ESBD_384889_1736359844196_Exhibit H A-E Questionnaire Form.pdf
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- Solicitation number
- 808-25-242851
- Issued by
- Foard County, Texas
About this file
This file is an Architectural/Engineering (A/E) Questionnaire Form (Exhibit H) that appears to be part of a Request for Qualifications (RFQ) submission package. The form is designed to collect comprehensive information about architectural and engineering firms interested in providing professional services, including details about their organization, personnel, capabilities, and project history.
The questionnaire requires firms to provide detailed information about their business structure, HUB status, key personnel, staff disciplines, service capabilities, professional liability coverage, and geographical service limits. The form includes sections for documenting schedule compliance and budget compliance for five relevant completed projects, requiring specific data about project timelines and financial details including owner's budget, cost estimates, contract amounts, and final construction costs. Notable requirements include professional registration/licensing in at least one of the requested service disciplines as defined in TGC 2254.002(A)(2), and the form must be completed and returned with the RFQ response.
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Text version
EXHIBIT H
A/E QUESTIONNAIRE FORM
1. Firm Name:
2. Address:
3. Tax Payer ID #:
4. E-mail Address:
5. Web Address:
6. Telephone: Fax:
7. Other Locations:
8. Organization Class: Individual Partnership
Corporation
Association
9. Date Established:
10. Former Business Name:
11. Date of Dissolution:
12. Subsidiary of:
13. Historically Underutilized Business Information: HUB? Yes No
Black American Hispanic American Native American American Woman
Other (specify)
14. Principals & Officers: (Names & Responsibilities: Management, Design, Production, Specification, Construction Administration, Business Development) Name Responsibility Name Responsibility
15. Key Personnel & Responsibilities:
Name Responsibility
16. Number of Personnel by Discipline*:
Discipline Number Number Registered Discipline Number Number Registered
Administration Interior Arch Architects Civil
Landscape Arch Environmental
Planning Drafting Programming Inspection
Structural Other (specify) Mechanical
Electrical
HVAC Net Total:
**Respondent must be registered/licensed, or have personnel on direct staff that are registered/licensed in at least one of the professional services discipline required to perform the services requested in this RFQ. Professional Services are defined in TGC 2254.002(A) (2).
17. Services Provided by Firm: (Please Check) Administration Architectural Drafting Inspection
Interior Arch Landscape Arch Planning Programming
Structural Mechanical Electrical HVAC
Civil Other (specify):
18. Professional Liability Coverage Errors & Omissions, etc.: Yes No
Amount:
19. Services Provided through Consultant (Please Check):
Administration Architectural Drafting Inspection
Interior Arch Landscape Arch Planning Programming Structural Mechanical Electrical HVAC
Civil Other (specify):
Name of Consultants Address
20. Geographical Limits:
21. Work Type Distribution by Proportion of Annual Average:
Work Type (Facility Use) % by Fee % by No. of Projects
Commercial, Office, Retail Industrial
Educational
Medical Other Institutional
Other (specify) Type:
New Building Design Restoration
Renovation
Interior Design Urban or Site Planning
Prime Engineering
Other (specify)
22. Projects in Last Five Years: See Attached
23. Date of Questionnaire:
24. Preparer Name:
Title:
Signature:
Schedule Compliance 5 most relevant completed projects
Design Phases Construction Phase
Insert Name of Project Here Study/ Analysis
Preliminary Design
Design Working Drawings
Construction Start
Substantial Completion
Contract Completion Date Actual Completion Date
Explanatory Note
Analysis
Preliminary
Design
Design Working
Drawings
Construction
Start
Substantial
Completion
Contract Completion Date
Analysis
Preliminary Design
Design Working Drawings
Construction Start
Substantial Completion
Contract Completion Date
Analysis
Preliminary Design
Design Working Drawings
Construction Start
Substantial Completion
Contract Completion Date
Analysis
Preliminary Design
Design Working Drawings
Construction Start
Substantial Completion
Contract Completion Date
Budget Compliance 5 most relevant completed projects
Insert Name of Project Here Comments:
Owner's Budget $ -
A/E Cost Estimate $ -
Successful Respondent Amount $ -
Construction Contract Amount $ -
Final Construction Cost $ -
Difference Between Initial Owner Budget and Contract Award
Insert Name of Project Here Comments:
Owner's Budget $ -
A/E Cost Estimate $ -
Successful Respondent Amount $ -
Construction Contract Amount $ -
Final Construction Cost $ -
Difference Between Initial Owner Budget and Contract Award
Insert Name of Project Here Comments:
Owner's Budget $ -
A/E Cost Estimate $ -
Successful Respondent Amount $ -
Construction Contract Amount $ -
Final Construction Cost $ -
Difference Between Initial Owner Budget and Contract Award
Insert Name of Project Here Comments:
Owner's Budget $ -
A/E Cost Estimate $ -
Successful Respondent Amount $ -
Construction Contract Amount $ -
Final Construction Cost $ -
Difference Between Initial Owner Budget and Contract Award
Insert Name of Project Here Comments:
Owner's Budget $ -
A/E Cost Estimate $ -
Successful Respondent Amount $ -
Construction Contract Amount $ -
Final Construction Cost $ -
Difference Between Initial Owner Budget and Contract Award
NOTE: THIS FORM MUST BE COMPLETED & RETURNED WITH THE RESPONSE
File details come from the government source that posted it. Updated .