S02-Architect and Engineering qualifications SF330 Exhibit P.pdf

STANDARD FORM 330 (REV. 7/2021)AUTHORIZED FOR LOCAL REPRODUCTION

2. PUBLIC NOTICE DATE 3. SOLICITATION OR PROJECT NUMBER

ARCHITECT-ENGINEER QUALIFICATIONS

PART I - CONTRACT-SPECIFIC QUALIFICATIONS

A. CONTRACT INFORMATION

1. TITLE AND LOCATION (City and State)

B. ARCHITECT-ENGINEER POINT OF CONTACT

4. NAME AND TITLE

5. NAME OF FIRM

6. TELEPHONE NUMBER 7. FAX NUMBER 8. E-MAIL ADDRESS

C. PROPOSED TEAM

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

(Check)

9. FIRM NAME 10. ADDRESS 11. ROLE IN THIS CONTRACT

PR

IM

E J-

V

PA

R

TN

ER

SU

BC

O

N

TR

AC

TO

R a.

CHECK IF BRANCH OFFICE

b.

CHECK IF BRANCH OFFICE

c.

CHECK IF BRANCH OFFICE

d.

CHECK IF BRANCH OFFICE

e.

CHECK IF BRANCH OFFICE

f.

CHECK IF BRANCH OFFICE

D. ORGANIZATIONAL CHART OF PROPOSED TEAM (Attached)

36C24926R0002

STANDARD FORM 330 (REV. 7/2021) PAGE 2

16. EDUCATION (Degree and Specialization) 17. CURRENT PROFESSIONAL REGISTRATION (State and Discipline)

E. RESUMES OF KEY PERSONNEL PROPOSED FOR THIS CONTRACT

(Complete one Section E for each key person.)

12. NAME 13. ROLE IN THIS CONTRACT 14. YEARS EXPERIENCE

a. TOTAL b. WITH CURRENT FIRM

15. FIRM NAME AND LOCATION (City and State)

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

19. RELEVANT PROJECTS

a.

(1) TITLE AND LOCATION (City and State) (2) YEAR COMPLETED PROFESSIONAL SERVICES CONSTRUCTION (If applicable)

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm b.

(1) TITLE AND LOCATION (City and State) (2) YEAR COMPLETED PROFESSIONAL SERVICES CONSTRUCTION (If applicable)

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm c.

(1) TITLE AND LOCATION (City and State) (2) YEAR COMPLETED PROFESSIONAL SERVICES CONSTRUCTION (If applicable)

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm d.

(1) TITLE AND LOCATION (City and State) (2) YEAR COMPLETED PROFESSIONAL SERVICES CONSTRUCTION (If applicable)

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm e.

(1) TITLE AND LOCATION (City and State) (2) YEAR COMPLETED PROFESSIONAL SERVICES CONSTRUCTION (If applicable)

(3) BRIEF DESCRIPTION (Brief scope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm

STANDARD FORM 330 (REV. 7/2021) PAGE 3

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.)

20. EXAMPLE PROJECT KEY

NUMBER

21. TITLE AND LOCATION (City and State) 22. YEAR COMPLETED PROFESSIONAL SERVICES CONSTRUCTION (If applicable)

23. PROJECT OWNER'S INFORMATION

a. PROJECT OWNER b. POINT OF CONTACT NAME c. POINT OF CONTACT TELEPHONE NUMBER

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

25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT

a.

(1) FIRM NAME (2) FIRM LOCATION (City and State) (3) ROLE b.

(1) FIRM NAME (2) FIRM LOCATION (City and State) (3) ROLE c.

(1) FIRM NAME (2) FIRM LOCATION (City and State) (3) ROLE d.

(1) FIRM NAME (2) FIRM LOCATION (City and State) (3) ROLE e.

(1) FIRM NAME (2) FIRM LOCATION (City and State) (3) ROLE f.

(1) FIRM NAME (2) FIRM LOCATION (City and State) (3) ROLE

STANDARD FORM 330 (REV. 7/2021) PAGE 4

G. KEY PERSONNEL PARTICIPATION IN EXAMPLE PROJECTS

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 before completing table.

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

1 2 3 4 5 6 7 8 9 10

29. EXAMPLE PROJECTS KEY

N UMBER TITLE OF EXAMPLE PROJECT (From Section F) NUMBER TITLE OF EXAMPLE PROJECT (From Section F)

1 6

2 7

3 8

4 9

5 10

STANDARD FORM 330 (REV. 7/2021) PAGE 5

31. SIGNATURE 32. DATE

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.

33. NAME AND TITLE

STANDARD FORM 330 (REV. 7/2021) PAGE 6

a. SIGNATURE b. DATE

PART II - GENERAL QUALIFICATIONS

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

2a. FIRM (or Branch Office) NAME 3. YEAR ESTABLISHED 4. UNIQUE ENTITY IDENTIFIER

2b. STREET 5. OWNERSHIP

a. TYPE

2c. CITY 2d. STATE 2e. ZIP CODE

b. SMALL BUSINESS STATUS 6a. POINT OF CONTACT NAME AND TITLE

7. NAME OF FIRM (If Block 2a is a Branch Office)

6b. TELEPHONE NUMBER 6c. EMAIL ADDRESS

8a. FORMER FIRM NAME(S) (If any) 8b. YEAR ESTABLISHED 8c. UNIQUE ENTITY IDENTIFIER

9. EMPLOYEES BY DISCIPLINE 10. PROFILE OF FIRM'S EXPERIENCE

AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS

a. Function Code b. Discipline

c. Number of Employees a. Profile Code b. Experience

c. Revenue Index Number

(see below)(1) FIRM (2) BRANCH

Other Employees Total

11. ANNUAL AVERAGE PROFESSIONAL

SERVICES REVENUES OF FIRM

FOR LAST 3 YEARS

(Insert revenue index number shown at right)

PROFESSIONAL SERVICES REVENUE INDEX NUMBER

1. Less than $100,000 6. $2 million to less than $5 million

2. $100,000 to less than $250,000 7. $5 million to less than $10 million

3. $250,000 to less than $500,000 8. $10 million to less than $25 million

4. $500,000 to less than $1 million 9. $25 million to less than $50 million

5. $1 million to less than $2 million 10. $50 million or greater

a. Federal Work

b. Non-Federal Work

c. Total Work

12. AUTHORIZED REPRESENTATIVE

The foregoing is a statement of facts.

c. NAME AND TITLE

1. SOLICITATION NUMBER (If any)

ARCHITECT-ENGINEER QUALIFICATIONS