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1. SOLICITATION NUMBER (If any) <br />ARCHITECT -ENGINEER QUALIFICATIONS <br />PART II - GENERAL QUALIFICATIONS <br />(If a firm has branch offices, complete for each specific branch office seeking work.) <br />2a. FIRM (w8ranch Office) NAME 3. YEAR ESTABLISHED 4. UNIQUE ENTITY IDENTIFIER <br />2b. STREET 5. OWNERSHIP <br />a. TYPE <br />2c. CITY 2d. STATE 2e. ZIP CODE <br />b. SMALL BUSINESS STATUS <br />6a. POINT OF CONTACT NAME AND TITLE <br />7. NAME OF FIRM (If Bbck 2a is a Branch Office) <br />6b. TELEPHONE NUMBER 6c. E-MAILADDRESS <br />Be. FORMER FIRM NAME(S) (If any) 8b. YEAR ESTABLISHED I <br />8c. UNIQUE ENTITY IDENTIFIER <br />9. EMPLOYEES BY DISCIPLINE 10. PROFILE OF FIRM'S EXPERIENCE <br />AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS <br />a. Function b. Discipline Number of Employees a. Profile b. Experience c Revenue Numberndex <br />Code (1) FIRM (2) BRANCH Code <br />see below) <br />Other Employees <br />Total <br />11. ANNUAL AVERAGE PROFESSIONAL PROFESSIONAL SERVICES REVENUE INDEX NUMBER <br />SERVICES REVENUES OF FIRM <br />FOR LAST 3 YEARS 1. Less than $100,000 6. $2 million to less than $5 million <br />(Insert revenue index number shown at right) 2. $100,000 to less than $250,000 7. $5 million to less than $10 million <br />a. Federal Work 3. $250,000 to less than $500,000 8. $10 million to less than $25 million <br />b. Non -Federal Work 4. $500,000 to less than $1 million 9. $25 million to less than $50 million <br />c. Total Work 5. $1 million to less than $2 million 10. $50 million or greater <br />12. AUTHORIZED REPRESENTATIVE <br />The foregoing is a statement of facts. <br />a. SIGNATURE b.DATE <br />c. NAME AND TITLE <br />STANDARD FORM 330 (REV. 8/2016) PAGE 6 <br />