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1 MAIN OPERATING ROOMS HVAC UPGRADE Project Number: 4346/A4L-363/966248. UCSD MEDICAL CENTER HILLCREST. UNIVERSITY OF CALIFORNIA, SAN DIEGO. PREQUALIFICATION QUESTIONNAIRE. For MAIN OPERATING ROOMS HVAC UPGRADE. UCSD MEDICAL CENTER HILLCREST. UNIVERSITY OF CALIFORNIA, SAN DIEGO. Project Number: 4346/A4L-363/966248. SUBMITTED BY: < please enter your company name here >. TRADE ( please indicate your trade (s)). [ ] Bid Package #2 Demolition [ ] Bid Package #3 Steel & Miscellaneous Metals [ ] Bid Package #13 Acoustic Ceilings/Accessories/Wall Protection BSD BUILDERS. 8825 REHCO ROAD, SUITE A. SAN DIEGO, CA 92121. ISSUE DATE: May 29, 2014.

2 (Where a time period is given, such as the last ten [10] years, the period is to be measured backwards from the date this prequalification questionnaire is required to be submitted). Page 1 of 16 Prequalification Questionnaire MAIN OPERATING ROOMS HVAC UPGRADE Project Number: 4346/A4L-363/966248. UCSD MEDICAL CENTER HILLCREST. UNIVERSITY OF CALIFORNIA, SAN DIEGO. Note: Submission of an incomplete and/or unclear Prequalification Questionnaire may result in the determination of the prospective Subcontractor as NON-PREQUALIFIED. SUBMITTED BY: ( name and Title) Printed or Typed (Trade). (Firm name . If a Joint Venture, state name if JV Entity).

3 (Contact name for all notices and correspondence). (Address). (City, State, Zip Code). _____ _____. (Telephone Number) (Facsimile Number). (E-mail Address). Each prospective Subcontractor shall have California Contractor's License(s), current, active and in good standing with the California Contractor's State License Board on the date and time of the Prequalification Questionnaire submittal is due and must submit this Prequalification Questionnaire with all portions completed, including required attachments. Each prospective Subcontractor must answer all of the following questions and provide all requested information, where applicable.

4 Any prospective Subcontractor failing to do so may be deemed to be not responsive and not responsible with respect to this Prequalification at the sole discretion of BSD Builders. Each prospective Subcontractor must submit one (1) printed set of the questionnaire. All Subcontractors that have submitted a Prequalification Questionnaire will be notified in writing of either successfully or not successfully achieving prequalification status. All information submitted for Prequalification evaluation will be considered official information acquired in confidence, and the BSD Builders will maintain its confidentiality to the extent permitted by law.

5 Page 2 of 16 Prequalification Questionnaire MAIN OPERATING ROOMS HVAC UPGRADE Project Number: 4346/A4L-363/966248. UCSD MEDICAL CENTER HILLCREST. UNIVERSITY OF CALIFORNIA, SAN DIEGO. It is critical that the prospective Subcontractor fills out all information required accurately, completely, truthfully and to the best of their knowledge. Ambiguous or incomplete information may lead to an unfavorable rating and subsequent status as non-prequalified. WHERE NECESSARY, COPY THE FORMS IN THIS PACKAGE. USE ONLY THESE FORMS. 1. PREQUALIFICATION DECLARATION. I, _____, hereby declare that I am the (Printed name ). _____ of _____.

6 (Title) ( name of Firm). Submitting this Prequalification Questionnaire; that I am duly authorized to sign this Prequalification Questionnaire on behalf of the above-named firm; and that all information set forth in this Prequalification Questionnaire and all attachments hereto are, to the best of my knowledge, true, accurate and complete as of its submission date. The undersigned declares under penalty of perjury that all of the prequalification information submitted with this form is true and correct and that this declaration was executed in _____ (County), _____, (State). on _____ (Date). _____. (Signature).

7 Page 3 of 16 Prequalification Questionnaire MAIN OPERATING ROOMS HVAC UPGRADE Project Number: 4346/A4L-363/966248. UCSD MEDICAL CENTER HILLCREST. UNIVERSITY OF CALIFORNIA, SAN DIEGO. 2. LICENSE. A. Does your firm hold a California Contractor's license(s), which is current, valid, and in good standing with the California Contractor's State License Board? License Classification/Code: _____. YES NO. B. Provide the following information about your firm's Contractor's license: 1. name of license holder exactly as on file with the California Contractor's State License Board: _____. 2. License Classification: _____.

8 3. License Code: _____. 4. License Number: _____. 5. Date Issued: _____. 6. Expiration Date: _____. C. Can you truthfully state that your firm's contractor's license hasn't been suspended or revoked by the California Contractor's State License Board within the last five (5) years? YES NO. If answer is no, explain on attached additional sheets. D. Has a complaint ever been filed with the Contractor's State License Board against your company that required a formal hearing or inquiry? YES NO. E. Does your firm have experience utilizing CPM logic, Primavera Project Planner scheduling software on your projects and would you utilize this experience on this project?

9 YES NO. Page 4 of 16 Prequalification Questionnaire MAIN OPERATING ROOMS HVAC UPGRADE Project Number: 4346/A4L-363/966248. UCSD MEDICAL CENTER HILLCREST. UNIVERSITY OF CALIFORNIA, SAN DIEGO. If No, name the software application(s) used or the software application you would propose for use on this project for scheduling. _____. 3. SURETY. Prospective Subcontractor desiring to be prequalified are informed that they will be subject to and must fully comply with all bid conditions and may be asked to provide a 100% payment and 100%. performance bonds. Prospective Subcontractor shall submit the below form, signed by representative of surety and notarized.

10 If firm has used current surety for less than ten years, list surety(ies) previously used and indicate number of years used to demonstrate ten (10) complete years of surety history. A. Is the surety to be used listed in the latest published State of California Department of Insurance list of Insurance Organizations Authorized by the Insurance Commissioner to Transact Business of Insurance in the State of California? YES NO. B. Is it true that the surety has not paid out any monies for the construction activities of the prospective Subcontractor whatsoever within the last ten (10) years? YES NO. If answer is No, explain on attached additional sheets.