Attachment_3_-_SF_330.pdf

PDF 11 MB Posted Mar 8, 2016

Attached to: Architect-Engineering Services (AES) Federal contract opportunity
Solicitation number: NNJ16571636R
Issued by: National Aeronautics and Space Administration Johnson Space Center

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A-E RFQ Amendment 1 - Attachment 3 - SF 330

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File	Type	Posted
SF_30-Amendment_3.pdf	PDF	Mar 21, 2016
Amendment_3_Page_2.pdf	PDF	Mar 21, 2016
SF_30_-_A E_Amendment_2.pdf	PDF	Mar 14, 2016
Amendment_2_A E_Page_2.docx	DOCX document	Mar 14, 2016
Amendment_1_Pages_2_-_5.pdf	PDF	Mar 8, 2016
Request_for_Qualifications-Amendment_1.pdf	PDF	Mar 8, 2016
SF_30_-_Amendment_1.pdf	PDF	Mar 8, 2016
A-E_Request_for_Qualifications.pdf	PDF	Feb 22, 2016
ATTACHMENT_2_Past_Performance_Questionnaire_and_Cover_Letter.docx	DOCX document	Feb 22, 2016
ATTACHMENT_1_-_NPR_8820.2G.pdf	PDF	Feb 22, 2016

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NNJ16571636R

ATTACHMENT 3 – STANDARD FORM 330

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C:\PERFORM\FORMS\S330.FRP

Barbara Williams

ARCHITECT-ENGINEER QUALIFICATIONS

OMB No.: 9000-0157 Expires: 11/30/2017

STANDARD FORM 330 (REV. 3/2013) PAGE 1 OF INSTRUCTIONS Prescribed by GSA - FAR (48 CFR) 53.236-2(b)

PURPOSE

Federal agencies use this form to obtain information from architect-engineer (A-E) firms about their professional qualifications. Federal agencies select firms for A-E contracts on the basis of professional qualifications as required by 40 U.S.C. chapter 11, Selection of Architects Engineers, and Part 36 of the Federal Acquisition Regulation (FAR).

The Selection of Architects and Engineers statute requires the public announcement of requirements for A-E services (with some exceptions provided by other statutes), and the selection of at least three of the most highly qualified firms based on demonstrated competence and professional qualifications according to specific criteria published in the announcement. The Act then requires the negotiation of a contract at a fair and reasonable price starting first with the most highly qualified firm.

The information used to evaluate firms is from this form and other sources, including performance evaluations, any additional data requested by the agency, and interviews with the most highly qualified firms and their references.

GENERAL INSTRUCTIONS

Part I presents the qualifications for a specific contract.

Part II presents the general qualifications of a firm or a specific branch office of a firm. Part II has two uses:

1. An A-E firm may submit Part II to the appropriate central, regional or local office of each Federal agency to be kept on file. A public announcement is not required for certain contracts, and agencies may use Part II as a basis for selecting at least three of the most highly qualified firms for discussions prior to requesting submission of Part I. Firms are encouraged to update Part II on file with agency offices, as appropriate, according to FAR Part 36. If a firm has branch offices, submit a separate Part II for each branch office seeking work.

2. Prepare a separate Part II for each firm that will be part of the team proposed for a specific contract and submitted with Part I. If a firm has branch offices, submit a separate Part II for each branch office that has a key role on the team.

INDIVIDUAL AGENCY INSTRUCTIONS

Individual agencies may supplement these instructions. For example, they may limit the number of projects or number of pages submitted in Part I in response to a public announcement for a particular project. Carefully comply with any agency instructions when preparing and submitting this form. Be as concise as possible and provide only the information requested by the agency.

DEFINITIONS

Architect-Engineer Services: Defined in FAR 2.101.

Branch Office: A geographically distinct place of business or subsidiary office of a firm that has a key role on the team.

Discipline: Primary technical capabilities of key personnel, as evidenced by academic degree, professional registration, certification, and/or extensive experience.

Firm: Defined in FAR 36.102.

Key Personnel: Individuals who will have major contract responsibilities and/or provide unusual or unique expertise.

SPECIFIC INSTRUCTIONS

Part I - Contract-Specific Qualifications

Section A. Contract Information.

1. Title and Location. Enter the title and location of the contract for which this form is being submitted, exactly as shown in the public announcement or agency request.

2. Public Notice Date. Enter the posted date of the agency's notice on the Federal Business Opportunity website (FedBizOpps), other form of public announcement or agency request for this contract.

3. Solicitation or Project Number. Enter the agency's solicitation number and/or project number, if applicable, exactly as shown in the public announcement or agency request for this contract.

Section B. Architect-Engineer Point of Contact.

4-8. Name, Title, Name of Firm, Telephone Number, Fax (Facsimile) Number and E-mail (Electronic Mail) Address. Provide information for a representative of the prime contractor or joint venture that the agency can contact for additional information.

AUTHORIZED FOR LOCAL REPRODUCTION

PAPERWORK REDUCTION ACT STATEMENT: Public reporting burden for this collection of information is estimated to average 29 hours (25 hours for part 1 and 4 hours for Part 2) per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing this burden, to U.S. General Services Administration, Regulatory Secretariat (MVCB)/IC 9000-0157, Office of Governmentwide Acquisition Policy,1800 F Street, NW, Washington, DC 20405.

Section C. Proposed Team.

9-11. Firm Name, Address, and Role in This Contract. Provide the contractual relationship, name, full mailing address, and a brief description of the role of each firm that will be involved in performance of this contract. List the prime contractor or joint venture partners first. If a firm has branch offices, indicate each individual branch office that will have a key role on the team. The named subcontractors and outside associates or consultants must be used, and any change must be approved by the contracting officer. (See FAR Part 52 Clause "Subcontractors and Outside Associates and Consultants (Architect-Engineer Services)".) Attach an additional sheet in the same format as Section C if needed.

Section D. Organizational Chart of Proposed Team.

As an attachment after Section C, present an organizational chart of the proposed team showing the names and roles of all key personnel listed in Section E and the firm they are associated with as listed in Section C.

Section E. Resumes of Key Personnel Proposed for This Contract.

Complete this section for each key person who will participate in this contract. Group by firm, with personnel of the prime contractor or joint venture partner firms first. The following blocks must be completed for each resume:

12. Name. Self-explanatory.

13. Role in This Contract. Self-explanatory.

14. Years Experience. Total years of relevant experience (block 14a), and years of relevant experience with current firm, but not necessarily the same branch office (block 14b).

15. Firm Name and Location. Name, city and state of the firm where the person currently works, which must correspond with one of the firms (or branch office of a firm, if appropriate) listed in Section C.

16. Education. Provide information on the highest relevant academic degree(s) received. Indicate the area(s) of specialization for each degree.

17. Current Professional Registration. Provide information on current relevant professional registration(s) in a State or possession of the United States, Puerto Rico, or the District of Columbia according to FAR Part 36.

18. Other Professional Qualifications. Provide information on any other professional qualifications relating to this contract, such as education, professional registration, publications, organizational memberships, certifications, training, awards, and foreign language capabilities.

19. Relevant Projects. Provide information on up to five projects in which the person had a significant role that demonstrates the person's capability relevant to her/his proposed role in this contract. These projects do not necessarily have to be any of the projects presented in Section F for the project team if the person was not involved in any of those projects or the person worked on other projects that were more relevant than the team projects in Section F. Use the check box provided to indicate if the project was performed with any office of the current firm. If any of the professional services or construction projects are not complete, leave Year Completed blank and indicate the status in Brief Description and Specific Role (block (3)).

Section F. Example Projects Which Best Illustrate Proposed Team's Qualifications for This Contract.

Select projects where multiple team members worked together, if possible, that demonstrate the team's capability to perform work similar to that required for this contract. Complete one Section F for each project. Present ten projects, unless otherwise specified by the agency. Complete the following blocks for each project:

20. Example Project Key Number. Start with "1" for the first project and number consecutively.

21. Title and Location. Title and location of project or contract. For an indefinite delivery contract, the location is the geographic scope of the contract.

22. Year Completed. Enter the year completed of the professional services (such as planning, engineering study, design, or surveying), and/or the year completed of construction, if applicable. If any of the professional services or the construction projects are not complete, leave Year Completed blank and indicate the status in Brief Description of Project and Relevance to This Contract (block 24).

23a. Project Owner. Project owner or user, such as a government agency or installation, an institution, a corporation or private individual.

23b. Point of Contact Name. Provide name of a person associated with the project owner or the organization which contracted for the professional services, who is very familiar with the project and the firm's (or firms') performance.

23c. Point of Contact Telephone Number Self-explanatory.

24. Brief Description of Project and Relevance to This Contract. Indicate scope, size, cost, principal elements and special features of the project. Discuss the relevance of the example project to this contract. Enter any other information requested by the agency for each example project.

STANDARD FORM 330 (REV. 3/2013) PAGE 2 OF INSTRUCTIONS

Jane A. Smith

Joseph B. Williams

Tara C. Donovan

Chief Architect

Chief Mech. Engineer

Chief Elec. Engineer

29. EXAMPLE PROJECTS KEY

25. Firms from Section C Involved with This Project. Indicate which firms (or branch offices, if appropriate) on the project team were involved in the example project, and their roles. List in the same order as Section C.

Section G. Key Personnel Participation in Example Projects.

This matrix is intended to graphically depict which key personnel identified in Section E worked on the example projects listed in Section F. Complete the following blocks (see example below).

26. and 27. Names of Key Personnel and Role in This Contract. List the names of the key personnel and their proposed roles in this contract in the same order as they appear in Section E.

28. Example Projects Listed in Section F. In the column under each project key number (see block 29) and for each key person, place an "X" under the project key number for participation in the same or similar role.

29. Example Projects Key. List the key numbers and titles of the example projects in the same order as they appear in Section F.

Section H. Additional Information.

30. Use this section to provide additional information specifically requested by the agency or to address selection criteria that are not covered by the information provided in Sections A-G.

Section I. Authorized Representative.

31. and 32. Signature of Authorized Representative and Date. An authorized representative of a joint venture or the prime contractor must sign and date the completed form. Signing attests that the information provided is current and factual, and that all firms on the proposed team agree to work on the project. Joint ventures selected for negotiations must make available a statement of participation by a principal of each member of the joint venture.

33. Name and Title. Self-explanatory.

STANDARD FORM 330 (REV. 3/2013) PAGE 3 OF INSTRUCTIONS

SAMPLE ENTRIES FOR SECTION G (MATRIX)

26. NAMES OF KEY PERSONNEL

(From Section E, Block 12)

27. ROLE IN THIS CONTRACT (From Section E, Block 13)

28. EXAMPLE PROJECTS LISTED IN SECTION F

(Fill in "Example Projects Key" section below first, before completing table. Place "X" under project key number for participation in same or similar role.)

NO.

TITLE OF EXAMPLE PROJECT (FROM SECTION F)

NO.

TITLE OF EXAMPLE PROJECT (FROM SECTION F)

XYZ Corporation Headquarters, Boston, MA

Founder's Museum, Newport RI

Federal Courthouse, Denver, CO

Justin J. Wilson Federal Building, Baton Rouge, LA

Part II - General Qualifications

See the " General Instructions " on page 1 for firms with branch offices. Prepare Part II for the specific branch office seeking work if the firm has branch offices.

1. Solicitation Number. If Part II is submitted for a specific contract, insert the agency's solicitation number and/or project number, if applicable, exactly as shown in the public announcement or agency request.

2a-2e. Firm (or Branch Office) Name and Address. Self-explanatory.

3. Year Established. Enter the year the firm (or branch office, if appropriate) was established under the current name.

4. DUNS Number. Insert the Data Universal Numbering System number issued by Dun and Bradstreet Information Services. Firms must have a DUNS number. See FAR Part 4.6.

5. Ownership.

a. Type. Enter the type of ownership or legal structure of the firm (sole proprietor, partnership, corporation, joint venture, etc.).

b. Small Business Status. Refer to the North American Industry Classification System (NAICS) code in the public announcement, and indicate if the firm is a small business according to the current size standard for that NAICS code (for example, Engineering Services (part of NAICS 541330), Architectural Services (NAICS 541310), Surveying and Mapping Services (NAICS 541370)). The small business categories and the internet website for the NAICS codes appear in FAR Part 19. Contact the requesting agency for any questions. Contact your local U.S. Small Business Administration office for any questions regarding Business Status.

6a-6c. Point of Contact. Provide this information for a representative of the firm that the agency can contact for additional information. The representative must be empowered to speak on contractual and policy matters.

7. Name of Firm. Enter the name of the firm if Part II is prepared for a branch office.

8a-8c. Former Firm Names. Indicate any other previous names for the firm (or branch office) during the last six years. Insert the year that this corporate name change was effective and the associated DUNS Number. This information is used to review past performance on Federal contracts.

9. Employees by Discipline. Use the relevant disciplines and associated function codes shown at the end of these instructions and list in the same numerical order. After the listed disciplines, write in any additional disciplines and leave the function code blank. List no more than 20 disciplines. Group remaining employees under "Other Employees" in column b. Each person can be counted only once according to his/her primary function. If Part II is prepared for a firm (including all branch offices), enter the number of employees by disciplines in column c(1). If Part II is prepared for a branch office, enter the number of employees by discipline in column c(2) and for the firm in column c(1).

10. Profile of Firm's Experience and Annual Average Revenue for Last 5 Years. Complete this block for the firm or branch office for which this Part II is prepared. Enter the experience categories which most accurately reflect the firm's technical capabilities and project experience. Use the relevant experience categories and associated profile codes shown at the end of these instructions, and list in the same numerical order. After the listed experience categories, write in any unlisted relevant project experience categories and leave the profile codes blank. For each type of experience, enter the appropriate revenue index number to reflect the professional services revenues received annually (averaged over the last 5 years) by the firm or branch office for performing that type of work. A particular project may be identified with one experience category or it may be broken into components, as best reflects the capabilities and types of work performed by the firm. However, do not double count the revenues received on a particular project.

11. Annual Average Professional Services Revenues of Firm for Last 3 Years. Complete this block for the firm or branch office for which this Part II is prepared. Enter the appropriate revenue index numbers to reflect the professional services revenues received annually (averaged over the last 3 years) by the firm or branch office. Indicate Federal work (performed directly for the Federal Government, either as the prime contractor or subcontractor), non-Federal work (all other domestic and foreign work, including Federally-assisted projects), and the total. If the firm has been in existence for less than 3 years, see the definition for "Annual Receipts" under FAR 19.101.

12. Authorized Representative. An authorized represent- ative of the firm or branch office must sign and date the completed form. Signing attests that the information provided is current and factual. Provide the name and title of the authorized representative who signed the form.

STANDARD FORM 330 (REV. 3/2013) PAGE 4 OF INSTRUCTIONS

List of Disciplines (Function Codes)

STANDARD FORM 330 (REV. 3/2013) PAGE 5 OF INSTRUCTIONS

Code

Description

Hydraulic Engineer

Hydrographic Surveyor

Hydrologist

Industrial Engineer

Industrial Hygienist

Interior Designer

Land Surveyor

Landscape Architect

Materials Engineer

Materials Handling Engineer

Mechanical Engineer

Mining Engineer

Oceanographer

Photo Interpreter

Photogrammetrist

Planner: Urban/Regional

Project Manager

Remote Sensing Specialist

Risk Assessor

Safety/Occupational Health Engineer

Sanitary Engineer

Scheduler

Security Specialist

Soils Engineer

Specifications Writer

Structural Engineer

Technician/Analyst

Toxicologist

Transportation Engineer

Value Engineer

Water Resources Engineer

Code

Description

Acoustical Engineer

Administrative

Aerial Photographer

Aeronautical Engineer

Archeologist

Architect

Biologist

CADD Technician

Cartographer

Chemical Engineer

Chemist

Civil Engineer

Communications Engineer

Computer Programmer

Construction Inspector

Construction Manager

Corrosion Engineer

Cost Engineer/Estimator

Ecologist

Economist

Electrical Engineer

Electronics Engineer

Environmental Engineer

Environmental Scientist

Fire Protection Engineer

Forensic Engineer

Foundation/Geotechnical Engineer

Geodetic Surveyor

Geographic Information System Specialist

Geologist

Health Facility Planner

List of Experience Categories (Profile Codes)

Acoustics, Noise Abatement

Aerial Photography; Airborne Data and Imagery Collection and Analysis

Agricultural Development; Grain Storage; Farm Mechanization

Air Pollution Control

Airports; Navaids; Airport Lighting; Aircraft Fueling

Airports; Terminals and Hangars; Freight Handling

Arctic Facilities

Animal Facilities

Anti-Terrorism/Force Protection

Asbestos Abatement

Auditoriums & Theaters

Automation; Controls; Instrumentation

Barracks; Dormitories

Bridges

Cartography

Cemeteries (Planning & Relocation)

Charting: Nautical and Aeronautical

Chemical Processing & Storage

Child Care/Development Facilities

Churches; Chapels

Coastal Engineering

Codes; Standards; Ordinances

Cold Storage; Refrigeration and Fast Freeze

Commercial Building (low rise) ; Shopping Centers

Community Facilities

Communications Systems; TV; Microwave

Computer Facilities; Computer Service

Conservation and Resource Management

Construction Management

Construction Surveying

Corrosion Control; Cathodic Protection; Electrolysis

Cost Estimating; Cost Engineering and Analysis; Parametric Costing; Forecasting

Cryogenic Facilities

Dams (Concrete; Arch)

Dams (Earth; Rock); Dikes; Levees

Desalinization (Process & Facilities)

Design-Build - Preparation of Requests for Proposals

Digital Elevation and Terrain Model Development

Digital Orthophotography

Dining Halls; Clubs; Restaurants

Dredging Studies and Design

Ecological & Archeological Investigations

Educational Facilities; Classrooms

Electrical Studies and Design

Electronics

Elevators; Escalators; People-Movers

Embassies and Chanceries

Energy Conservation; New Energy Sources

Engineering Economics

Environmental Impact Studies, Assessments or Statements

Environmental and Natural Resource Mapping

Environmental Planning

Environmental Remediation

Environmental Testing and Analysis

Fallout Shelters; Blast-Resistant Design

Field Houses; Gyms; Stadiums

Fire Protection

Fisheries; Fish ladders

Forensic Engineering

Forestry & Forest products

Garages; Vehicle Maintenance Facilities; Parking Decks

Gas Systems (Propane; Natural, Etc.)

Geodetic Surveying: Ground and Air-borne

Geographic Information System Services: Development, Analysis, and Data Collection

Geospatial Data Conversion: Scanning, Digitizing, Compilation, Attributing, Scribing, Drafting

Graphic Design

Harbors; Jetties; Piers, Ship Terminal Facilities

Hazardous Materials Handling and Storage

Hazardous, Toxic, Radioactive Waste Remediation

Heating; Ventilating; Air Conditioning

Health Systems Planning

Highrise; Air-Rights-Type Buildings

Highways; Streets; Airfield Paving; Parking Lots

Historical Preservation

Hospital & Medical Facilities

Hotels; Motels

Housing (Residential, Multi-Family; Apartments; Condominiums)

Hydraulics & Pneumatics

Hydrographic Surveying

STANDARD FORM 330 (REV. 3/2013) PAGE 6 OF INSTRUCTIONS

Code

Description

Code

Description

A01

A02

A03

A04

A05

A06

A07

A08

A09

A10

A11

A12

B01

B02

C01

C02

C03

C04

C05

C06

C07

C08

C09

C10

C11

C12

C13

C14

C15

C16

C17

C18

C19

D01

D02

D03

D04

D05

D06

D07

D08

E01

E02

E03

E04

E05

E06

E07

E08

E09

E10

E11

E12

E13

F01

F02

F03

F04

F05

F06

G01

G02

G03

G04

G05

G06

H01

H02

H03

H04

H05

H06

H07

H08

H09

H10

H11

H12

H13

List of Experience Categories (Profile Codes)

Product, Machine Equipment Design

Pneumatic Structures, Air-Support Buildings

Postal Facilities

Power Generation, Transmission, Distribution

Public Safety Facilities

Radar; Sonar; Radio & Radar Telescopes

Radio Frequency Systems & Shieldings

Railroad; Rapid Transit

Recreation Facilities (Parks, Marinas, Etc.)

Refrigeration Plants/Systems

Rehabilitation (Buildings; Structures; Facilities)

Remote Sensing

Research Facilities

Resources Recovery; Recycling

Risk Analysis

Rivers; Canals; Waterways; Flood Control

Roofing

Safety Engineering; Accident Studies; OSHA Studies

Security Systems; Intruder & Smoke Detection

Seismic Designs & Studies

Sewage Collection, Treatment and Disposal

Soils & Geologic Studies; Foundations

Solar Energy Utilization

Solid Wastes; Incineration; Landfill

Special Environments; Clean Rooms, Etc.

Structural Design; Special Structures

Surveying; Platting; Mapping; Flood Plain Studies

Sustainable Design

Swimming Pools

Storm Water Handling & Facilities

Telephone Systems (Rural; Mobile; Intercom, Etc.)

Testing & Inspection Services

Traffic & Transportation Engineering

Topographic Surveying and Mapping

Towers (Self-Supporting & Guyed Systems)

Tunnels & Subways

STANDARD FORM 330 (REV. 3/2013) PAGE 7 OF INSTRUCTIONS

Code

Description

Code

Description

I01

I02

I03

I04

I05

I06

J01

L01

L02

L03

L04

L05

L06

M01

M02

M03

M04

M05

M06

M07

M08

N01

N02

N03

O01

O02

O03

P01

P02

P03

P04

P05

P06

P07

P08

P09

P10

P11

P12

P13

R01

R02

R03

R04

R05

R06

R07

R08

R09

R10

R11

R12

S01

S02

S03

S04

S05

S06

S07

S08

S09

S10

S11

S12

S13

T01

T02

T03

T04

T05

T06

Industrial Buildings; Manufacturing Plants

Industrial Processes; Quality Control

Industrial Waste Treatment

Intelligent Transportation Systems

Interior Design; Space Planning

Irrigation; Drainage

Judicial and Courtroom Facilities

Laboratories; Medical Research Facilities

Land Surveying

Landscape Architecture

Libraries; Museums; Galleries

Lighting (Interior; Display; Theater, Etc.)

Lighting (Exteriors; Streets; Memorials; Athletic Fields, Etc.)

Mapping Location/Addressing Systems

Materials Handling Systems; Conveyors; Sorters

Metallurgy

Microclimatology; Tropical Engineering

Military Design Standards

Mining & Mineralogy

Missile Facilities (Silos; Fuels; Transport)

Modular Systems Design; Pre-Fabricated Structures or Components

Naval Architecture; Off-Shore Platforms

Navigation Structures; Locks

Nuclear Facilities; Nuclear Shielding

Office Buildings; Industrial Parks

Oceanographic Engineering

Ordnance; Munitions; Special Weapons

Petroleum Exploration; Refining

Petroleum and Fuel (Storage and Distribution)

Photogrammetry

Pipelines (Cross-Country - Liquid & Gas)

Planning (Community, Regional, Areawide and State)

Planning (Site, Installation, and Project)

Plumbing & Piping Design

Prisons & Correctional Facilities

List of Experience Categories (Profile Codes)

STANDARD FORM 330 (REV. 3/2013) PAGE 8 OF INSTRUCTIONS

Code

Description

U01

U02

U03

V01

W01

W02

W03

W04

Z01

Unexploded Ordnance Remediation

Urban Renewals; Community Development

Utilities (Gas and Steam)

Value Analysis; Life-Cycle Costing

Warehouses & Depots

Water Resources; Hydrology; Ground Water

Water Supply; Treatment and Distribution

Wind Tunnels; Research/Testing Facilities Design

Zoning; Land Use Studies

5. NAME OF FIRM

PART I - CONTRACT-SPECIFIC QUALIFICATIONS

ARCHITECT - ENGINEER QUALIFICATIONS

A. CONTRACT INFORMATION

1. TITLE AND LOCATION (City and State)

2. PUBLIC NOTICE DATE

3. SOLICITATION OR PROJECT NUMBER

B. ARCHITECT-ENGINEER POINT OF CONTACT

C. PROPOSED TEAM

(Complete this section for the prime contractor and all key subcontractors.)

4. NAME AND TITLE

8. E-MAIL ADDRESS

7. FAX NUMBER

6. TELEPHONE NUMBER

(Check)

PRIME

J-V PARTNER

SUBCON-

TRACTOR

9. FIRM NAME

10. ADDRESS

11. ROLE IN THIS CONTRACT

STANDARD FORM 330 (REV. 3/2013) PAGE 1

D. ORGANIZATIONAL CHART OF PROPOSED TEAM

(Attached)

CHECK IF BRANCH OFFICE

AUTHORIZED FOR LOCAL REPRODUCTION

12. NAME

13. ROLE IN THIS CONTRACT

18. OTHER PROFESSIONAL QUALIFICATIONS (Publications, Organizations, Training, Awards, etc.)

E. RESUMES OF KEY PERSONNEL PROPOSED FOR THIS CONTRACT

(Complete one Section E for each key person.)

14. YEARS EXPERIENCE

b. WITH CURRENT FIRM

a. TOTAL

17. CURRENT PROFESSIONAL REGISTRATION (STATE AND DISCIPLINE)

16. EDUCATION (DEGREE AND SPECIALIZATION)

15. FIRM NAME AND LOCATION (City and State)

STANDARD FORM 330 (REV. 3/2013) PAGE 2

(1) TITLE AND LOCATION (City and State)

PROFESSIONAL SERVICES

CONSTRUCTION (If applicable)

(1) TITLE AND LOCATION (City and State)

(2) YEAR COMPLETED

PROFESSIONAL SERVICES

CONSTRUCTION (If applicable)

(1) TITLE AND LOCATION (City and State)

(2) YEAR COMPLETED

PROFESSIONAL SERVICES

CONSTRUCTION (If applicable)

(1) TITLE AND LOCATION (City and State)

(2) YEAR COMPLETED

PROFESSIONAL SERVICES

CONSTRUCTION (If applicable) e.

Check if project performed with current firm

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE

Check if project performed with current firm

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE

19. RELEVANT PROJECTS

(1) TITLE AND LOCATION (City and State)

(2) YEAR COMPLETED

PROFESSIONAL SERVICES

CONSTRUCTION (If applicable)

(2) YEAR COMPLETED

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE

Check if project performed with current firm

F. EXAMPLE PROJECTS WHICH BEST ILLUSTRATE PROPOSED TEAM'S

QUALIFICATIONS FOR THIS CONTRACT

(Present as many projects as requested by the agency, or 10 projects, if not specified.

Complete one Section F for each project.)

a. PROJECT OWNER

21. TITLE AND LOCATION (City and State)

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT

24. BRIEF DESCRIPTION OF PROJECT AND RELEVANCE TO THIS CONTRACT (Include scope, size, and cost)

20. EXAMPLE PROJECT KEY NUMBER

(1) FIRM NAME

(2) FIRM LOCATION (City and State)

(3) ROLE

(1) FIRM NAME

(2) FIRM LOCATION (City and State)

(3) ROLE

(1) FIRM NAME

(2) FIRM LOCATION (City and State)

(3) ROLE

(1) FIRM NAME

(2) FIRM LOCATION (City and State)

STANDARD FORM 330 (REV. 3/2013) PAGE 3

(3) ROLE

(1) FIRM NAME

(2) FIRM LOCATION (City and State)

(3) ROLE

b. POINT OF CONTACT NAME

23. PROJECT OWNER'S INFORMATION

c. POINT OF CONTACT TELEPHONE NUMBER

(3) ROLE

(1) FIRM NAME

(2) FIRM LOCATION (City and State)

22. YEAR COMPLETED

PROFESSIONAL SERVICES

CONSTRUCTION (If applicable)

TITLE OF EXAMPLE PROJECT (FROM SECTION F)

G. KEY PERSONNEL PARTICIPATION IN EXAMPLE PROJECTS

STANDARD FORM 330 (REV. 3/2013) PAGE 4

26. NAMES OF KEY PERSONNEL

(From Section E, Block 12)

27. ROLE IN THIS

CONTRACT

(From Section E, Block 13)

29. EXAMPLE PROJECTS KEY

NO.

TITLE OF EXAMPLE PROJECT (FROM SECTION F)

NO.

28. EXAMPLE PROJECTS LISTED IN SECTION F

(Fill in "Example Projects Key" section below before completing table.

Place "X" under project key number for participation in same or similar role.)

H. ADDITIONAL INFORMATION

30. PROVIDE ANY ADDITIONAL INFORMATION REQUESTED BY THE AGENCY. ATTACH ADDITIONAL SHEETS AS NEEDED.

I. AUTHORIZED REPRESENTATIVE

The foregoing is a statement of facts.

31. SIGNATURE

32. DATE

33. NAME AND TITLE

STANDARD FORM 330 (REV. 3/2013) PAGE 5

PART II - GENERAL QUALIFICATIONS

(If a firm has branch offices, complete for each specific branch office seeking work.)

a. SIGNATURE

ARCHITECT-ENGINEER QUALIFICATIONS

2a. FIRM (OR BRANCH OFFICE) NAME

2b. STREET

2c. CITY

2d. STATE

2e. ZIP CODE

3. YEAR ESTABLISHED

4. DUNS NUMBER

5. OWNERSHIP

b. Discipline

c. No. of Employees

10. PROFILE OF FIRM'S EXPERIENCE

AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS

b. Experience

c. Revenue Index Number

(see below)

STANDARD FORM 330 (REV. 3/2013) PAGE 6

1. SOLICITATION NUMBER (If any)

8a. FORMER FIRM NAME(S) (If any)

8b. YR. ESTABLISHED

9. EMPLOYEES BY DISCIPLINE

Total

(1) FIRM

(2) BRANCH

Less than $100,000

$100,00 to less than $250,000

$250,000 to less than $500,000

$500,000 to less than $1 million

$1 million to less than $2 million

11. ANNUAL AVERAGE PROFESSIONAL SERVICES REVENUES OF FIRM

FOR LAST 3 YEARS

(Insert revenue index number shown at right)

7. NAME OF FIRM (If block 2a is a branch office)

6a. POINT OF CONTACT NAME AND TITLE

6c. E-MAIL ADDRESS

8c. DUNS NUMBER

a. Federal Work

b. Non-Federal Work

c. Total Work

12. AUTHORIZED REPRESENTATIVE

The foregoing is a statement of facts.

b. DATE

c. NAME AND TITLE

a. Function Code

a. Profile Code

6b. TELEPHONE NUMBER

a. TYPE

b. SMALL BUSINESS STATUS

PROFESSIONAL SERVICES REVENUE INDEX NUMBER

$2 million to less than $5 million

$5 million to less than $10 million

$10 million to less than $25 million

$25 million to less than $50 million

10.

$50 million or greater

Other Employees

AUTHORIZED FOR LOCAL REPRODUCTION

21. TITLE AND LOCATION (City and State):

12. c. NAME AND TITLE:

7. NAME OF FIRM (If block 2a is a branch office):

6. c. E-MAIL ADDRESS:

A. CONTRACT INFORMATION 3. SOLICITATION OR PROJECT NUMBER:

6. b. TELEPHONE NUMBER:

B. ARCHITECT-ENGINEER POINT OF CONTACT. 7. FAX NUMBER:

A. CONTRACT INFORMATION. 2. PUBLIC NOTICE DATE. Enter 2 digit month, 2 digit day and 4 digit year.:

C. PROPOSED TEAM. a. PRIME:

C. PROPOSED TEAM. a. SUBCONTRACTOR:

C. PROPOSED TEAM. b. SUBCONTRACTOR:

C. PROPOSED TEAM. c. SUBCONTRACTOR:

C. PROPOSED TEAM. d. SUBCONTRACTOR:

C. PROPOSED TEAM. e. SUBCONTRACTOR:

C. PROPOSED TEAM. f. SUBCONTRACTOR:

C. PROPOSED TEAM. a. JV PARTNER:

C. PROPOSED TEAM. b. JV PARTNER:

C. PROPOSED TEAM. c. JV PARTNER:

C. PROPOSED TEAM. d. JV PARTNER:

C. PROPOSED TEAM. e. JV PARTNER:

C. PROPOSED TEAM. f. JV PARTNER:

C. PROPOSED TEAM. b. PRIME:

C. PROPOSED TEAM. c. PRIME:

C. PROPOSED TEAM. d. PRIME:

C. PROPOSED TEAM. e. PRIME:

C. PROPOSED TEAM. f. PRIME:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. a. 1. FIRM NAME:

C. PROPOSED TEAM. 10a. ADDRESS:

C. PROPOSED TEAM. 11a. ROLE IN THIS CONTRACT:

C. PROPOSED TEAM. 11b. ROLE IN THIS CONTRACT:

C. PROPOSED TEAM. 11c. ROLE IN THIS CONTRACT:

C. PROPOSED TEAM. 11d. ROLE IN THIS CONTRACT:

C. PROPOSED TEAM. 11e. ROLE IN THIS CONTRACT:

C. PROPOSED TEAM. 11f. ROLE IN THIS CONTRACT:

C. PROPOSED TEAM. 10b. ADDRESS:

C. PROPOSED TEAM. 10c. ADDRESS:

C. PROPOSED TEAM. 10d. ADDRESS:

C. PROPOSED TEAM. 10e. ADDRESS:

C. PROPOSED TEAM. 10f. ADDRESS:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. b. 1. FIRM NAME:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. c. 1. FIRM NAME:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. e. 1. FIRM NAME:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. f. 1. FIRM NAME:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. d. 1. FIRM NAME:

19. RELEVANT PROJECTS. a. 3. Check if project performed with current firm:

19. RELEVANT PROJECTS. b. 3. Check if project performed with current firm:

19. RELEVANT PROJECTS. c. 3. Check if project performed with current firm:

19. RELEVANT PROJECTS. d. 3. Check if project performed with current firm:

19. RELEVANT PROJECTS. e. 3. Check if project performed with current firm:

9. f. CHECK IF BRANCH OFFICE:

D. ORGANIZATIONAL CHART OF PROPOSED TEAM. (Attached):

12. NAME:

2. a. FIRM (OR BRANCH OFFICE) NAME:

16. EDUCATION (DEGREE AND SPECIALIZATION):

18. OTHER PROFESSIONAL QUALIFICATIONS (Publications, Organizations, Training, Awards, etc.):

19. RELEVANT PROJECTS. a. 1. TITLE AND LOCATION (City and State):

19. RELEVANT PROJECTS. a. 3. BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE:

19. RELEVANT PROJECTS. b. 3. BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE:

19. RELEVANT PROJECTS. c. 3. BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE:

19. RELEVANT PROJECTS. d. 3. BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE:

19. RELEVANT PROJECTS. e. 3. BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE:

19. RELEVANT PROJECTS. b. 1. TITLE AND LOCATION (City and State):

19. RELEVANT PROJECTS. c. 1. TITLE AND LOCATION (City and State):

19. RELEVANT PROJECTS. d. 1. TITLE AND LOCATION (City and State):

19. RELEVANT PROJECTS. e. 1. TITLE AND LOCATION (City and State):

17. CURRENT PROFESSIONAL REGISTRATION (STATE AND DISCIPLINE):

27. ROLE IN THIS CONTRACT (From Section E, Block 13). :

14. YEARS EXPERIENCE. a. TOTAL:

14. YEARS EXPERIENCE. b. WITH CURRENT FIRM:

22. YEAR COMPLETED. PROFESSIONAL SERVICES. :

22. YEAR COMPLETED. CONSTRUCTION(If Applicable). :

23. PROJECT OWNER'S INFORMATION. a. PROJECT OWNER:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. a. 3. ROLE:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. b. 3. ROLE:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. c. 3. ROLE:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. d. 3. ROLE:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. e. 3. ROLE:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. f. 3. ROLE:

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. a. 2. FIRM LOCATION (City and State):

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. c. 2. FIRM LOCATION (City and State):

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. d. 2. FIRM LOCATION (City and State):

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. e. 2. FIRM LOCATION (City and State):

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. f. 2. FIRM LOCATION (City and State):

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT. b. 2. FIRM LOCATION (City and State):

24. BRIEF DESCRIPTION OF PROJECT AND RELEVANCE TO THIS CONTRACT (Include scope, size, and cost):

6. a. POINT OF CONTACT NAME AND TITLE:

20. EXAMPLE PROJECT KEY NUMBER:

26. NAMES OF KEY PERSONNEL

(From Section E, Block 12). Line 20 of 20.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 1.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 4.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 5.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 6.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 10.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 9.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 8.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table. Place "X" under project key number for participation in same or similar role.) 7.:

28. EXAMPLE PROJECTS LISTED IN SECTION F. (Fill in "Example Projects Key" section below before completing table.

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File details come from the government source that posted it. Updated Nov 14, 2017.