ESBD_534309_1783027807848_0009660 Attachment B - A-E Questionnaire Form.docx
DOCX document 54 KB Posted
- Solicitation number
- 0009660
- Issued by
- Texas
About this file
This is an Architect/Engineer (A/E) Questionnaire Form issued by the Texas Facilities Commission, Facilities Design and Construction division, for the RFQ regarding A/E Services for William P. Clements Restrooms and Breakrooms Renovations. The questionnaire requests comprehensive information from prospective firms seeking to provide architectural and engineering services for the project renovation work. Respondents must provide detailed organizational information, staffing credentials, professional qualifications, and relevant experience documentation. The form requires submission of information concerning firm organization, personnel by discipline with professional registrations and licenses, and specific services the firm can provide across multiple disciplines including architectural, structural, mechanical, electrical, HVAC, civil, and related design services.
The questionnaire mandates that responding firms demonstrate professional liability coverage and maintain staffing with at least one registered or licensed professional in disciplines required for the services requested under Texas Government Code 2254.002(A)(2). Firms must document their five most relevant completed projects from the past five years, providing detailed schedules for design phases (study/analysis, preliminary design, design development, and working drawings) and construction phases (construction start through final completion), along with budget compliance information showing owner's budget, A/E cost estimates, successful respondent amounts, construction contract amounts, final construction costs, and budget variances. Additionally, respondents must indicate geographical service limits, work type distribution by facility use and project type, and identify any services provided through subconsultants with corresponding consultant names and addresses. The form also collects information regarding firm classification, HUB status, and other organizational details necessary for vendor qualification and selection evaluation.
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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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