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Gilbane Building Company 14 <br /> Prequalification Form for First-Tier Subcontractors under CM at Risk <br /> Orange County Crisis Diversion Facility <br /> 2.10c Safety—Written Plan,Training, Inspections <br /> Does your company have a written Safety/Health Program and required Drug Testing Program? IAYes =No <br /> Does your company provide weekly safety and health training to your on-site employees? IAYes ONo <br /> Does your company perform weekly safety and health inspections of the workplace? DYes =No <br /> (Prequalification Ratings Matrix. Give 3 points for each yes response above,for a maximum of 9 points.) <br /> 2.11. Documented HUB Plan <br /> Does this company currently have a documented plan for engaging subcontractor participation from Historically <br /> Underutilized Businesses? DYes ONo If yes, company HUB Plan may be requested by Gilbane. <br /> (Prequalification Ratings Matrix: if company has a current,documented HUB plan give 4 points. If no,give 0 points.) <br /> SECTION 3. Project Specific Staff <br /> 3.1. Superintendent Resume <br /> The assigned project superintendent for this project shall be: <br /> Include a resume. Have you included a resume? DYes =No <br /> (Prequalification Ratings Matrix: If resume included,give 2 points. If no,give 0 points.) <br /> 3.2. Superintendent Experience <br /> The years of experience this superintendent has on this specific project type is_<1 _1-2 _3-4 _5 or more <br /> (Prequalification Ratings Matrix: If<1 give 0 points,if 1-2,give 0.5 point,3-4 give 1 point,if 5 or more give 2 points.) <br /> 3.3. Project Manager Resume <br /> The assigned project manager for this project shall be: <br /> Include a resume. Have you included a resume? DYes =No <br /> (Prequalification Ratings Matrix: If resume included,give 2 points. If no,give 0 points.) <br /> 3.4. Project Manager Experience <br /> The years of experience the project manager has on this specific project type is_<1 _1-2 _3-4 _5 or more <br /> (Prequalification Ratings Matrix: If<1 give 0 points,if 1-2,give 0.5 point,3-4 give 1 point,if 5 or more give 2 points.) <br /> Page 10 112 <br />