Attachment_B_-_AE_Data_Forms.pdf

State Corporation Commission ID Number / Partnership Name:

Micro Business Small Business Woman Owned Bus.

Minority Owned Bus.

Svc. Disabled Veteran

Firm's APELSCIDLA License #:

Firm's DSBSD Certification #:

FIRM NAME

Mechanical Engineers Electrical Engineers

CONTINUE SYNOPSIS OF RESPONDING FIRM ON FORM AE-1A

TOTALS

Landscape Architects Interior Designers Asbestos Designers Surveyors

Specifications CADD Operators Construction Admin. / Insp.

Structural Engineers

Project Managers

OFFICE WHERE WORK WILL BE DONE ENTIRE FIRM

7) NUMBER OF PERSONNEL IN FIRM:

Soils Engineer

UnlicensedLicensed Unlicensed Licensed

Name Title Email Address Phone Number

PRIME BEFORE?

WORKED WITH

FUNCTION / RESPONSIBILITY

TELEPHONE:

5) NAMES OF NOT MORE THAN TWO PRINCIPALS TO CONTACT: (Title and Phone Number)

6) PROPOSED CONSULTANTS OR OTHER OFFICES PROVIDING SERVICES:

Sole Proprietorship

FAX:

b) List other names and years:

RFP #

3) NAME AND ADDRESS OF PARENT COMPANY / HOME OFFICE: 4) SPECIFIC TYPE OF OWNERSHIP:

Submittal For (Project Title):

Submitted By (Firm Name):

FAX:

FEIN / SSN:

Check all that apply:

Limited Liability Co.

Professional Corp.

Partnership

AE-1

TELEPHONE:

a) Years under present name………..

PC # :

(Rev. 4/19)

1) FIRM NAME AND ADDRESS: (office where work will be done) 2) YEARS IN BUSINESS:

ARCHITECTURAL / ENGINEERING FIRM DATA

SYNOPSIS OF RESPONDING FIRM

GMU HECO FORM

Architects Civil Engineers

00 0

GENERAL INSTRUCTIONS

DO NOT attempt to fill in these forms "on-line". First download and save a copy to you computer, then fill in the saved copy.

Read the Specific Instructions below to assist you in completing the various AE Data forms.

Click on the sheet tabs below to go to the appropriate form.

( If you need more than one copy of a specific type of form, make a copy of this Excel file.)

Fill in the fields highlighted in yellow. You can use the tab key to move easily from field-to-field. You can also use the mouse to select the field you wish fill. (On large text fields, you must use the mouse to select them, rather than the tab key.)

Some fields contain selection lists. These fields are denoted with an arrow just to the right of the field. To select from the list of choices, click on the arrow and then select the appropriate choice.

When complete, print the appropriate forms, assemble them in order, and submit them to the address noted in the RFP.

Be factual and concise. Remember that the Building Committee members will be reviewing numerous responses to an RFP before selecting 3 to 5 firms for an interview.

Deviation from the prescribed format is NOT encouraged as it makes it more difficult for the Building Committee to review submittals. Form AE-6 allows you to include other supplemental data which is not covered on Forms AE-1 through AE-5.

SPECIFIC INSTRUCTIONS

Form AE-1 & 1A SYNOPSIS OF RESPONDING FIRM Insert RFP # to which response is being made.

Insert name of Responding Firm.

Insert name of Project and Project Code (PC #).

1 Show name, physical address and mailing address of respondent.

Provide telephone number and FAX # of respondent.

Provide SSN, if Sole Proprietorship, or Federal Employer Identification Number (FEIN) for other forms of ownership.

2a,b Provide information requested.

3 Provide name & address of Parent Company or Home Office Provide its telephone number and FAX #

4 Show Type of Ownership of firm and any disadvantaged firm statuses which also apply.

Provide the firm's APELSCIDLA license number. ( APELSCIDLA = Commonwealth of Virginia's Board for Architects, Professional Engineers, Land Surveyors, Certified Interior Designers and Landscape Architects.

Refer to the Department of Professional and Occupational Regulation for additional information.)

If applicable, provide the firm's DSBSD Certification #. ( DSBSD = Commonwealth of Virginia's Department of Small Business and Supplier Diversity. )

5 Show name of principal(s) to contact concerning this RFP response. Show position title and telephone number.

6 Show the name of consultant(s) or other office, the nature of the consultant or other office's project responsibility/discipline. Answer with a yes or no if proposed consultant has worked with respondent.

7 Indicate number on "In-House" technical person(s) in various disciplines and skills levels. (Attach Form AE-2 for each consultant or other office.)

8 Show the name of the Professional Liability Insurance Carrier and the policy Limits of Liability with deductible.

INSTRUCTIONS FOR COMPLETING AE DATA FORMS

FOR SUBMISSION TO COMMONWEALTH OF VIRGINIA

AGENCIES IN RESPONSE TO REQUESTS FOR PROPOSALS

GMU HECO FORM

(Rev. 4/19)

9 Describe proposed involvement of Micro and Small businesses.

10 List State Agencies for whom the firm has worked in last 10 years.

11 List up to five (5) recently designed projects that have similar scopes or features. Provide Representative Project Data Form AE-5 for each.

General: Provide respondents typed name, title, signature and date.

Form AE-2 CONSULTANT / OTHER OFFICE

Complete an AE-2 form for each consultant firm who will assist the responding (i.e., prime) firm on this project.

If other offices of the responding firm will be employed on this project, complete an AE-2 form for each such office.

General:

Insert RFP # being responded to Insert name of Entity responding Insert name of Project and PC #

1 Show consultant/other office firm name, physical address and mailing address.

Provide telephone number and FAX # of respondent.

Provide SSN, if Sole Proprietorship, or Federal Employer Identification Number (FEIN) for other forms of ownership.

2a,b Provide information requested.

3 Provide name & Address of Parent Company or Home Office of Consultant Provide its telephone number and FAX #.

4 Show Type of Ownership of firm and any disadvantaged firm statuses which also apply.

Provide the firm's APELSCIDLA license number. ( APELSCIDLA = Commonwealth of Virginia's Board for Architects, Professional Engineers, Land Surveyors, Certified Interior Designers and Landscape Architects.

Refer to the Department of Professional and Occupational Regulation for additional information.)

If applicable, provide the firm's DSBSD Certification #. ( DSBSD = Commonwealth of Virginia's Department of Small Business and Supplier Diversity. )

5 Show name, title, and phone number of principal(s) who will be "in charge" of this firm's work on this project.

6 Indicate number of "In-House" technical personnel by discipline and skill level in consultant's or other office.

7 Describe Functions or Services to be provided by this consultant or other office.

8 Indicate on how many projects this consultant has provided services to the prime in the past 10 years.

9 Show the consultant's Professional Liability Limits of Insurance with deductible.

General: Provide consultant's typed name, title, signature and date.

Form AE-3 PROJECT STAFFING ORGANIZATION General:

Insert RFP # being responded to Insert name of Entity responding Insert name of Project and PC #

1 List Project Manager and primary responsible charge designer for each discipline or specialty. Complete a separate Form AE-4 for each person listed.

2 Will the persons listed be available to design this project? Do you have sufficient staff to commit to design this project on schedule considering the other work you and your consultants have? Explain.

3 How do you propose to assign responsibilities and coordinate the various disciplines involved?

4 Explain how you propose to assure that the documents clearly and fully describe the work to be done and how the work shown by various disciplines will be coordinated.

General: Provide respondent's typed name, title, signature and date.

Form AE-4 PERSONNEL QUALIFICATIONS Use Separate AE-4 for EACH KEY PERSON for this project)

General:

Insert RFP # to which response is being made.

Insert name of Responding Firm.

Insert name of Project and Project Code (PC #).

1 Name, Title, and usual job assignment of key person for this project.

2 This person's job assignment for THIS project.

3 This person's employer.

4 This person's total years of applicable experience and years of experience with current employer.

5 List College/University attended, Degree earned, year completed, and curriculum or area of specialization.

6 Provide information on initial professional registration. Provide Virginia 6 digit registration/license number as it appears on the APELSA certificate.

7 Indicate if individual has attended a CPSM training seminar, and if so, enter the date of the last CPSM seminar attended.

8 Tell what experience or qualifications this person has which makes her or him especially valuable for this particular project.

General: Provide respondent's typed name, title, signature and date.

Form AE-5 REPRESENTATIVE PROJECT DATA General:

Insert RFP# to which response is being made.

Insert name of Responding Firm.

Insert name of Project and Project Code (PC #).

Using copies of form AE-5, provide information on no more than 5 representative projects which best demonstrate the proposed team's experience and qualifications for this type of project. List projects which have features, functions, types of construction, systems, type of use, or type of occupancy similar to those envisioned for this project.

1 Provide representative project name, type of facility (e.g., dorm, hospital, etc.) and the project location.

2 Provide information concerning the Owner or Agency for possible reference check.

3 Provide information concerning the Contractor who built the project.

4 For each discipline shown, list the names of the firms which were responsible for the design in that discipline. Also list the key personnel, still with the firm, for each discipline. Include the most significant special consultant, if any.

5 List the applicable codes which applied to this project.

6 Briefly describe the project and its features. What is special about this project that would be of interest to the Building Committee for the proposed project?

7 Provide requested construction data.

8 Describe any Micro and Small Business participation. Include name of firm(s), their project function, and percent of fee.

Form AE-6 SUPPLEMENTAL INFORMATION General:

Insert RFP# to which response is being made.

Insert name of Responding Firm.

Insert name of Project and Project Code (PC #).

Provide additional Relevant information in brief outline or bullet format.

Why should your firm be selected for an interview?

What expertise can you or your consultants bring to this project to assure optimum functional space utilization design and its timely and cost effective completion?

Photographs of past projects or other elaborate material are not required unless specifically requested in the RFP.

Firms selected for interviews may, at that time, present supplemental data to further clarify their qualification, skills, abilities, performance record and approach to providing the services.

9) DESCRIBE PROPOSED PARTICIPATION OF MICRO BUSINESSES AND SMALL BUSINESSES: (Function and % of fee involved) The proposed total small business participation is %.

11) LIST NOT MORE THAN FIVE PROJECTS DESIGNED WITHIN THE LAST TEN YEARS WHICH HAVE SIMILAR SCOPES OR

FEATURES TO THIS PROJECT. ATTACH A REPRESENTATIVE PROJECT FORM AE-5 FOR EACH.

PROJECT DATE OF AWARD

Title: Date:

The foregoing is a statement of fact.

Signature:Typed Name:

AE-1A

AGENCY PROJECT

8) LIST PROFESSIONAL LIABILITY INSURANCE CARRIER, LIMITS OF LIABILITY, AND DEDUCTIBLE:

10) LIST STATE AGENCIES FOR WHICH THE FIRM HAS HAD A PRIME CONTRACT: (within the last ten years)

RFP #

ARCHITECTURAL / ENGINEERING FIRM DATA

SYNOPSIS OF RESPONDING FIRM (continued)

Submitted By (Firm Name): 0

GMU HECO FORM

(Rev. 4/19)

LOCATION

State Corporation Commission ID Number / Partnership Name:

Micro Business Small Business Woman Owned Bus.

Minority Owned Bus.

Svc. Disabled Veteran

Firm's APELSCIDLA License #:

Firm's DSBSD Certificate #:

8) ON HOW MANY PROJECTS HAS THE CONSULTANT WORKED WITH THE PROPOSER IN THE LAST TEN YEARS?

9) LIMITS OF PROFESSIONAL LIABILITY INSURANCE AND DEDUCTIBLE:

Title: Date:

Signature:

The foregoing is a statement of fact.

Typed Name:

6) NUMBER OF PERSONNEL IN FIRM:

ENTIRE FIRM

00 0TOTALS

Landscape Architects Interior Designers Asbestos Designers Surveyors Construction Admin. / Insp.

7) FUNCTIONS OR SERVICES TO BE PROVIDED:

Specifications

TELEPHONE:

Architects Civil Engineers

Professional Corp.

PC # :

(Rev. 4/19)

ARCHITECTURAL / ENGINEERING FIRM DATA

CONSULTANT / OTHER OFFICE

GMU HECO FORM

AE-2

TELEPHONE:

Limited Liability Co.

Partnership Sole Proprietorship

FAX:

2) YEARS IN BUSINESS 1) FIRM NAME AND ADDRESS: (office where work will be done)

Submitted By (Firm Name):

RFP #

Project Managers Licensed Unlicensed Licensed

OFFICE WHERE WORK WILL BE DONE

5) NAMES OF NOT MORE THAN TWO PRINCIPALS TO CONTACT: (Title and Phone Number)

Check all that apply:

Submittal For (Project Title):

a) Years under present name………..

b) List other names and years:

3) NAME AND ADDRESS OF PARENT COMPANY / HOME OFFICE: 4) SPECIFIC TYPE OF OWNERSHIP:

FEIN / SSN:

Soils Engineer

FAX:

Structural Engineers Mechanical Engineers Electrical Engineers

Unlicensed

Phone Number

CADD Operators

Name Title Email Address

1) KEY PERSONNEL DESIGNATED FOR THIS PROJECT: (Include Form AE-4 for Each)

2) DESCRIBE AVAILABILITY OF STAFF AND CONSULTANTS TO WORK ON THIS PROJECT:

3) DESCRIBE PROJECT METHODOLOGY, I.E., HOW WILL THE WORK FUNCTIONS, RESPONSIBILITIES AND

COORDINATION BE PERFORMED?

4) DESCRIBE THE METHOD OF QUALITY ASSURANCE YOU WILL USE FOR THE DOCUMENTS FOR THIS PROJECT.

The foregoing is a statement of fact.

Electrical Engineer Civil Engineer

AE-3

Submitted By (Firm Name):

GMU HECO FORM

(Rev. 4/19)

ARCHITECTURAL / ENGINEERING FIRM DATA

PROJECT STAFFING ORGANIZATION

RFP #

Submittal For (Project Title): PC # :

Function Name Title Firm / Office

Project Manager Architect

Date:

Typed Name:

Title:

Signature:

Structural Engineer Mechanical Engineer

1) NAME:

TITLE:

TYPICAL DUTY OR ASSIGNMENT:

2) ASSIGNMENT FOR THIS PROJECT:

PERCENT

Has this person attended a CPSM Training Seminar? If "Yes", list date of last attendance:

( List up to six (6) relevant projects and indicate individual's role and responsibility for each. )

The foregoing is a statement of fact.

or ENGINEER #

PC # :

OFFICE:

% OF TYPICAL 40 HOUR WORKWEEK THIS PERSON WOULD SPEND ON THIS PROJECT:

4) YEARS OF EXPERIENCE:

3) EMPLOYEE OF:

7) CONSTRUCTION AND PROFESSIONAL SERVICES MANUAL (CPSM) TRAINING:

Role / Responsibility

Date:

Typed Name:

Title:

Signature:

PERSONNEL QUALIFICATIONS

RFP #

5) EDUCATION: COLLEGE / DEGREE(S) / YEAR / SPECIALIZATION:

Project Completion DateProject

8) EXPERIENCE AND / OR QUALIFICATIONS RELEVANT TO THIS PROJECT:

YEARS WITH THIS FIRM

AE-4

6) ACTIVE REGISTRATION: Year first registered / State / Discipline or Type

COMMONWEALTH OF VIRGINIA 6-DIGIT REGISTRATION / CERTIFICATE / LICENSE NUMBER:

ARCHITECT #

YEARS TOTAL EXPERIENCE

GMU HECO FORM

(Rev. 4/19)

Submitted By (Firm Name):

BRIEF RESUME OF KEY INDIVIDUAL PROPOSED FOR THIS PROJECT. PROVIDE ONE FORM FOR EACH PERSON.

Submittal For (Project Title):

ARCHITECTURAL / ENGINEERING FIRM DATA

2) OWNER:

Project Administrator: Title:

Address: Email Address:

Phone Number:

FAX Number:

3) PRIME CONTRACTOR:

Project Manager: Phone Number:

Superintendent: Email Address:

Prime A/E Architectural Structural Mechanical Electrical Civil

(Place "X" in all codes that applied to this project)

IBC Other (describe):

7) CONSTRUCTION DATA: Duration (months)

Type: PROJECT SCHEDULE:

Gross Area: sf Design

Construction

Number of Floor Levels:

Owner's Budget: Number of Change Orders:

A/E Estimate: Cost of Change Orders:

Low Bid: Substantial Completion Date:

Proposed Participation: % Final (Actual) Participation: %

The foregoing is statement of fact.

1) PROJECT NAME:

PC # :

Assignment on Project

PROJECT TYPE: LOCATION:

Discipline Firm / Employer Individual

4) NAMES OF KEY DESIGNERS/PROJECT MANAGERS STILL WITH THE FIRM AND THEIR SPECIFIC PROJECT RESPONSIBILITIES:

VUSBC ADAAG ASAD

5) NAMES OF APPLICABLE CODES:

Typed Name:

8) DESCRIBE ANY MICRO BUSINESS OR SMALL BUSINESS PARTICIPATION ON THE DESIGN PHASE (Firm, Function, % of Fee):

Title:

Signature:

Date:

AE-5

LIFE SAFETY

6) DESCRIPTION OF RELEVANT PROJECT FEATURES:

Sched Actual

Submittal For (Project Title):

GMU HECO FORM

(Rev. 4/19)

Submitted By (Firm Name):

RFP #

REPRESENTATIVE PROJECT DATA

The foregoing is a statement of fact.

Title:

Submittal For (Project Title):

Date:

Typed Name:

PC # :

Signature:

AE-6

RFP #

SUPPLEMENTAL INFORMATION

GMU HECO FORM

(Rev. 4/19)

Submitted By (Firm Name):