Part A: Hired Commercial Vehicle Program- Contractor ... · Corporation of British Columbia (ICBC) form APV-47 is a form accepted by the City. 2. Not less than $5,000,000 liability

5203629

Application PackageEngineering and Public Works

Fleet and Environmental Programs

Part A: Hired Commercial Vehicle Program- Contractor Application Forms

(Please do not bind or use staples in your Application package)

COMPANY NAME: ___________________________________________________________

CONTACT PERSON: _______________________________________________________

OFFICE TELEPHONE: _____________________________________________________

CELL: ____________________________________________________________________

EMAIL: ___________________________________________________________________

SIGNATURE: ________________________________________________________________

OFFICE USE ONLY

Required Submitted ()

Documents Submitted

Part A Forms Completed

City of Richmond 5 Contractor’s Application Package – Hired Commercial Vehicle Program Part A: Hired Commercial Vehicle Program- Contractor Application Forms

5203629

FORM A - DOCUMENT CHECKLIST

**NOTE: November 1 of each year is the anniversary date. Applicants are requested to submit documents by October 1st for review by the City **

Please ensure you have included the following documents with your Application:

Required Document Submitted ()

Note

A. ICBC Vehicle Registration & Third Party Liability Coverage ($5m)

B. WorkSafe BC Coverage

C. Proof of Goods and Service Tax Registration List GST Reg. No.

D. Acceptable Driver’s Abstract for each driver proposed (N and P Prints)

E. Valid B.C. Driver’s Licence

F. Driver/Operator Certification, as applicable

G.

Police Information Check for each driver/operator proposed (including contracted drivers and operators) – ensure that this is sent to the City’s Human Resources Division

H. Driver/Operator Qualification Form

I. Richmond Business License List License No.

J. Commercial General Liability Insurance (Owned Automobile Coverage for each vehicle)

K. Hired Trucks Only - Copy of current Commercial Vehicle Inspection Report

L. Rate Sheets (Forms M(a) and/or M(b), as applicable)

Refer to section 3.0, Required Documents, for more details

Authorized Signature: Date:

In the event of an Emergency Condition, I agree to provide the City upon its request and as available, all equipment and/or trucks listed in my Application in order to support the City’s emergency operations (check only one):

Yes No


5203629

1.0 General

1.1 Acceptance of Terms and Conditions

a) By submitting an Application under this Application process, Applicants confirm their acceptance of and agreement to abide by the City’s terms and conditions outlined in this document. Applicants should ensure that they have submitted a complete set of the documents listed on the checklist and should sign the checklist in order for their Applications to be considered by the City.

1.2 Annual Renewal

a) If a Contractor is selected by the City to perform the services required under this Application process, then the Contractor must ensure that these required documents are renewed annually by the anniversary date in order to maintain eligibility for consideration as a Contractor under the City’s Hired Equipment and Hired Trucking programs. It is the Contractor’s sole responsibility to initiate and submit to the City’s Stores Division (at the address listed on the cover page of this document) updated copies of all documents listed in this Part A (the “Required Documents”) by the anniversary date.

b) Regardless of its position on the list, if a Contractor wishes to submit the Required Documents prior to this anniversary date, then it may submit the Required Documents to the City who will accept these documents for review no earlier than one month prior to the anniversary date.

c) If a Contractor has never been placed on the City’s equipment or trucking lists, it may submit the Required Documents to the City who will accept these documents for review.

1.3 Notification of Changes/Updated Information

a) It is the Contractor’s sole responsibility to ensure updated documents as outlined in this Part A are provided to the City if at any time a change occurs, within 30 (thirty) days of the change, in order to maintain eligibility for consideration as a Contractor under the City’s Hired Commercial Vehicle Program (which includes its Hired Equipment and Hired Trucking programs).

2.0 Disqualification for Non-Compliance

2.1 The following will result in the Contractor being disqualified and removed from the City’s Hired Commercial Vehicle Program, at the sole discretion of the City’s General Manager of Engineering and Public Works, whose decision will be final and binding:


5203629

1. Failure to submit required documentation on the anniversary date, as required under 1.1 above,

2. Failure to provide updated documentation, i.e. if a change occurs as required under 1.2 above,

3. Providing false or misleading documents or information to the City.

3.0 Required Documents

a) Proof of commercial general liability insurance that covers your business operations and is for a limit of not less than five (5) million that lists the City as Additional Insured.

b) Proof of automobile liability insurance for each vehicle you propose to the City for use under the hired commercial vehicle program; such coverage must include the following limits:

1. Not less than $2,000,000 for owned trucks. The Insurance Corporation of British Columbia (ICBC) form APV-47 is a form accepted by the City.

2. Not less than $5,000,000 liability for owned equipment licensed to be on the road, through ICBC or in combination with ICBC and an Umbrella carrier.

See Part C section 15.2 of this Application Package for further information on the City’s insurance requirements. The City reserves the right to increase its required limits at any time.

c) WorkSafe BC Coverage – Proof of WSBC coverage must be included for your company and separately for all truck drivers and equipment operators and sub-contractors who are NOT your employees (i.e., sub-contracted drivers and operators.) See also Part C, section 16 for further information on WorkSafe BC Coverage requirements.

d) Certificate of Proof of Goods and Service Tax Registration. A company invoice with your GST number and company name is acceptable.

e) For each operator/driver proposed, both N Print and P Print abstracts, dated no less than 10 (ten) days prior to the Application date, must be included. The City will refuse to hire operator/drivers with abstracts that show:

1. a drivers licence status other than normal;

2. the drivers licence class is NOT applicable to the City’s requirements;

3. too many penalties;

4. more than 4 (four) tickets with penalty points in the past 2 (two) years;

5. any motor vehicle-related Criminal Code convictions in the past 3 (three) years;


5203629

6. a history of many accidents;

7. a history of substance abuse related convictions.

f) For each operator/driver proposed, proof of Valid B.C. Driver's Licence (a colour copy of the front and back of each license.) A learner's permit is not acceptable.

g) As applicable, provide copies of any certifications or assessments for each driver/operator proposed.

h) Police Information Check (“PIC”) for each driver/operator proposed (including sub-contracted drivers and operators.) The City will not reimburse Applicants for the cost of obtaining criminal record checks.

i) For each driver/operator proposed, a driver/operator qualification form that lists the work experience and qualifications for each driver/operator proposed. Please see the sample on the following page for an example of an appropriate format. Note that references for each driver/ operator may also be required.

j) Valid Richmond Business License - more information is available at this link: (http://www.richmond.ca/busdev/licences.htm).

k) Equipment Only - Proof of Ownership (Bill of Sale or other supporting documents) for each piece of equipment.

l) Copy of current Commercial Vehicle Inspection Report for each vehicle (Hired Trucks only).

m) Rate Sheets – Form M(a) and/or Form M(b) as applicable.

Driver/Operator Qualification Form (For Applicant Use)

5203629

Name

Address

Contact

Certification (Indicate Equipment Certification/s including: Where obtained and Dates)

Licensing (Indicate Class of Driver’s License)

Driving experience (Indicate workplace and duration)

Equipment Operation Experience (Indicate workplace and duration)

Driver/Operator Qualification Form (SAMPLE – DO NOT USE)

5203629

Name John Smith

Address 123 Main Street, Richmond BC ABC 123

Contact 111-222-3333

Certification (Indicate Equipment Certification/s including: Where obtained and Dates)

Hydraulic Excavator Operator Training – Operator Training School, completed in

Jan 2000.

Industrial First Aid – BC First Aid, completed Dec 2005.

Licensing (Indicate Class of Driver’s License)

Class 1 with air endorsement.

Driving experience (Indicate workplace and duration)

25 years in commercial transportation including dump truck, truck and pony and

transfer experience.

25 years owner operator ABC Company.

Equipment Operation Experience (Indicate workplace and duration)

Excavator operator for ABC Company for 15 years.

Sample: Acceptable Copy of a BC Driver’s License

5203629

**NOTE – Drivers and Operators proposed to the City must have a BC Driver’s license with Class 1, 3 or 5 designations, as appropriate to the work performed. **

1, 3, 5

Sample: Commercial General Liability Insurance Certificate

5203629

NOTE – the City of Richmond must be added as Additional Insured

Limits

and

require-

ments

are

listed in

Part C,

section

15.2 of

this

applicat

-ion

package

Sample: Richmond Business License

5203629

**NOTE: An intermunicipal business license will be accepted only if accompanied by a valid, current-year Richmond business license**

Sample: WorkSafe BC Clearance Letter

5203629

Sample: Police Information Check

5203629

**NOTE: Applicants must ensure that this form is sent to the City of Richmond Human Resources Division**

Sample: Commercial Vehicle Inspection Report

5203629

**NOTE – this is only required for trucks**

Sample: ICBC Owner’s Certificate of Insurance and Vehicle License

5203629

Sample: Driver’s Abstract – “N” and “P” Prints

5203629

Equipment Rate Sheet

5203629

FORM M(a) - Hired Equipment Rental Form (Gradalls)

Fleet Operations

Company Name: Address: Phone No: Cell No:

Contact Person: Title: Email:

Year

Equipment Any Other Charges?

Please specify.

Attachments

GRADALL Description Emissions Tier

Level

Hourly Rate (Includes Operator)

Move Charges Applicable? If yes, specify rate

(Indicate cost structure such as hourly rate, daily rate, per

location, etc.)

Attachment Description (if applicable)

Hourly Rate Daily Rate

Gradalls City Set Rate

$130.00 $ $

City Set Rate

$130.00 $ $

City Set Rate

$130.00 $ $

City Set Rate

$130.00 $ $

List additional gradalls $ $ $

$ $ $

$ $ $

$ $ $


5203629

FORM M(a) - Hired Equipment Rental Form (Equipment) continued Fleet Operations

Year


Please specify.

Attachments

EQUIPMENT Description Emissions Tier

Level




location, etc.)



Backhoe $ $ $

$ $ $

$ $ $

$ $ $

$ $ $

Bobcat $ $ $

$ $ $

$ $ $

$ $ $

$ $ $

Crane Truck $ $ $

$ $ $

$ $ $

$ $ $


5203629


Year


Please specify.

Attachments


Level




location, etc.)



Flusher $ $ $

$ $ $

$ $ $

Excavator $ $ $

$ $ $

$ $ $

Loader $ $ $

$ $ $

$ $ $

Sweeper $ $ $

$ $ $

$ $ $

$ $ $


5203629


Year


Please specify.

Attachments


Level




location, etc.)



Other Equipment $ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

$ $ $

Truck Rate Sheet

5203629

FORM M(b) - Hired Truck Rental Form

Fleet Operations

Company Name: Address: Phone No: Cell No:

Contact Person: Title: Email:

Year

Truck Attachments or Additional Hauling

Truck Description (specify whether single or tandem)

State Emissions Standards




Single Axle City Set Rate

$55.00 Transfer Box $

City Set Rate

$55.00 Pony Trailer $

City Set Rate

$55.00 $

City Set Rate

$55.00 $

Tandem Axle City Set Rate

$75.00 $

City Set Rate

$75.00 $

City Set Rate

$75.00 $

Truck Rate Sheet

5203629

FORM M(b) - Hired Truck Rental Form continued Fleet Operations

Year

Truck Attachments or Additional Hauling

Truck Description (specify whether single or tandem)

State Emissions Standards




Truck and Pony City Set Rate

$95.00 $

City Set Rate

$95.00 $

City Set Rate

$95.00 $

City Set Rate

$95.00 $

City Set Rate

$95.00 $

Other Trucks $ $

$ $

$ $

$ $

$ $

If trucks are used for Rip Rap Hauling, the City will pay an additional $3.00 per hour.

$

**End of Part A**