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State of North Carolina <br />Prequalification for Single Prime Contractors <br />Contract Dollar Value <br />Final Contract Dollar Value <br />Scheduled Completion Date <br />Actual Completion Date <br />Performance Rating or Letter of <br />Commendation <br />Sub- Contractor Relations — References <br />from similar relevant projects <br />#1— Sub - Contractor Reference <br />#2 — Sub - Contractor Reference <br />#3 — Sub - Contractor Reference <br />(General project references were requested in section 2. a. (4), based on a "Yes" response, and 2. c. (2). If this <br />comparable project information is already reflected in those responses, please simply identify the relevant projects and <br />detailed information.] <br />Staffing and Organizational Structure <br />3. b. (1) Staff Qualifications - Provide organizational structure reflecting authority, responsibility and proportion of time <br />dedicated to this project and job descriptions for all key positions. Provide evidence that the key personnel have worked <br />together successfully as a team. <br />3. b. (2) Project- specific Staff Experience - Project- specific employment history is requested for key personnel for similar <br />projects performed within the last five years. As attachments, include qualifications (resumes) of the project team key <br />personnel to be assigned to this project. For each resume, include name, length of time employed with your company, <br />proposed position, education and training, professional registrations/ licenses, and affiliations, company and project- <br />specific employment history. <br />Information should include project size and description, time and budget performance, position held, authority and <br />responsibilities, contributions made to project success, and include owner /architect contacts with phone numbers. <br />3. b. (3) Staff Availability - Are key personnel also proposed on any other projects for which bidding and contracting is <br />pending? LL Yes L- No If yes, describe general availability and qualifications of potential substitutes. <br />Other Unique Information <br />3. c. [This section reflects any further project- specific or unique project requirements, such as clean room, <br />hospital /medical, prison, LEED certification, construction recycling, schedule constraints, etc. DO NOT REPEAT ABOVE <br />QUESTIONS. Expand line items and distribute points consistent with any additions.] <br />Prequalification — Form 03 -01 -11 11 of 12 <br />Attachment number 3 <br />F -1 Page 74 <br />