Agenda 02-03-2026; 8-h - Approval of Prequalification Assessment Tool for the Crisis Diversion Facility

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Gilbane Building Company 9 Prequalification Form for First-Tier Subcontractors under CM at Risk Orange County Crisis Diversion Facility 1.7. Insurance The minimum requirement of insurance coverage is listed below. Firms must indicate that they can provide evidence of insurance coverage, should they be the successful bidder by attaching a copy of their current insurance certificate. Have you attached a copy of your insurance certificate? I IYes I INo • Insurance Carriers—All insurance carriers must have an AM Best Rating of"A"or better • General Liability with a required limit of no less than $1,000,000 each occurrence, $2,000,000 general aggregate per project. • Worker's Compensation per statue and Employer Liability with the required limit of no less than $1,000,000 each accident, $1,000,000 Disease policy limit, $1,000,000 Disease each employee • Automobile Liability—Requirement of no less than $1,000,000 combined single limit for Any Auto. • Additional Insured—Gilbane Building Company and Forsyth County and the Forsyth County Board of Education. (Required upon contract award) • Excess Liability(Umbrella) policy with the required limit of no less than $5,000,000 each occurrence, $5,000,000 aggregate (limits will increase if the firm will be providing any crane usage). • Waiver of subrogation— In favor of Gilbane Building Company and Orange County. (Required upon contract award) (Prequalification Ratings Matrix: If insurance certificate attached give 1 point. If limits meet or exceed the required limits indicated above give additional 3 points. If insurance certificate not attached give 0 points.) 1.8. Financials Attach latest fiscal year-end CPA Prepared (audited, reviewed or compiled) Financial Statements (current within the past 12-month period). A financial statement includes the CPA opinion letter, balance sheet, income statement, cashflow, additional schedules/addendums, notes section, etc. If CPA prepared financial statements are not available,then an internally prepared (unaudited) balance sheet and income statement may be submitted by the firm, with confirmation from an officer of the company as to the validity of the statements. If there is a situation where the CPA statement isn't available because it has not been completed by the CPA,then the previous year's CPA report should be submitted along with an internally prepared (unaudited) balance sheet and income statement for the recent fiscal year end. Financial information may be submitted in the following ways: 1. Submission as an attachment to this Prequalification form. (Firm must submit financial data and may clearly indicate a request for confidentiality to avoid this item from becoming part of public record.) OR 2. Gilbane's Prequalification database, www.compass-app.com. If this option has been used, please indicate below OR 3. Individual review with Gilbane Controller, Matt McGarry, at mmcgarry@gilbaneco.com or 617 478-3368, via email, mail, live online review or in person review at Gilbane's office in Charlotte, NC. Have you attached financial statements? EAYes EANo Have you submitted through www.compass-app.com (optional)? EAYes EANo Have you held a private review with Gilbane Controller(optional)? EAYes EANo Page 5 112