i v a l e n t f o r m f o r e a c h i n j u r y o r i ll n e s s r e c o r d e d o n t h i s f o r m . I f y o u ' r e n o t s u r e w h e t h e r a c a s e is r e c o r d a b l e , c a l l y o u r lo c a l O S H A o f f i c e f o r h e l p . OS H A ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Th e W o o d l a n d s Es t a b l i s h m e n t n a m e 27 5 - 3 1 2 5 - 0 4 6/ 1 1 n o t s e l e c t e d EE e x p e r i e n c e d p a i n i n s h o u l d e r w h i l e us i n g p r y b a r o n p i e c e o f p i p e 11 1 1 43 8 - 3 1 8 0 - 0 7 8/ 2 3 cu t t i n g p l a s t i c w i t h a bo x c u t t e r E E w a s c u t t i n g p l a s t i c w / a b o x c u t t e r , su s t a i n e d a l a c e r a t i o n t o L t f o r e a r m , mi d w a y b e t w e e n w r i s t / e l b o w . 15 1 50 5 - 3 1 8 0 - 0 8 10 / 1 7 la c e r a t i o n t o l t m i d d l e f i n g e r a n d c u t t o l t fo o t f r o m g r i n d e r 14 6 1 45 1 - 3 1 3 2 - 0 4 9/ 9 rt h a n d c a u g h t b e t w e e n p a r t o f a c r a n e an d a c a r t 13 7 1 49 5 - 3 1 3 2 - 0 5 10 / 4 La y n e E E r e a r e n d e d b y t h i r d p a r t y 1 1 8 1 02 3 - 3 1 3 5 - 0 2 1/ 2 3 no t s e l e c t e d Wh i l e a s s i s t i n g w i t h lo a d i n g l a r g e c h u n k of s t e e l R h a n d / f i n g e r s w e r e c r u s h e d 11 11 7 - 3 1 3 6 - 0 1 3/ 5 no t s e l e c t e d wr e n c h s l i p p e d s t r i k i n g e e o n t h e R t si d e o f h i s h e a d 11 55 4 - 3 1 3 6 - 0 2 12 / 9 cr o s s e d m e d i a n o n i c e a n d h i t s e m i he a d - o n 1 1 54 6 - 1 0 4 2 - 1 2 12 / 1 0 jo b s i t e sl i p p e d o n i c e a n d c u t h i s l e f t f o r e a r m 11 29 5 - 3 1 2 5 - 0 5 6/ 2 7 B a t o n R o u g e , L A EE c u t w r i s t w h i l e u s i n g a s a w 11 52 0 - 3 1 2 5 - 0 8 10 / 2 4 sp i d e r b i t e 11 19 2 - 3 1 7 2 - 0 1 4/ 1 7 no t s e l e c t e d EE w a s w a s s p r a y e d i n L e y e a n d L e a r wi t h b r a k e f l u i d b y c o - w o r k e r 11 08 9 - 3 8 1 0 - 0 2 2/ 2 7 no t s e l e c t e d W h i l e t i g h t e n i n g a n c h o r b o l t i n c o n c r e t e , wr e n c h s l i p p e d . E E 11 28 2 - 3 1 3 2 - 0 2 6/ 1 7 n o t s e l e c t e d W h i l e g r i n d i n g p i p e , s m a l l p i e c e o f de b r i s g o t i n E E e y e 11 38 0 - 3 8 1 0 - 0 4 7/ 1 0 no t s e l e c t e d wi n c h r e c o i l h a n d l e o n d u m p t r u c k sw u n g a r o u n d , s t r i k i n g E E ' s w r i s t 11 48 7 - 3 9 0 2 - 0 4 9/ 3 0 pa r t i c l e i n r t e y e 11 Pa g e t o t a l s 1 8 7 1 0 2 9 2 4 6 4 2 6 0 0 0 0 0 Pa g e 1 o f 1 ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) All other illnesses Poisoning Hearing Loss Respiratory Condition Skin Disorder Injury Be s u r e t o t r a n s f e r t h e s e t o t a l s t o t h e S u m m a r y p a g e ( F o r m 3 0 0 A ) b e f o r e y o u p o s t i t . Pu b l i c r e p o r t i n g b u r d e n f o r t h i s c o l l e c t i o n o f i n f o r m a t i o n i s e s t i m a t e d t o av e r a g e 1 4 m i n u t e s p e r r e s p o n s e , i n c l u d i n g t i m e t o r e v i e w t h e i n s t r u c t i o n , se a r c h a n d g a t h e r t h e d a t a n e e d e d , a n d c o m p le t e a n d r e v i e w t h e c o l l e c t i o n o f in f o r m a t i o n . P e r s o n s a r e n o t r e q u i r e d t o r e s p o n d t o t h e c o l l e c t i o n o f in f o r m a t i o n u n l e s s i t d i s p l a y s a c u r r e n t l y v a l i d O M B c o n t r o l n u m b e r . I f y o u ha v e a n y c o m m e n t s a b o u t t h e s e e s t i m a t e s o r a n y a s p e c t s o f t h i s d a t a co l l e c t i o n , c o n t a c t : U S D e p a r t m e n t o f L a b o r , O S H A O f f i c e o f S t a t i s t i c s , R N 3 6 4 4 2 0 0 C t i t t i A N W W h i t D C 2 0 2 1 0 D t Ye a r 2 0 1 2 St r e e t Ci t y Zi p 6 6 2 0 5 0 5 1 4 2 2 17 81 (G ) ( H ) (I ) ( J ) O R 23 7 1 1 0 49 9 58 5 (K ) ( L ) To t a l n u m b e r o f … Kn o w i n g l y f a l s i f y i n g t h i s d o c u m e n t m a y r e s u l t i n a f i n e . (M ) (1 ) I n j u r y 41 (4 ) P o i s o n i n g 0 (2 ) S k i n D i s o r d e r 0 (5 ) H e a r i n g L o s s 0 (3 ) R e s p i r a t o r y Co n d i t i o n 0 ( 6 ) A l l O t h e r I l l n e s s e s 0 U. S . D e p a r t m e n t o f L a b o r OS H A ' s F o r m 3 0 0 A (R e v . 0 1 / 2 0 0 4 ) Su m m a r y o f W o r k - R e l a t e d I n j u r i e s a n d I l l n e s s e s Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Ti t l e Da t e Sa f e t y D i r e c t o r 1/ 2 8 / 2 0 1 3 W a t e r W e l l D r i l l i n s To t a l n u m b e r o f da y s a w a y f r o m wo r k To t a l n u m b e r o f d a y s o f jo b t r a n s f e r o r r e s t r i c t i o n Pu b l i c r e p o r t i n g b u r d e n f o r t h i s c o l l e c t i o n o f i n f o r m a t i o n i s e s t i m a t e d t o a v e r a g e 5 0 m i n u t e s p e r r e s p o n s e , i n c l u d i n g t i m e t o r ev i e w t h e i n s t r u c t i o n , s e a r c h a n d ga t h e r t h e d a t a n e e d e d , a n d c o m p l e t e a n d r e v i e w t h e c o l l e c t i o n o f i n f o r m a t i o n . P e r s o n s a r e n o t r e q u i r e d t o r e s p o n d t o t h e c o l l ec t i o n o f i n f o r m a t i o n u n l e s s i t di s p l a y s a c u r r e n t l y v a l i d O M B c o n t r o l n u m b e r . I f y o u h a v e a n y co m m e n t s a b o u t t h e s e e s t i m a t e s o r a n y a s p e c t s o f t h i s d a t a c o l l ec t i o n , c o n t a c t : U S D e p a r t m e n t of L a b o r , O S H A O f f i c e o f S t a t i s t i c s , R o o m N - 3 6 4 4 , 2 0 0 C o n s t i t u t i o n A v e , N W , W a s h i n g t o n , D C 2 0 2 1 0 . D o n o t s e n d t h e c o m p l e t e d f o rm s t o t h i s o f f i c e . In j u r y a n d I l l n e s s T y p e s In d u s t r y d e s c r i p t i o n ( e . g . , M a n u f a ct u r e o f m o t o r t r u c k t r a i l e r s ) Po s t t h i s S u m m a r y p a g e f r o m F e b r u a r y 1 t o A p r i l 3 0 o f t h e y e a r f o l l o w i n g t h e y e a r c o v e r e d b y t h e f o r m Es t a b l i s h m e n t i n f o r m a t i o n To t a l n u m b e r o f de a t h s Nu m b e r o f C a s e s Us i n g t h e L o g , c o u n t t h e i n d i v i d u a l e n t r i e s y o u m a d e f o r e a c h c a t e g o r y . T h e n w r i t e t h e t o t a l s b e l o w , ma k i n g s u r e y o u ' v e a d d e d t h e e n t r i e s f r o m e v e r y p a g e o f t h e l o g . I f y o u h a d n o c a s e s w r i t e " 0 . " Em p l o y e e s f o r m e r e m p l o y e e s , a n d t h e i r r e p r e s e n t a t i v e s h a v e t h e r i g h t t o r e v i e w t h e O S H A F o r m 3 0 0 i n it s e n t i r e t y . T h e y a l s o h a v e l i m i t e d a c c e s s t o t h e O S H A F o r m 3 0 1 o r i t s e q u i v a l e n t . S e e 2 9 C F R 19 0 4 . 3 5 , i n O S H A ' s R e c o r d k e e p i n g r u l e , f o r f u r t h e r d e t a i l s o n t h e a c c e s s p r o v i s i o n s f o r t h e s e f o r m s . To t a l n u m b e r o f ca s e s w i t h d a y s aw a y f r o m w o r k To t a l n u m b e r o f c a s e s wi t h j o b t r a n s f e r o r re s t r i c t i o n 19 2 5 2 4 2 . 7 5 Si g n h e r e St a n d a r d I n d u s t r i a l C l a s s i f i c a t i o n ( S I C ) , i f k n o w n ( e . g . , S I C 3 7 1 5 ) To t a l n u m b e r o f ot h e r r e c o r d a b l e ca s e s Nu m b e r o f D a y s Al l e s t a b l i s h m e n t s c o v e r e d b y P a r t 1 9 0 4 m u s t c o m p l e t e t h i s S u m m a r y p a g e , e v e n i f n o i n j u r i e s o r il l n e s s e s o c c u r r e d d u r i n g t h e y e a r . R e m e m b e r t o r e v i e w t h e L o g t o v e r i f y t h a t t h e e n t r i e s a r e c o m p l e t e To t a l h o u r s w o r k e d b y a l l e m p l o y e e s l a s t ye a r An n u a l a v e r a g e n u m b e r o f e m p l o y e e s 10 3 9 La y n e C h r i s t e n s e n C o m p a n y - H e a v y C i v i l D i v i s i o n St a t e 91 3 - 7 0 7 - 5 9 3 7 Ph o n e Co m p a n y e x e c u t i v e I c e r t i f y t h a t I h a v e e x a m i n e d t h i s d o c u me n t a n d t h a t t o t h e b e s t o f m y k n o wl e d g e t h e e n t r i e s a r e t r u e , a c c u r a t e , a n d co m p l e t e . No r t h A m e r i c a n I n d u s t r i a l C l a s s i f i c a t i o n ( N A I C S ) , i f k n o w n ( e . g . , 3 3 6 2 1 2 ) Em p l o y m e n t i n f o r m a t i o n Mi s s i o n W o o d s Yo u r e s t a b l i s h m e n t n a m e 19 0 0 S h a w n e e M i s s i o n P a r k w a y KS Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) 00 1 - 3 1 1 5 - 0 1 1/ 6 N o t S e l e c t e d St r u c k i n t h e j a w b y a n o t h e r e m p l o y e e as h e w a s f a l l i n g XX 03 4 - 3 1 8 0 - 0 3 1/ 1 2 J o b S i t e Ex p e r i e n c e d b a c k p a i n w h i l e p u l l i n g re b a r X 10 3 X 01 4 - 3 1 2 0 - 0 2 1/ 2 0 N o t S e l e c t e d In j u r e d f i n g e r c l i m b i n g u p a w a l l X 16 2 X 03 7 - 3 8 1 0 - 0 2 2/ 1 5 N o t S e l e c t e d Ex p e r i e n c e d l o w e r b a c k p a i n a f t e r di g g i n g t u n n e l XX 01 1 - 3 1 8 0 - 0 1 2/ 1 6 J o b S i t e La c e r a t e d t h u m b w h i l e c a r r r y i n g p i p e s X 13 X 01 0 - 3 1 2 0 - 0 1 2/ 2 1 J o b S i t e En t r a p p e d f i n g e r b e t w e e n m o t o r a n d ra i l i n g w h i l e c a r r y i n g m o t o r d o w n s t a i r s X 12 X 02 2 - 3 1 6 5 - 0 1 3/ 1 3 J o b S i t e Sm a s h i n j u r y t o L i n d e x f i n g e r X 27 X 02 4 - 3 1 8 0 - 0 2 3/ 1 6 J o b S i t e Fi n g e r l a c e r a t i o n f r o m s t r e e t p l a t e XX 02 7 - 3 8 1 0 - 0 1 3/ 2 1 N o t S e l e c t e d Cr u s h i n j u r y t o R t h u m b w h i l e d r i l l i n g X 63 2 X 03 0 - 3 1 3 2 - 0 1 3/ 2 7 J o b S i t e Am p u t a t i o n w h i l e i n s t a l l i n g b u c k e t o n ex c a v a t o r X 41 X 04 6 - 3 1 2 5 - 0 1 4/ 2 5 J o b S i t e La c e r a t i o n t o R s m a l l f i n g e r X X 04 8 - 3 1 3 0 - 0 1 4/ 3 0 J o b S i t e Mu l t i p l e i n j u r i e s f r o m c a v e i n X X 06 4 - 3 1 3 0 - 0 3 5/ 1 2 Jo b S i t e S h o w e r e d b y m e t a l / s p a r k s i n t o R e y e XX 06 0 - 3 1 3 0 - 0 2 5/ 2 2 Jo b S i t e R f o r e f i n g e r l a c e r a t i o n w h i l e c u t t i n g me t a l w / g r i n d e r X 9 X Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder Poisoning Hearing Loss Da y s a w a y fr o m w o r k U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 2 Cl a s s i f y t h e c a s e Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e o n e t y p e o f il l n e s s : La y n e C h r i s t e n s e n C o m p a n y - H e a v y C i v i l D i v i s i o n KS Respiratory Condition Re m a i n e d a t w o r k Injury Lo g o f W o r k - R e l a t e d I n j u r i e s a n d I l l n Wh e r e t h e e v e n t o c c u r r e d ( e . g . Lo a d i n g d o c k n o r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , p a r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ot h e r r e c o r d - ab l e c a s e s (m o . / d a y ) Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s On j o b tr a n s f e r o r re s t r i c t i o n (d a y s ) At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k a c t iv i t y o r j o b t r a n s f e r , d a y s aw a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h at a r e d i a g n o s e d b y a ph y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d w o r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e sp e c i f i c r e c o r d i n g c r i t e r i a li s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . F e e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n ju r y a n d i l l n e s s i n c i d e n t re p o r t ( O S H A F o r m 3 0 1 ) o r e q u i v a l e n t f o r m f o r e a c h i n j u r y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f y o u ' r e n o t s u r e w h e t h e r a c a s e is r e c o r d a b l e , c a l l y o u r lo c a l O S H A o f f i c e f o r h e l p. OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Mi s s i o n W o o d s Es t a b l i s h m e n t n a m e Jo b t r a n s f e r or r e s t r i c t i o n Ca s e N o . CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : De a t h 06 7 - 3 1 8 0 - 0 4 5/ 2 9 Jo b S i t e La c e r a t i o n t o R l e g w h i l e u s i n g u t i l i t y kn i f e o n s m a l l p i e c e o f w o o d XX 06 6 - 3 8 1 0 - 0 3 5/ 3 1 Jo b S i t e D r o p p e d m a n h o l e c o v e r o n t o e X 24 X 07 9 - 1 0 4 2 - 0 1 6/ 5 Jo b S i t e Ex p e r i e n c e d l o w e r b a c k p a i n w h i l e em p t y i n g H 2 O f i l t e r s i n t a n k s X 11 7 8 8 X 08 2 - 3 1 3 0 - 0 4 6/ 1 1 No t S e l e c t e d F e l l o f f l a d d e r , i n j u r e d L w r i s t X 14 X 09 5 - 1 0 4 2 - 0 4 6/ 1 4 No t S e l e c t e d Ex p e r i e n c e d b u r n i n g s e n s a t i o n t o l e g s wh i l e d r i l l i n g s o w m i l l s u s i n g c e m e n t XX 09 4 - 1 0 4 2 - 0 3 6/ 1 8 No t S e l e c t e d Su s t a i n e d R f o o t s p r a i n / s t r a i n a f t e r fa l l i n g o f f s t e p f o r m w h i l e p u l l i n g n a i l s X 18 0 X 08 3 - 3 1 3 2 - 0 2 6/ 2 1 Jo b S i t e Su s t a i n e d p u n c t u r e w o u n d t h r o u g h L mi d d l e f i n g e r w h i l e u s i n g n a i l g u n XX 09 3 - 1 0 4 2 - 0 2 6/ 2 5 No t S e l e c t e d S t r a i n e d n e c k w h i l e l i f t i n g 2 0 f t b e a m s X 24 X 09 7 - 1 0 4 2 - 0 5 6/ 2 7 No t S e l e c t e d La c e r a t i o n t o R w r i s t w h i l e c a r r y i n g re b a r XX 10 5 - 3 1 3 6 - 0 2 7/ 5 No t S e l e c t e d Ex p e r i n c e d l o w e r b a c k p a i n a f t e r he a r i n g a ' p o p ' w h i l e m o v i n g a 5 ' ' sa n d l i n e XX 09 9 - 3 1 3 6 - 0 1 7/ 7 No t S e l e c t e d Fe l l o f f l a d d e r f r o m 2 n d r u n g , f r a c t u r e d L a n k l e X 14 8 X 07 8 - 3 1 1 5 - 0 2 7/ 3 0 No t S e l e c t e d Em p l o y e e g o t a f o r e i g n b o d y i n R e y e wh i l e u s i n g i m p a c t w r e n c h XX 11 6 - 3 1 2 0 - 0 3 8/ 8 No t S e l e c t e d EE s t r u c k i n s h o u l d e r b y 7 0 p o u n d s t e m gu i d e XX 11 7 - 3 8 1 0 - 0 4 8/ 8 No t S e l e c t e d St r u c k R h a n d & f i n g e r s w h i l e ha m m e r i n g r e b a r i n t o g r o u n d X 1 X 12 3 - 3 1 2 0 - 0 4 8/ 2 8 F i e l d - L a b o r e r St r u c k i n h e a d b y f a l l i n g b e a m X 9 X 12 8 - 3 1 6 5 - 0 2 9/ 2 0 N o t S e l e c t e d cr u s h i n j u r y t o L m i d d l e f i n g e r w / n a i l av u l s i o n w h i l e m o v i n g a l a d d e r X 41 X 12 9 - 3 1 3 2 - 0 3 9/ 2 5 J o b S i t e Sp r a i n e d R a n k l e w h i l e e x i t i n g s k i d st e e r XX 13 8 - 3 1 7 2 - 0 1 10 / 2 2 J o b S i t e Fr o n t e n d l o a d e r h o o d f e l l o n R h a n d X 9 X 13 9 - 3 1 2 0 - 0 5 10 / 2 3 J o b S i t e Cu t l e f t f o o t b y g l a s s w h i l e w o r k i n g i n wa t e r t r o u g h , r e s u l t i n g i n t e t n u s s h o t XX 14 0 - 3 9 0 2 - 0 1 10 / 2 3 N o t S e l e c t e d EE h a d b e e n o p e r a t i n g f r o n t e n d l o a d e r an d w a s e x i t i n g t h e c a b a n d s h u t h i s R ha n d i n t h e c a b d o o r i n j u r i n g h i s m i d d l e fi n g e r XX 14 9 - 1 0 4 2 - 0 6 11 / 8 N o t S e l e c t e d Em p l o y e e w a s i n s i d e t r e n c h b o x , t u r n e d to s t e p d o w n a l a d d e r . L a d d e r w e n t t h e ot h e r w a y , e m p l o y e e l a n d e d o n L s i d e X 24 X 15 0 - 3 1 2 5 - 0 2 11 / 1 1 J o b S i t e EE p i c k e d u p w a l k b o a r d t o m o v e f r o m ne w c o n c r e t e a n d s t e p p e d o n a r o c k , ca u s i n g b o a r d t o s h i f t . L o w / m i d b a c k po p p e d r e s u l t i n g i n p a i n XX 15 3 - 3 1 3 2 - 0 4 11 / 2 0 J o b S i t e EE d i s l o c a t e d s h o u l d e r w h i l e c l i m b i n g do w n f r o m e x c a v a t o r c a b XX 15 4 - 3 1 7 0 - 0 4 11 / 3 0 O t h e r EE w a s c l i m b i n g u p 2 s t e p s i n t o t r u c k , af t e r g r a b b i n g t h e e x t e r i o r h a n d r a i l i t br o k e c a s u i n g E E t o f a l l 3 f e e t a n d in j u r e b a c k o f h e a d , b a c k , a n d R s i d e XX 15 6 - 3 1 3 0 - 0 5 12 / 1 f i e l d EE c h e s t s t r u c k c o n t r o l p a n e l , h i t so m e t h i n g i n t h e r o a d w h i l e o p e r a t i n g bo b c a t w / s w e e p e r a t t a c h m e n t XX 15 7 - 3 1 3 2 - 0 5 12 / 4 Y a r d EE d e e p c u t t o r i g h t l o w e r l e g , s u t u r e s , lo a d i n g s t e e l b e a m s o n t o t r a i l e r , 1 ro l l e d o f f , s h a r p c o r n e r p l a t e s t r u c k E E le g XX 15 9 - 3 1 2 5 - 0 3 12 / 2 7 J o b S i t e W h i l e E E w a s c l i m b i n g u p l a d d e r , t h e la d d e r s l i d o u t f r o m u n d e r n e a t h h i m ca u s i n g t h e w r e n c h h e w a s h o l d i n g t o hi t h i s R e y e XX Pa g e t o t a l s 0 5 1 4 2 2 4 9 9 5 8 5 4 1 0 0 0 0 0 Pa g e 1 o f 1 ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) All other illnesses Poisoning Hearing Loss Respiratory Condition Skin Disorder Injury Be s u r e t o t r a n s f e r t h e s e t o t a l s t o t h e S u m m a r y p a g e ( F o r m 3 0 0 A ) b e f o r e y o u p o s t i t . Pu b l i c r e p o r t i n g b u r d e n f o r t h i s c o l l e c t i o n o f i n f o r m a t i o n i s e s t i m a t e d t o av e r a g e 1 4 m i n u t e s p e r r e s p o n s e , i n c l u d i n g t i m e t o r e v i e w t h e i n s t r u c t i o n , se a r c h a n d g a t h e r t h e d a t a n e e d e d , a n d c o m p l e t e a n d r e v i e w t h e c o l l e c t i o n o f in f o r m a t i o n . P e r s o n s a r e n o t r e q u i r e d t o r e s p o n d t o t h e c o l l e c t i o n o f in f o r m a t i o n u n l e s s i t d i s p l a y s a c u r r e n t l y v a l i d O M B c o n t r o l n u m b e r . I f y o u ha v e a n y c o m m e n t s a b o u t t h e s e e s t i m a t e s o r a n y a s p e c t s o f t h i s d a t a co l l e c t i o n , c o n t a c t : U S D e p a r t m e n t o f L a b o r , O S H A O f f i c e o f S t a t i s t i c s , R o o m N 3 6 4 4 2 0 0 C t i t t i A N W W h i t D C 2 0 2 1 0 D t d t h Ye a r 2 0 1 1 St r e e t Ci t y Zi p 4 7 4 5 2 01 6 6 1 3 17 81 (G ) ( H ) (I) (J) OR 23 7 1 1 0 16 2 1 6 6 2 (K ) ( L ) To t a l n u m b e r o f … Kn o w i n g l y f a l s i f y i n g t h i s d o c u m e n t m a y r e s u l t i n a f i n e . (M ) (1 ) I n j u r y 35 (4) P o i s o n i n g 0 (2) S k i n D i s o r d e r 0 (5) H e a r i n g L o s s 0 (3 ) R e s p i r a t o r y Co n d i t i o n 0 ( 6 ) A l l O t h e r I l l n e s s e s 0 Si g n h e r e St a t e Em p l o y m e n t i n f o r m a t i o n To t a l n u m b e r o f da y s a w a y f r o m wo r k To t a l n u m b e r o f d a y s o f jo b t r a n s f e r o r r e s t r i c t i o n Pu b l i c r e p o r t i n g b u r d e n f o r t h i s c o l l e c t i o n o f i n f o r m a t i o n i s e s t i m a t e d t o a v e r a g e 5 0 m i n u t e s p e r r e s p o n s e , i n c l u d i n g t i m e t o r ev i e w t h e i n s t r u c t i o n , s e a r c h a n d ga t h e r t h e d a t a n e e d e d , a n d c o m p l e t e a n d r e v i e w t h e c o l l e c t i o n o f i n f o r m a t i o n . P e r s o n s a r e n o t r e q u i r e d t o r e s p o n d t o t h e c o l l ec t i o n o f i n f o r m a t i o n u n l e s s i t di s p l a y s a c u r r e n t l y v a l i d O M B c o n t r o l n u m b e r . I f y o u h a v e a n y c o m m e n t s a b o u t t h e s e e s t i m a t e s o r a n y a s p e c t s o f t h i s d a t a c o l l ec t i o n , c o n t a c t : U S D e p a r t m e n t of L a b o r , O S H A O f f i c e o f S t a t i s t i c s , R o o m N -36 4 4 , 2 0 0 C o n s t i t u t i o n A v e , N W , W a s h i n g t o n , D C 2 0 2 1 0 . D o n o t s e n d t h e c o m p l e t e d f o r m s t o t h i s o f f i c e . In j u r y a n d I l l n e s s T y p e s Ph o n e Co m p a n y e x e c u t i v e I c e r t i f y t h a t I h a v e e x a m i n e d t h i s d o c u m e n t a n d t h a t t o t h e b e s t o f m y k n o w l e d g e t h e e n t r i e s a r e t r u e , a c c u r a t e , a n d co m p l e t e . 91 3 - 3 4 2 - 4 8 0 3 U. S . D e p a r t m e n t o f L a b o r OS H A ' s F o r m 3 0 0 A (R e v . 0 1 / 2 0 0 4 ) Su m m a r y o f W o r k - R e l a t e d I n j u r i e s a n d I l l n e s s e s Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n In d u s t r y d e s c r i p t i o n ( e . g . , M a n u f a c t u r e o f m o t o r t r u c k t r a i l e r s ) Po s t t h i s S u m m a r y p a g e f r o m F e b r u a r y 1 t o A p r i l 3 0 o f t h e y e a r f o l l o w i n g t h e y e a r c o v e r e d b y t h e f o r m Al l e s t a b l i s h m e n t s c o v e r e d b y P a r t 1 9 0 4 m u s t c o m p l e t e t h i s S u m m a r y p a g e , e v e n i f n o i n j u r i e s o r il l n e s s e s o c c u r r e d d u r i n g t h e yea r . R e m e m b e r t o r e v i e w t h e L o g t o v e r i f y t h a t t h e e n t r i e s a r e c o m p l e t e Us i n g t h e L o g , c o u n t t h e i n d i v i d u a l e n t r i e s y o u m a d e f o r e a c h c a t e g o r y . T h e n w r i t e t h e t o t a l s b e l o w , ma k i n g s u r e y o u ' v e a d d e d t h e e n t r i e s f r o m e v e r y p a g e o f t h e l o g . I f y o u h a d n o c a s e s w r i t e " 0 . " Em p l o y e e s f o r m e r e m p l o y e e s , a n d t h e i r r e p r e s e n t a t i v e s h a v e t h e r i g h t t o r e v i e w t h e O S H A F o r m 3 0 0 i n it s e n t i r e t y . T h e y a l s o h a v e l i m i t e d a c c e s s t o t h e O S H A F o r m 3 0 1 o r i t s e q u i v a l e n t . S e e 2 9 C F R 19 0 4 . 3 5 , i n O S H A ' s R e c o r d k e e p i n g r u l e , f o r f u r t h e r d e t a i l s o n t h e a c c e s s p r o v i s i o n s f o r t h e s e f o r m s . To t a l n u m b e r o f ca s e s w i t h d a y s aw a y f r o m w o r k To t a l n u m b e r o f c a s e s wi t h j o b t r a n s f e r o r re s t r i c t i o n 1, 7 3 9 , 4 2 7 . 2 5 La y n e H e a v y C i v i l Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Ti t l e Da t e Di r e c t o r S E H S 1/ 3 1 / 2 0 1 2 Dr i l l i n g Es t a b l i s h m e n t i n f o r m a t i o n To t a l n u m b e r o f de a t h s Nu m b e r o f C a s e s Or l e a n s Yo u r e s t a b l i s h m e n t n a m e 45 2 0 N . S t a t e R o a d IN To t a l n u m b e r o f ot h e r r e c o r d a b l e ca s e s Nu m b e r o f D a y s To t a l h o u r s w o r k e d b y a l l e m p l o y e e s l a s t ye a r St a n d a r d I n d u s t r i a l C l a s s i f i c a t i o n ( S I C ) , i f k n o w n ( e . g . , S I C 3 7 1 5 ) An n u a l a v e r a g e n u m b e r o f e m p l o y e e s No r t h A m e r i c a n I n d u s t r i a l C l a s s i f i c a t i o n ( N A I C S ) , i f k n o w n ( e . g . , 3 3 6 2 1 2 ) 94 6 He a v y C i v i l D i v i s i o n Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) 10 7 - 3 1 3 0 - 0 2 4 0 8 2 9 Ot h e r Sp i d e r B i t e t o A r m 1 1 11 3 - 3 1 3 2 - 0 2 4 0 8 4 3 Jo b s i t e Tr i p p e d o v e r a t r e e r o o t i n a n a l l e y to e s w e r e h y p e r - e x t e n d e d . 1 3 9 16 1 11 5 - 1 0 4 2 - 0 2 4 0 8 5 6 Jo b S i t e Cr u s h i n j u r y t o R f o o t w h i l e u s i n g el e c t r i c p a l l e t 1 21 1 12 7 - 3 8 1 0 4 0 9 0 3 Jo b S i t e Ca r p a l T u n n e l S y n d r o m e , p o s s i b l y fr o m h a m m e r i n g r o c k s w i t h t r a c k h o e 1 1 00 3 - 3 1 2 0 - 0 1 1 / 4 Jo b s i t e R k n e e s p r a i n s u s t a i n e d w h e n l e g be c a m e e n t r a p p e d w h i l e s t e p p i n g o v e r pi p e 1 1 8 0 35 1 00 5 - 3 8 1 0 - 0 1 1 / 5 Jo b s i t e R s h o u l d e r t e a r a ft e r f a l l f r o m l a d d e r 1 1 1 3 1 01 1 - 3 1 1 0 - 0 1 1 / 2 1 Jo b s i t e Fr a c t u r e d R l o w e r l e g o n w h e n s t r u c k by 2 4 i n p i e c e o f p l a s t i c p i p e . 1 1 8 0 1 Lo g o f W o r k - R e l a t e d I n j u r i e s a Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k ac t i v i t y o r j o b t r a n s f e r , d a y s a w a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - re l a t e d i n j u r i e s a n d i l l n e s s e s t h a t a r e d i a g n o s e d b y a p h y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d wo r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a l i s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . Fe e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n j u r y a n d i l l n e s s i n c i d e n t r e p o r t ( O S H A F o r m 30 1 ) o r e qui v a l e n t f o r m f o r e a c h i n jur y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f you ' r e n o t s u r e w h e t h e r a c a s e i s r e c o r d a b l e , c a l l OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Or l e a n s At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 1 (m o . / d a y) Hearing Loss Respiratory Condition On j o b tr a n s f e r or re s t r i c t i o n (d a y s ) W h e r e t h e ev e n t oc c u r r e d ( e . g . Lo a d i n g d o c k no r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , pa r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e on e t y p e o f i l l n e s s : Poisoning Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s Injury De a t h Ca s e N o . Ot h e r r e c o r d - ab l e c a s e s Da y s a w a y fr o m w o r k Re m a i n e d a t w o r k Jo b t r a n s f e r or r e s t r i c t i o n Cl a s s i f y t h e c a s e Es t a b l i s h m e n t n a m e CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : IN La y n e H e a v y C i v i l Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) Lo g o f W o r k - R e l a t e d I n j u r i e s a Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k ac t i v i t y o r j o b t r a n s f e r , d a y s a w a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - re l a t e d i n j u r i e s a n d i l l n e s s e s t h a t a r e d i a g n o s e d b y a p h y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d wo r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a l i s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . Fe e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n j u r y a n d i l l n e s s i n c i d e n t r e p o r t ( O S H A F o r m 30 1 ) o r e qui v a l e n t f o r m f o r e a c h i n jur y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f you ' r e n o t s u r e w h e t h e r a c a s e i s r e c o r d a b l e , c a l l OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Or l e a n s At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 1 (m o . / d a y) Hearing Loss Respiratory Condition On j o b tr a n s f e r or re s t r i c t i o n (d a y s ) W h e r e t h e ev e n t oc c u r r e d ( e . g . Lo a d i n g d o c k no r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , pa r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e on e t y p e o f i l l n e s s : Poisoning Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s Injury De a t h Ca s e N o . Ot h e r r e c o r d - ab l e c a s e s Da y s a w a y fr o m w o r k Re m a i n e d a t w o r k Jo b t r a n s f e r or r e s t r i c t i o n Cl a s s i f y t h e c a s e Es t a b l i s h m e n t n a m e CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : IN La y n e H e a v y C i v i l Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder 01 2 - 3 1 3 6 - 0 1 1 / 2 2 Jo b s i t e R w r i s t s p r a i n s u s t a i n e d i n s l i p / f a l l wh i l e s e t t i n g u p a p o n d l i n e r 1 6 4 1 2 5 1 01 4 - 3 1 7 2 - 0 1 1 / 2 5 Jo b s i t e St r a i n e d l o w e r b a c k w h e n m o v i n g a wa t e r p u m p . 1 1 8 0 1 01 6 - 3 1 1 0 - 0 2 2 / 1 1 Jo b s i t e Wh i l e c u t t i n g w i t h p i p e s a w , s a w sl i p p e d , g u a r d h i t t o p o f L h a n d re s u l t i n g i n a c u t . 1 48 1 01 8 - 3 1 1 0 - 0 3 2 / 1 7 Jo b s i t e ba c k s t r a i n w h e n s l i p p e d w h i l e c l i m b i n g f r o m ex c a v a t o r 1 1 8 0 8 4 1 01 9 - 3 1 1 0 - 0 4 2 / 1 8 Jo b s i t e Wh i l e p e r f o r m i n g a n a i r t e s t t h e t e s t pl u g b l e w o u t s t r k i n g h i s b o t t o m l i p re s u l t i n g i n a l a c e r a t i o n t o l o w e r l i p . 1 1 02 8 - 3 8 1 0 - 0 2 3 / 1 0 Jo b s i t e St r u c k i n r i g h t t h u m b w i t h i m p a c t wr e n c h i n u s e b y c o w o r k e r r e s u l t e d i n po s s i b l e t o r n l i g a m e n t . 1 1 1 5 5 1 Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) Lo g o f W o r k - R e l a t e d I n j u r i e s a Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k ac t i v i t y o r j o b t r a n s f e r , d a y s a w a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - re l a t e d i n j u r i e s a n d i l l n e s s e s t h a t a r e d i a g n o s e d b y a p h y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d wo r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a l i s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . Fe e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n j u r y a n d i l l n e s s i n c i d e n t r e p o r t ( O S H A F o r m 30 1 ) o r e qui v a l e n t f o r m f o r e a c h i n jur y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f you ' r e n o t s u r e w h e t h e r a c a s e i s r e c o r d a b l e , c a l l OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Or l e a n s At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 1 (m o . / d a y) Hearing Loss Respiratory Condition On j o b tr a n s f e r or re s t r i c t i o n (d a y s ) W h e r e t h e ev e n t oc c u r r e d ( e . g . Lo a d i n g d o c k no r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , pa r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e on e t y p e o f i l l n e s s : Poisoning Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s Injury De a t h Ca s e N o . Ot h e r r e c o r d - ab l e c a s e s Da y s a w a y fr o m w o r k Re m a i n e d a t w o r k Jo b t r a n s f e r or r e s t r i c t i o n Cl a s s i f y t h e c a s e Es t a b l i s h m e n t n a m e CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : IN La y n e H e a v y C i v i l Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder 03 3 - 3 1 1 0 - 0 5 4 / 6 Jo b s i t e Up p e r b a c k a n d n e c k i n j u r y f r o m fa l l i n g i n t r e n c h b o x h a n d i n g l a s e r t o EE 1 1 8 0 1 03 9 - 3 8 1 0 - 0 3 4 / 1 4 Jo b s i t e u p m u d w i t h s h o v e l . 1 1 04 2 - 3 1 8 0 - 0 1 4 / 1 9 Jo b s i t e mi n i e x c a v a t o r s t u c k h i m , f e l l o v e r t h e tr a c k , f r a c t u r e d L a n k l e 1 1 8 0 1 04 3 - 3 1 2 0 - 0 2 4 / 1 9 Jo b s i t e St r a i n e d a n k l e , k n e e a n d l e g f r o m sl i p p i n g o f f 3 f t h i g h p l a t f o r m 1 1 04 5 - 3 1 1 0 - 0 6 4 / 2 8 Jo b s i t e R k n e e c o n t u s i o n , l a y i n g p i p e i n d i t c h , 20 0 l b c o n c r e t e f e l l s t r i k i n g k n e e 1 1 0 8 1 05 2 - 3 1 1 0 - 0 7 5 / 1 2 Jo b s i t e Sp i n e s t r a i n a n d s h o u l d e r p a i n (r e q u i r i n g s u r g e r y ) f r o m M V A 1 2 7 9 1 1 05 7 - 3 1 6 5 - 0 1 5 / 2 4 In T r a n s i t N e c k a n d b a c k s t r a i n f r o m M V A 1 71 06 3 - 1 0 4 2 - 0 1 6 / 6 Jo b s i t e La c e r a t i o n t o R I n d e x f i n g e r t i p w h i l e un l o a d i n g g a n g b o x 1 1 Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) Lo g o f W o r k - R e l a t e d I n j u r i e s a Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k ac t i v i t y o r j o b t r a n s f e r , d a y s a w a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - re l a t e d i n j u r i e s a n d i l l n e s s e s t h a t a r e d i a g n o s e d b y a p h y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d wo r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a l i s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . Fe e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n j u r y a n d i l l n e s s i n c i d e n t r e p o r t ( O S H A F o r m 30 1 ) o r e qui v a l e n t f o r m f o r e a c h i n jur y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f you ' r e n o t s u r e w h e t h e r a c a s e i s r e c o r d a b l e , c a l l OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Or l e a n s At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 1 (m o . / d a y) Hearing Loss Respiratory Condition On j o b tr a n s f e r or re s t r i c t i o n (d a y s ) W h e r e t h e ev e n t oc c u r r e d ( e . g . Lo a d i n g d o c k no r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , pa r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e on e t y p e o f i l l n e s s : Poisoning Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s Injury De a t h Ca s e N o . Ot h e r r e c o r d - ab l e c a s e s Da y s a w a y fr o m w o r k Re m a i n e d a t w o r k Jo b t r a n s f e r or r e s t r i c t i o n Cl a s s i f y t h e c a s e Es t a b l i s h m e n t n a m e CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : IN La y n e H e a v y C i v i l Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder 06 4 - 3 1 1 5 - 0 1 6 / 6 Jo b s i t e R. k n e e s p r a i n f r o m c a r r y i n g p i p e do w n e m b a n k m e n t 1 1 06 9 - 3 1 3 2 - 0 1 6 / 2 0 Ot h e r La c e r a t i o n t o L h a n d f r o m k n i f e 1 1 07 0 - 3 1 1 0 - 0 8 6 / 2 0 Ot h e r l o w b a c k p a i n f r o m c l i m b i n g i n t o t r u c k 1 1 4 2 7 1 07 1 - 3 1 1 0 - 0 9 6 / 2 3 Jo b s i t e l a c e r a t i o n s t o h e a d f r o m l i f t g r a t e 1 31 07 3 - 3 1 8 0 - 0 2 6 / 2 9 Jo b s i t e Pu n c t u r e w o u n d t o R f o o t f r o m st e p p i n g o n n a i l 1 1 08 1 - 3 1 1 0 - 1 0 7 / 2 0 Jo b s i t e fr a c t u r e d L m i d d l e f i n g e r w h i l e m o v i n g a c o n c r e t e d o n u t a n d i t s l i p p e d cr u s h i n g f i n g e r 1 1 08 2 - 3 1 7 2 - 0 2 7 / 2 2 Yar d / O f f i c e Pu n c t u r e w o u n d t o r i g h t f o o t f r o m st e p p i n g o n n a i l . 1 1 08 3 - 3 1 8 0 - 0 3 7 / 2 2 Un k n o w n FB i n l e f t f o r e a r m f r o m b r o k e n ha m m e r . 1 1 Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) Lo g o f W o r k - R e l a t e d I n j u r i e s a Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k ac t i v i t y o r j o b t r a n s f e r , d a y s a w a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - re l a t e d i n j u r i e s a n d i l l n e s s e s t h a t a r e d i a g n o s e d b y a p h y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d wo r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a l i s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . Fe e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n j u r y a n d i l l n e s s i n c i d e n t r e p o r t ( O S H A F o r m 30 1 ) o r e qui v a l e n t f o r m f o r e a c h i n jur y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f you ' r e n o t s u r e w h e t h e r a c a s e i s r e c o r d a b l e , c a l l OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Or l e a n s At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 1 (m o . / d a y) Hearing Loss Respiratory Condition On j o b tr a n s f e r or re s t r i c t i o n (d a y s ) W h e r e t h e ev e n t oc c u r r e d ( e . g . Lo a d i n g d o c k no r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , pa r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e on e t y p e o f i l l n e s s : Poisoning Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s Injury De a t h Ca s e N o . Ot h e r r e c o r d - ab l e c a s e s Da y s a w a y fr o m w o r k Re m a i n e d a t w o r k Jo b t r a n s f e r or r e s t r i c t i o n Cl a s s i f y t h e c a s e Es t a b l i s h m e n t n a m e CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : IN La y n e H e a v y C i v i l Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder 08 4 - 3 1 2 0 - 0 3 8 / 1 Ot h e r an k l e s p r a i n a n d t e n d o n s t r a i n f r o m mi s - s t e p p i n g w h i l e c l e a n i n g t h e f l o o r 1 3 0 1 08 8 - 3 9 0 1 - 0 1 8 / 1 6 Jo b s i t e re a c h e d L h a n d u p o n t o p o f co n c r e t e , c o n c r e t e ci r c u l a t i n g m a c h i n e ra n o v e r t o p , s e v e r e d a m a g e L h a n d 1 1 3 7 1 08 9 - 3 1 6 5 - 0 2 8 / 1 8 Jo b s i t e cr u s h i n j u r y t o L m i d d l e f i n g e r f r o m pi p e f l a n g e s 1 1 09 3 - 3 8 1 0 - 0 4 8 / 2 9 Jo b s i t e la c e r a t i o n s a n d f r a c t u r e s t o t h e f a c e fr o m s a w b l a d e 1 8 2 4 1 09 6 - 3 1 6 5 - 0 3 4 1 1 6 0 Jo b s i t e EE w a s s t a n d i n g o n l e f t s i d e o f ex c a v a t o r w h e n i t t u r n e d s t r u c k E E i n ch e s t p u s h i n g h i m i n t o a i r c o m p r e s s o r 1 22 1 09 7 - 3 1 3 0 - 0 1 9 / 9 Jo b s i t e st r a i n e d m u s c l e s i n t h e l o w e r b a c k wh i l e p u s h i n g b r a c e 1 41 Ye a r Ci t y S t a t e (A ) ( D ) ( E ) ( F ) (M ) (G ) ( H ) ( I ) ( J ) ( K ) ( L ) ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) Lo g o f W o r k - R e l a t e d I n j u r i e s a Yo u m u s t r e c o r d i n f o r m a t i o n a b o u t e v e r y w o r k - r e l a t e d i n j u r y o r i l l n e s s t h a t i n v o l v e s l o s s o f c o n s c i o u s n e s s , r e s t r i c t e d w o r k ac t i v i t y o r j o b t r a n s f e r , d a y s a w a y f r o m w o r k , o r m e d i c a l t r e a t m e n t b e y o n d f i r s t a i d . Y o u m u s t a l s o r e c o r d s i g n i f i c a n t w o r k - re l a t e d i n j u r i e s a n d i l l n e s s e s t h a t a r e d i a g n o s e d b y a p h y s i c i a n o r l i c e n s e d h e a l t h c a r e p r o f e s s i o n a l . Y o u m u s t a l s o r e c o r d wo r k - r e l a t e d i n j u r i e s a n d i l l n e s s e s t h a t m e e t a n y o f t h e s p e c i f i c r e c o r d i n g c r i t e r i a l i s t e d i n 2 9 C F R 1 9 0 4 . 8 t h r o u g h 1 9 0 4 . 1 2 . Fe e l f r e e t o u s e t w o l i n e s f o r a s i n g l e c a s e i f y o u n e e d t o . Y o u m u s t c o m p l e t e a n i n j u r y a n d i l l n e s s i n c i d e n t r e p o r t ( O S H A F o r m 30 1 ) o r e qui v a l e n t f o r m f o r e a c h i n jur y o r i l l n e s s r e c o r d e d o n t h i s f o r m . I f you ' r e n o t s u r e w h e t h e r a c a s e i s r e c o r d a b l e , c a l l OS HA ' s F o r m 3 0 0 (R e v . 0 1 / 2 0 0 4 ) Fo r m a p p r o v e d O M B n o . 1 2 1 8 - 0 1 7 6 Or l e a n s At t e n t i o n : T h i s f o r m c o n t a i n s i n f o r m a t i o n r e l a t i n g to e m p l o y e e h e a l t h a n d m u s t b e u s e d i n a m a n n e r th a t p r o t e c t s t h e c o n f i d e n t i a l i t y o f e m p l o y e e s t o t h e ex t e n t p o s s i b l e w h i l e t h e i n f o r m a t i o n i s b e i n g u s e d fo r o c c u p a t i o n a l s a f e t y a n d h e a l t h p u r p o s e s . U. S . D e p a r t m e n t o f L a b o r Oc c u p a t i o n a l S a f e t y a n d H e a l t h A d m i n i s t r a t i o n 20 1 1 (m o . / d a y) Hearing Loss Respiratory Condition On j o b tr a n s f e r or re s t r i c t i o n (d a y s ) W h e r e t h e ev e n t oc c u r r e d ( e . g . Lo a d i n g d o c k no r t h e n d ) De s c r i b e i n j u r y o r i l l n e s s , pa r t s o f b o d y a f f e c t e d , an d o b j e c t / s u b s t a n c e t h a t d i r e c t l y i n j u r e d o r m a d e pe r s o n i l l ( e . g . S e c o n d d e g r e e b u r n s o n r i g h t fo r e a r m f r o m a c e t y l e n e t o r c h ) Ch e c k t h e " i n j u r y " c o l u m n o r c h o o s e on e t y p e o f i l l n e s s : Poisoning Id e n t i f y t h e D e s c r i b e t h e c a s e Da t e o f in j u r y o r on s e t o f il l n e s s Injury De a t h Ca s e N o . Ot h e r r e c o r d - ab l e c a s e s Da y s a w a y fr o m w o r k Re m a i n e d a t w o r k Jo b t r a n s f e r or r e s t r i c t i o n Cl a s s i f y t h e c a s e Es t a b l i s h m e n t n a m e CH E C K O N L Y O N E b o x f o r e a c h c a s e b a s e d o n th e m o s t s e r i o u s o u t c o m e f o r t h a t c a s e : En t e r t h e n u m b e r o f da y s t h e i n j u r e d o r i l l wo r k e r w a s : IN La y n e H e a v y C i v i l Aw a y Fr o m Wo r k (d a y s ) All other illnesses Skin Disorder Pa g e t o t a l s 0 1 6 6 1 3 1 6 2 1 6 6 2 3 5 0 0 0 0 0 Pa g e 1 o f 1 ( 1 ) ( 2 ) ( 3 ) ( 4 ) ( 5 ) ( 6 ) Pu b l i c r e p o r t i n g b u r d e n f o r t h i s c o l l e c t i o n o f in f o r m a t i o n i s e s t i m a t e d t o a v e r a g e 1 4 m i n u t e s p e r re s p o n s e , i n c l u d i n g t i m e t o r e v i e w t h e i n s t r u c t i o n , se a r c h a n d g a t h e r t h e d a t a n e e d e d , a n d c o m p l e t e an d r e v i e w t h e c o l l e c t i o n o f i n f o r m a t i o n . P e r s o n s ar e n o t r e q u i r e d t o r e s p o n d t o t h e c o l l e c t i o n o f in f o r m a t i o n u n l e s s i t d i s p l a y s a c u r r e n t l y v a l i d O M B tl b I f h t b t Respiratory Condition All other illnesses Poisoning Hearing Loss Injury Skin Disorder Be s u r e t o t r a n s f e r t h e s e t o t a l s t o t h e S u m m a r y p a g e ( F o r m 3 0 0 A ) b e f o r e y o u p o s t i t . Our team is client-oriented. We want the Village of Miami Shores to participate to its maximum desire in the development of the project, so that the end result is what the Village wants and needs, the first time through. We have worked with many of our clients for 20+ years. These long term relationships have afforded us many opportunities to meet the needs of our client needs and the ability to provide the Village of Miami Shores with the experience and personnel that this project requires. We are sure that our current and past project performance, as well as our individual team members’ experience and qualification s, are more than satisfactory to meet the needs of the Village of Miami Shores. COMMUNICATION PROTOCOL Co-Location of Team During the design and construction stage of the project, key staff members of the Layne Design-Build (DB) Team will co-locate in the office of CPH located at 1992 SW 1st Street, Miami, Florida 33135, Phone: 305-274-4805. Co-location is the most appropriate way for our team to develop and maintain integrated and seamless workflow among team members. Lines of Communication Our team recognizes the significance of proper communication throughout the duration of the project. To maintain the project schedule proposed herein, it is important to maintain timely, internal communications and communication between th e consultant, subconsultants, the Village, and permitting agencies. These communications must be clear, concise, and precise. We will use proven, in -place, vertical lines of communication and data transfer procedures from the Project Manager to the various design discipline managers and field personnel. Design-Builder Communications Design Phase We believe it will be important to communicate face-to-face with our team on a regular basis and have scheduled monthly discipline team and Design -Build team meetings outside of the scheduled meetings with the Village. Our team will assemble on a regular basis for face-to-face meetings in Miami with the construction estimators, subcontractors and vendors. Every agenda will include value engineering and construct ability so that the team communicates the most cost efficient design and construction approaches for the project. At a minimum, the attendance of the project manager, design manager, and construction manager will be mandatory at these meetings. It will be mandatory at certain stages of the design evolution that certain discipline leaders, construction estimators and construction superintendents also attend the meetings. Ability to Interface with the Village G Capabilities of the Team . . . . . . . . . . .. . . . . . . . . . . . . . .  Current and past project experience  Qualified and experienced key personnel  Satisfactory safety record  Ability to interface with the Village These meetings are proposed at appropriate stages of the design when operations personnel can understand the design objectives and can provide constructive input. As always, the Village operations, technical and construction staff is encouraged to attend all the design discipline and DB team meetings to provid e continuous input to the design so we can provide the most value quality to the project. Construction Phase We expect the construction questions to be minimal because the Design -Build process provides continuous VE and constructability input throughout the design period from stakeholders. However, field questions will arise during construction on projects of this complexity. We propose the Layne site management team will coordinate daily construction issues directly with the design team. This communication will be supplemented by site visits of CPH staff on an as needed basis. CPH personnel will also attend monthly administrative construction progress meetings. Reports. We will provide weekly project status reports which cover construction activities, unresolved issues, and recommendations. These reports will facilitate our goal of maintaining Village staff’s involvement throughout the project and will specifically include: a summary of the tasks completed from the previous period, work proposed to be completed in the upcoming period, budget compliance, schedule compliance, outstanding issues, safety compliance, and a summary of recent weather conditions. Resolution of Design and Construction Period Posted Comments. We expect that comments and ideas will be discussed by the construction project team during critical stages of the project. In our experience, comments and ideas may go unresolved for weeks if they are not given proper attention and focus. If this situation begins to occur, we recommend a weekly conference call to resolve all items from the discussion group which have been posted for seven days or more. The conference call will be conducted by the DB PM and include the Design PM, and the Village’s PM. Progress Meetings. The Layne Team will conduct regular progress meetings to coordinate all construction activities. These progress meetings include both external meetings between the Layne DB Team and the Village, and internal team meetings. We will prepare and distribute an agenda of all project meetings at least two days before the meeting. Critical issues to be discussed will be identified, and all participants will have the opportunity to add items, as they desire. The agenda will also include a review of action items from the previous meeting, and assignment of tasks requiring action arising from this meeting. The Project Manager will conduct the progress meetings. The frequency of the meetings will vary through the course of the project. Construction team meetings will be held weekly, typically early in the week to allow discussion of work to be accomplished during that week. We anticipate addressing procurement and design issues bimonthly or monthly, as needed. Other local stakeholders will be invited to attend progress meetings when issues of concern to them are on the agenda. STAFFING PLAN/ DEPTH OF CONSTRUCTION AND CORPORATE PROFESSIONAL RESOURCES AVAILABLE Layne Heavy Civil, Inc. has a total of 738 employees across 11 offices nationwide. Of those, 495 of them are hourly employees consisting of Foremen, and Tradesmen and some Administrative personnel, and 243 are salary employees consisting of upper management, Project Managers, Construction Managers, Estimators and other Administrative personnel. Layne has sufficient manpower to successfully complete this project. The key personnel proposed for this project are available and prepared to begin work on this project as soon as a contract is awarded. There are no known major pending projects or anticipated organizational changes that could impact the ability to dedicate personnel and resources needed to complete this contract in a reasonable timeframe. Key Personnel SAFETY COMPLIANCE MDT COMPLIANCE Layne will maintain compliance with the applicable provisions of Miami -Dade Transit Construction Safety Manual (Rev. No. 6, May 2012) and the applicable provisions of Miami-Dade Transit Adjacent Construction Safety Manual (Nov. 2011). Layne will follow the standards and criteria for the construction, developments and maintenance of all properties that have or may enter the Safety Zone that has been established at either side of the Metrorail and/or Metromover systems. Additionally, Layne will give primary consideration to the safety of Bus patrons and property and will follow direction provided regarding train/bus traffic, or train/bus safety. SPECIAL EVENTS ACCOMMODATIONS Layne will coordinate with officials to plan for and accommodate special events which may impact operations of this project and will allow for them in the schedule or modify accordingly. SAFETY REPRESENTATIVE Layne has designated Eddie Medina as our full -time Safety Representative who will be responsible for work site safety during the prosecution of the work. Layne Corporate policy mandates our Safety Representative report to Layne Corporate, and not the Superintendent.