ESBD_497746_1775683887938_0008505 Attachment B - A-E Questionnaire Form.docx
DOCX document 55 KB Posted
- Solicitation number
- 0008505
- Issued by
- Harris County, Texas
About this file
This is an Architect/Engineer (A/E) Questionnaire Form issued by the Texas Facilities Commission, Facilities Design and Construction division. The document serves as an application and qualification assessment tool for firms seeking to provide architectural and engineering services to the state of Texas. The questionnaire requests comprehensive firm information including business structure, organization history, HUB certification status, personnel credentials by discipline, service capabilities, and professional liability insurance coverage. Respondents must demonstrate that they maintain at least one registered or licensed professional in disciplines required for the specific services requested, as defined under Texas Government Code Section 2254.002(A)(2). The form requires firms to identify geographical service limits, work type distribution by proportion of annual revenue and project count, and detailed information on the five most relevant completed projects from the preceding five years.
The questionnaire includes two compliance sections requiring detailed project-specific information. The Schedule Compliance section requests documentation of design phases (study/analysis through preliminary and working drawings) and construction phases (start through final completion) for five relevant projects, including contract and actual completion dates with explanatory notes for any variances. The Budget Compliance section requires financial data for the same five projects, including owner's budget, A/E cost estimates, successful respondent amounts, construction contract amounts, final construction costs, and variance documentation between initial owner budgets and contract awards. The form does not specify pricing, set-asides, incumbent status, funding sources, or contract term information, as it functions primarily as a pre-qualification questionnaire rather than a formal solicitation document.
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A/E QUESTIONNAIRE
Texas Facilities Commission Facilities Design and Construction P.O. Box 13047 Austin, Texas 78711-3047
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
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
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
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
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
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 |
| $ - |
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