HomeMy WebLinkAboutAttachment A SF330-16eARCHITECT -ENGINEER QUALIFICATIONS
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ration Date: 1213112020
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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 STANDARD FORM 330 (REV. 812016) PAGE 1 OF INSTRUCTIONS
Prescribed by GSA - FAR (48 CFR) 53.236-2(b)
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.
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
As an attachment after Section C, present an organizational together, if possible, that demonstrate the team's capability to
chart of the proposed team showing the names and roles of all perform work similar to that required for this contract. Complete
key personnel listed in Section E and the firm they are one Section F for each project. Present ten projects, unless
associated with as listed in Section C. otherwise specified by the agency. Complete the following
blocks for each project:
Section E. Resumes of Key Personnel Proposed for this
Contract. 20. Example Project Key Number. Start with "1" for the first
project and number consecutively.
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.
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. 812016)
PAGE 2 OF INSTRUCTIONS
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.
26. NAMES OF KEY
PERSONNEL
(From Section E,
Block 12)
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.
SAMPLE ENTRIES FOR SECTION G (MATRIX)
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 'V under project key number for
participation in same or similar role.)
1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 F 10
Jane A. Smith Chief Architect X X
Joseph B. Williams Chief Mechanical Engineer X X X X
Tara C. Donovan Chief Electricial Engineer X X X
29. EXAMPLE PROJECTS KEY
JUMBER
TITLE OF EXAMPLE PROJECT (From Section F)
NUMBER
TITLE OF EXAMPLE PROJECT (From Section F)
1
Federal Courthouse, Denver, CO
6
XYZ Corporation Headquarters, Boston, MA
2
Justin J. Wilson Federal Building,
Baton Rouge, LA
7
Founder's Museum, Newport, RI
STANDARD FORM 330 (REV=177
PAGE 3 OF INSTRUCTIONS
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 PartII
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. 812016)
PAGE 4 OF INSTRUCTIONS
List of Disciplines (Function Codes)
Code
Description
Code
01
Acoustical Engineer
32
02
Administrative
33
03
Aerial Photographer
34
04
Aeronautical Engineer
35
O5
Archeologist
36
06
Architect
37
07
Biologist
38
08
CADD Technician
39
09
Cartographer
40
10
Chemical Engineer
41
11
Chemist
42
12
Civil Engineer
43
13
Communications Engineer
44
14
Computer Programmer
45
15
Construction Inspector
46
16
Construction Manager
47
17
Corrosion Engineer
48
18
Cost Engineer/Estimator
49
19
Ecologist
50
20
Economist
51
21
Electrical Engineer
52
22
Electronics Engineer
53
23
Environmental Engineer
54
24
Environmental Scientist
55
25
Fire Protection Engineer
56
26
Forensic Engineer
57
27
Foundation/Geotechnical Engineer
58
28
Geodetic Surveyor
59
29
Geographic Information System Specialist
60
30
Geologist
61
31
Health Facility Planner
62
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
STANDARD FORM 330 (REV. 812016)
PAGE 5 OF INSTRUCTIONS
List of Experience Categories (Profile Codes)
Code
Description
Code
Description
A01
Acoustics, Noise Abatement
E01
Ecological & Archeological Investigations
A02
Aerial Photography, Airborne Data and Imagery
E02
Educational Facilities, Classrooms
Collection and Analysis
E03
Electrical Studies and Design
A03
Agricultural Development, Grain Storage, Farm Mechanization
E04
Electronics
A04
Air Pollution Control
E05
Elevators, Escalators, People -Movers
A05
Airports, Navaids; Airport Lighting, Aircraft Fueling
E06
Embassies and Chanceries
A06
Airports, Terminals and Hangars, Freight Handling
E07
Energy Conservation, New Energy Sources
A07
Arctic Facilities
E08
Engineering Economics
E09
Environmental Impact Studies,
A08
Animal Facilities
Assessments or Statements
A09
Anti-Terrorism/Force Protection
E10
Environmental and Natural Resource
A10
Asbestos Abatement
Mapping
All
Auditoriums & Theaters
El
Environmental Planning
Al2
Automation, Controls, Instrumentation
E12
Environmental Remediation
E13
Environmental Testing and Analysis
B01
Barracks, Dormitories
B02
Bridges
F01
Fallout Shelters, Blast -Resistant Design
F02
Field Houses, Gyms, Stadiums
C01
Cartography
F03
Fire Protection
CO2
Cemeteries (Planning & Relocation)
F04
Fisheries, Fish ladders
CO3
Charting: Nautical and Aeronautical
FO5
Forensic Engineering
F06
Forestry & Forest products
C04
Chemical Processing & Storage
CO5
Child Care/Development Facilities
G01
Garages, Vehicle Maintenance Facilities,
C06
Churches, Chapels
Parking Decks
C07
Coastal Engineering
G02
Gas Systems (Propane, Natural, Etc.)
C08
Codes, Standards, Ordinances
G03
Surve Y in Ground and Air -borne
Geodetic 9
C09
Cold Storage, Refrigeration and Fast Freeze
G04
Geographic Information System Services:
C10
Commercial Building (low rise) , Shopping Centers
Development, Analysis, and Data Collection
C11
Community Facilities
GO5
Geospatial Data Conversion: Scanning,
C12
Communications Systems, TV, Microwave
Digitizing, Compilation, Attributing, Scribing,
C13
Computer Facilities, Computer Service
Drafting
C14
Conservation and Resource Management
G06
Graphic Design
C15
Construction Management
H01
Harbors; Jetties; Piers, Ship Terminal
C16
Construction Surveying
Facilities
C17
Corrosion Control, Cathodic Protection, Electrolysis
H02
Hazardous Materials Handling and Storage
C18
Cost Estimating, Cost Engineering and
H03
Hazardous, Toxic, Radioactive Waste
Analysis, Parametric Costing, Forecasting
Remediation
C19
Cryogenic Facilities
H04
Heating, Ventilating, Air Conditioning
HO5
Health Systems Planning
D01
Dams (Concrete, Arch)
H06
Highrise; Air -Rights -Type Buildings
D02
Dams (Earth, Rock), Dikes, Levees
H07
Highways, Streets, Airfield Paving, Parking
Lots
D03
Desalinization (Process & Facilities)
H08
Historical Preservation
D04
Design -Build - Preparation of Requests for Proposals
H09
Hospital & Medical Facilities
DO5
Digital Elevation and Terrain Model Development
H10
Hotels, Motels
D06
Digital Orthophotography
H11
Housing (Residential, Multi -Family,
D07
Dining Halls, Clubs, Restaurants
Apartments, Condominiums)
D08
Dredging Studies and Design
H12
Hydraulics & Pneumatics
H13
Hydrographic Surveying
STANDARD FORM 330 (REV. 812016)
PAGE 6 OF INSTRUCTIONS
STANDARD FORM 330 (REV. 812016)
PAGE 7 OF INSTRUCTIONS
List of Experience Categories (Profile Codes continued)
Code
Description
Code
Description
101
Industrial Buildings, Manufacturing Plants
P09
Product, Machine Equipment Design
102
Industrial Processes, Quality Control
P10
Pneumatic Structures, Air -Support Buildings
103
Industrial Waste Treatment
P11
Postal Facilities
104
Intelligent Transportation Systems
P12
Power Generation, Transmission, Distribution
105
Interior Design, Space Planning
P13
Public Safety Facilities
106
Irrigation, Drainage
R01
Radar, Sonar, Radio & Radar Telescopes
J01
Judicial and Courtroom Facilities
R02
Radio Frequency Systems & Shieldings
L01
Laboratories, Medical Research Facilities
R03
Railroad, Rapid Transit
L02
Land Surveying
R04
Recreation Facilities (Parks, Marinas, Etc.)
L03
Landscape Architecture
RO5
Refrigeration Plants/Systems
L04
Libraries, Museums, Galleries
R06
Rehabilitation (Buildings, Structures, Facilities)
LO5
Lighting (Interior, Display, Theater, Etc.)
R07
Remote Sensing
L06
Lighting (Exteriors, Streets, Memorials,
R08
Research Facilities
Athletic Fields, Etc.)
R09
Resources Recovery; Recycling
M01
Mapping Location/Addressing Systems
R10
Risk Analysis
M02
Materials Handling Systems, Conveyors, Sorters
Rl l
Rivers, Canals, Waterways, Flood Control
M03
Metallurgy
R12
Roofing
M04
Microclimatology; Tropical Engineering
S01
Safety Engineering; Accident Studies; OSHA
MO5
Military Design Standards
Studies
M06
Mining & Mineralogy
S02
Security Systems, Intruder & Smoke Detection
M07
Missile Facilities (Silos, Fuels, Transport)
S03
Seismic Designs & Studies
M08
Modular Systems Design, Pre -Fabricated Structures or
SO4
Sewage Collection, Treatment and Disposal
Components
SO5
Soils &Geologic Studies; Foundations
S06
Solar Energy Utilization
N01
Naval Architecture, Off -Shore Platforms
S07
Solid Wastes; Incineration; Landfill
NO2
Navigation Structures, Locks
S08
Special Environments, Clean Rooms, Etc.
NO3
Nuclear Facilities, Nuclear Shielding
S09
Structural Design, Special Structures
001
Office Buildings; Industrial Parks
S10
Surveying, Platting, Mapping, Flood
002
Oceanographic Engineering
Plain Studies
003
Ordnance, Munitions, Special Weapons
S11
Sustainable Design
S12
Swimming Pools
P01
Petroleum Exploration, Refining
S13
Storm Water Handling & Facilities
P02
Petroleum and Fuel (Storage and Distribution)
T01
Telephone Systems (Rural, Mobile; Intercom,
P03
Photogrammetry
Etc.)
PO4
Pipelines (Cross -Country - Liquid & Gas)
T02
Testing & Inspection Services
PO5
Planning (Community, Regional, Areawide and State)
T03
Traffic & Transportation Engineering
T04
Topographic Surveying and Mapping
P06
Planning (Site, Installation, and Project)
TO5
Towers (Self -Supporting & Guyed Systems)
P07
Plumbing & Piping Design
T06
Tunnels & Subways
P08
Prisons & Correctional Facilities
STANDARD FORM 330 (REV. 812016)
PAGE 7 OF INSTRUCTIONS
List of Experience Categories (Profile Codes continued)
Code
Description
U01
Unexploded Ordnance Remediation
UO2
Urban Renewals, Community Development
UO3
Utilities (Gas and Steam)
Vol
Value Analysis, Life -Cycle Costing
W01
Warehouses & Depots
W02
Water Resources, Hydrology, Ground Water
W03
Water Supply, Treatment and Distribution
W04
Wind Tunnels, Research/Testing Facilities Design
Z01
Zoning, Land Use Studies
STANDARD FORM 330 (REV. 812016)
PAGE 8 OF INSTRUCTIONS
ARCHITECT - ENGINEER QUALIFICATIONS
PART I - CONTRACT -SPECIFIC QUALIFICATIONS
A. CONTRACT INFORMATION
1. TITLEAND LOCATION (Cityand State)
2. PUBLIC NOTICE DATE 3. SOLICITATION OR PROJECT NUMBER
B. ARCHITECT -ENGINEER POINT OF CONTACT
4. NAMEANDTITLE
5. NAME OF FIRM
6. TELEPHONE NUMBER 7. FAX NUMBER 8.E-MAILADDRESS
C. PROPOSED TEAM
(Complete this section for the prime contractor and all key subcontractors.)
D. ORGANIZATIONAL CHART OF PROPOSED TEAM ❑ (Attached)
AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 330 (REV. 812016)
(Check)
woo
�Z'°
9. FIRM NAME
10. ADDRESS
11. ROLE IN THIS CONTRACT
a
'¢Dm
m
wo
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)
AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 330 (REV. 812016)
E. RESUMES OF KEY PERSONNEL PROPOSED FOR THIS CONTRACT
(Complete one Section E for each key person.)
15. FIRM NAME AND LOCATION (Cdyand State)
16. EDUCATION (Degree and Specialization)
17. CURRENT PROFESSIONAL REGISTRATION (State and Discipline)
18. OTHER PROFESSIONAL QUALIFICATIONS (Publications, Organizations, Training, Awards, etc.)
19. RELEVANT PROJECTS
STANDARD FORM 330 (REV. 8/2016) PAGE 2
(1) TITLE AND LOCATION (Cdy and State)
(2) YEAR COMPLETED
PROFESSIONAL SERVICES
CONSTRUCTION (If applicable)
a.
(3) BRIEF DESCRIPTION (Briefscope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm
(1) TITLE AND LOCATION (Cdy and State)
(2) YEAR COMPLETED
PROFESSIONAL SERVICES
CONSTRUCTION (If applicable)
b.
(3) BRIEF DESCRIPTION (Briefscope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm
(1) TITLE AND LOCATION (Cdy and State)
(2) YEAR COMPLETED
PROFESSIONAL SERVICES CONSTRUCTION (If applicable)
C.
(3) BRIEF DESCRIPTION (Briefscope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm
(1) TITLE AND LOCATION (Cdy and State)
(2) YEAR COMPLETED
PROFESSIONAL SERVICES
CONSTRUCTION (If applicable)
d
(3) BRIEF DESCRIPTION (Briefscope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm
(1) TITLE AND LOCATION (Cdy and State)
(2) YEAR COMPLETED
PROFESSIONAL SERVICES
CONSTRUCTION (If applicable)
e.
(3) BRIEF DESCRIPTION (Briefscope, size, cost, etc.) AND SPECIFIC ROLE Check if project performed with current firm
STANDARD FORM 330 (REV. 8/2016) PAGE 2
QUALIFICATIONS FOR THIS CONTRACT
(Present as many projects as requested by the agency, or 10 pro
Complete one Section F for each proiect. )
21. TITLEAND LOCATION (Cdyand State)
a. PROJECT OWNER
20. EXAMPLE PROJECT KEY
NUMBER
if not specified.
22. YEAR COMPLETED
PROFESSIONAL SERVICES I CONSTRUCTION (If applicable)
23. PROJECT OWNER'S INFORMATION
b. POINT OF CONTACT NAME
scope,
C. rUHN I Ur UUN IAU I I eLern UNe IVUIVIbtK
25. FIRMS FROM SECTION C INVOLVED WITH THIS PROJECT
STANDARD FORM 330 (REV. 8/2016) PAGE 3
(1) FIRM NAME
(2) FIRM LOCATION (Cityand State)
(3) ROLE
a.
(1) FIRM NAME
(2) FIRM LOCATION (Cityand State)
(3) ROLE
b.
(1) FIRM NAME
(2) FIRM LOCATION (Cityand State)
(3) ROLE
C.
(1) FIRM NAME
(2) FIRM LOCATION (Cityand State)
(3) ROLE
d.
(1) FIRM NAME
(2) FIRM LOCATION (Cityand State)
(3) ROLE
e.
(1) FIRM NAME
(2) FIRM LOCATION (Cityand State)
(3) ROLE
f.
STANDARD FORM 330 (REV. 8/2016) PAGE 3
G. KEY PERSONNEL PARTICIPATION IN EXAMPLE PROJECTS
26. NAMES OF KEY 27. ROLE IN THIS 28. EXAMPLE PROJECTS LISTED IN SECTION F
PERSONNEL CONTRACT (Fill in "Example Projects Key" section below before completing table.
(From Section E, Block 12) (From Section E, Block 13) Place "X" under project key number for participation in same or similar role.)
1 1 2 1 3 1 4 1 5 1 6 1 7 1 8 1 9 1 10
29. EXAMPLE PROJECTS KEY
DUMBER
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. 8/2016) PAGE 4
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. 8/2016) PAGE 5
1. SOLICITATION NUMBER (If any)
ARCHITECT -ENGINEER QUALIFICATIONS
PART II - GENERAL QUALIFICATIONS
(If a firm has branch offices, complete for each specific branch office seeking work.)
2a. FIRM (w8ranch 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 Bbck 2a is a Branch Office)
6b. TELEPHONE NUMBER 6c. E-MAILADDRESS
Be. FORMER FIRM NAME(S) (If any) 8b. YEAR ESTABLISHED I
8c. UNIQUE ENTITY IDENTIFIER
9. EMPLOYEES BY DISCIPLINE 10. PROFILE OF FIRM'S EXPERIENCE
AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS
a. Function b. Discipline Number of Employees a. Profile b. Experience c Revenue Numberndex
Code (1) FIRM (2) BRANCH Code
see below)
Other Employees
Total
11. ANNUAL AVERAGE PROFESSIONAL PROFESSIONAL SERVICES REVENUE INDEX NUMBER
SERVICES REVENUES OF FIRM
FOR LAST 3 YEARS 1. Less than $100,000 6. $2 million to less than $5 million
(Insert revenue index number shown at right) 2. $100,000 to less than $250,000 7. $5 million to less than $10 million
a. Federal Work 3. $250,000 to less than $500,000 8. $10 million to less than $25 million
b. Non -Federal Work 4. $500,000 to less than $1 million 9. $25 million to less than $50 million
c. Total Work 5. $1 million to less than $2 million 10. $50 million or greater
12. AUTHORIZED REPRESENTATIVE
The foregoing is a statement of facts.
a. SIGNATURE b.DATE
c. NAME AND TITLE
STANDARD FORM 330 (REV. 8/2016) PAGE 6