Sources Sought SF330-16e_FORM.pdf

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 ADDRESS7. FAX NUMBER6. TELEPHONE NUMBER

(Check)

P R

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TN

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

a.

b.

c.

d.

e.

f.

STANDARD FORM 330 (REV. 8/2016)

D. ORGANIZATIONAL CHART OF PROPOSED TEAM (Attached)

CHECK IF BRANCH OFFICE

CHECK IF BRANCH OFFICE

CHECK IF BRANCH OFFICE

CHECK IF BRANCH OFFICE

CHECK IF BRANCH OFFICE

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 FIRMa. 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. 8/2016) PAGE 2

a.

b.

c.

d.

(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

Check if project performed with current firm

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

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

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

Check if project performed with current firm

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

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. 8/2016) 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. UNIQUE ENTITY IDENTIFIER

5. OWNERSHIP

b. Discipline

c. Number 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. 8/2016) PAGE 6

1. SOLICITATION NUMBER (If any)

8a. FORMER FIRM NAME(S) (If any) 8b. YEAR ESTABLISHED

9. EMPLOYEES BY DISCIPLINE

Total

(1) FIRM (2) BRANCH

1. Less than $100,000

2. $100,000 to less than $250,000

3. $250,000 to less than $500,000

4. $500,000 to less than $1 million

5. $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. UNIQUE ENTITY IDENTIFIER

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

6. $2 million to less than $5 million

7. $5 million to less than $10 million

8. $10 million to less than $25 million

9. $25 million to less than $50 million

10. $50 million or greater

Other Employees

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. Unique Entity Identifier. Insert the unique entity identifier issued by the entity designated at SAM. 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 unique entity identifier. 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 representative 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. 8/2016)

PAGE 4 OF INSTRUCTIONS

List of Disciplines (Function Codes)

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. 8/2016)

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 continued)

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. 8/2016)

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 continued)

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