C1DA--Facility Wide Security Camera Upgrade

PUBLIC ANNOUNCEMENT FOR PROCUREMENT OF ARCHITECT-ENGINEERING (A/E) SERVICES: This is a request for Standard Form 330, Architect-Engineer Qualifications only. A-E Services are being procured in accordance with the Selection of Architects and Engineers Statute (Public Law 92-582), formerly known as the Brooks Act, and implemented in Federal Acquisition Regulation (FAR) subpart 36.6. All submissions will be evaluated in accordance with the below selection criteria. The Government will not pay, nor reimburse, any costs associated with responding to this request. The Government is under no obligation to award a contract as a result of this announcement. Firms will be selected based on demonstrated competence and qualifications for the required work. Any resulting award for the proposed A/E services will be procured under a negotiated Firm-Fixed Price contract. The NAICS Code for this acquisition is 541330, Engineering Services, and the applicable Small Business Size Standard is $16.5 million annual revenue. During performance, the selected A/E firm will be required to attend meetings in person, on site, at the Salem VA Medical Center, Salem, VA. Therefore, the area of consideration is RESTRICTED to a maximum 500-mile radius of the Salem VA Medical Center, 1970 Roanoke Blvd, Salem, Virginia 24153 in which either the A/E firm s Primary or established Auxiliary/Satellite office must be located. NOTE: The 500-mile radius will be measured by one or more of the nationally recognized commercial free on-line mapping services from the Primary or established Auxiliary/Satellite Office Address to the above VA address (shortest driving distance option). Proximity of the firms assigned office, to the project site, including within the 500-mile radius, is one of the criteria on which selection of the most highly qualified firms will be based. Interested parties shall ensure current licensing to provide real property design services (Engineer Services) in accordance with the State regulations of which the firms assigned office is located, and shall have a current registration in: (1.) the System for Award Management (SAM) database at https://www.sam.gov, (2.) and the Vendor Information Pages database at http://www.va.gov/osdbu, if applicable, and (3.) have submitted the current cycle VETS-4212 Report at http://www.dol.gov/vets/programs/fcp/main.htm (for contracts in the amount of $150,000.00 or more). Failure of a proposed SDVOSB to be certified by the CVE at the time the SF 330 is submitted shall result in elimination from further consideration. DUE DATE FOR SF330 QUALIFICATIONS SUBMISSIONS: July 14, 2020 @ 11:00am EST PROJECT INFORMATION: Project No.: 658-20-105 Project Title: Facility Wide Security Camera Upgrade Place of Performance: Salem VA Medical Center (VAMC), 1970 Roanoke Blvd, Salem, Virginia 24153 A/E SCOPE OF WORK PROJECT NO. 658-20-105 FACILITY WIDE SECURITY CAMERA UPGRADE VETERANS AFFAIRS MEDICAL CENTER SALEM, VA 24153 1. General Description of Services: Provide professional engineering services to include option analysis and development, investigative surveys and reports, phasing design, planning, consultation and visits, design work, preparation of contract drawings and specifications, preparation of cost estimates and provision of construction period services as necessary for demolition, construction, inspection, testing and certification for all required components for Project 658-20-105 Facility Wide Security Camera Upgrade, at Salem VA Medical Center (VAMC), Salem, Virginia. 2. Project Description: The intent of this project is to provide a complete design to replace and upgrade the existing security camera system at the Salem VAMC, Lynchburg, Staunton, and Wytheville Community Based Outpatient Clinics to a new high definition CCTV monitoring system to include replacement of replace all field equipment, head-end recordings, displays, and communications systems. VASS shall be designed and engineered as stand-alone system systems with their own infrastructure at each Medical facility and CBOC location. The design shall include replacement of the existing sixty-nine (69) security cameras with new IP camera and the addition of new IP cameras as needed to comply with VA Physical Security Design Standards. VASS shall be designed and engineered as stand-alone system systems with their own infrastructure at each Medical facility and CBOC location. A critical element of this design will be ensuring the Salem VA Medical Center remains fully operational during construction and impacts of construction are minimized to the greatest extent possible. In particular, AE shall carefully review the impact of construction on medical instrument and equipment cleaning/sterilization services, warehouse operations and storage capacity, and shipping/receiving services at loading docks to ensure these services remain fully operational throughout construction. Based on the scope of work for this project it is anticipated certain aspects of construction will be significantly limited to include means and methods of construction, work hours, noise restrictions, infection control limitations, and construction/connection of temporary facilities. It is the responsibility of the AE to work with medical facility staff to identify and define facility operations and services that will be affected and develop a plan to minimize impacts to the affected services. These requirements shall be clearly detailed in the contract drawings and specifications. 3. Construction Amount: The project is to be designed within an estimated base construction cost of $1,218,500 with at least 2 deduct alternates totaling 20%. If the base bid cost exceeds budget and deduct alternates do not bring the project within the construction budget, the A/E shall redesign or take steps necessary to reduce cost so that budget limitations are not exceeded. 4. Design Standards: The project design shall be completed in accordance with this A/E scope and all appropriate Department of Veterans Affairs (VA) design standards, manuals, guides, specifications, and other criteria unless otherwise approved by the VA. The A/E shall retrieve all VA design information and standards from the VA Facilities Web Site (http://www.va.gov/facmgt/standard). These documents and all national, state and local codes adopted and used by the VA shall be incorporated into the design of this project and reflected in the construction cost estimate. The facility record drawings and AutoCAD files are available for the A/E s use. NOTE: Not all record drawings are available on AutoCAD. Additionally, the A/E is responsible for field verification of all facility record drawings. 5. BIM Requirements: Design is to be accomplished using AutoCAD 2016 to include BIM. Design and cost estimates to be in compliance with A/E requirements listed on the VA website. 6. Construction Period Services: As part of the A/E design and construction period services is required to purchase and utilize Submittal Exchange. All documents transmitted for purposes of administration of the contract are to be in electronic (PDF) format and transmitted via an Internet-based submittal service that receives, logs and stores documents, provides electronic stamping and signatures, and notifies addressees via email. Internet-based submittal service shall be used for transmittal of all submittals, request for information (RFI), progress documentation, contract modification documents (e.g. change proposals, change orders), certified payrolls, daily reports, test reports, and any other document the COR wishes to make part of the project record. Prime Contractors, subcontractors, suppliers, and Architect's consultants are to be permitted to use the service at no extra charge. Paper document transmittals will not be reviewed; emailed PDF documents will not be reviewed. All other specified submittal and document transmission procedures apply, except that electronic document requirements do not apply to samples or color selection charts. The cost of the service is to be paid for by A/E Set up ownership of the electronic submittal service account such that the Government is the sole owner and has full rights to the account. Coordinate with the Contracting Officer Representative to fulfill this requirement. Submittal Service: The selected service is: Submittal Exchange (tel: 1-800714-0024): www.submittalexchange.com. Training: Selected service shall include web-based training sessions for Government, Contractor, and AE personnel. Project Closeout: The AE shall maintain Submittal Exchange services for 90 days following VA acceptance of the final design. Selected internet based service shall provide archived copies of all files to the Government as part of closeout. 7. Energy Requirements: New construction and applicable renovations shall meet the Federal Government s standard for a sustainable building the following shall be incorporated into the project: Any facet of renovation must meet the minimum requirements of ASHRAE Standard 90.1 2010 or most current standard effective at the time of AE contract award. A one-page summary of key components will be provided with the design information from the VA. The summary which will be provided is not all encompassing, and the Standard s compliance report shall be submitted at the Final Design phase for each facet of the design as required by the standard. In addition to the ASHRAE Standard 90.1 compliance reports, the A/E shall evaluate applicability of VHA requirements with regards to LEED or Green Globe certification and make a recommendation to the VA with regards to applicability to this Project. The final decision with regards to applicability of certification requirements shall rest with the VA. The project shall be designed to meet all federal energy conservation requirements and goals applicable to VHA projects. 8. Deductive Alternates: AE shall ensure the project design includes viable deductive alternates equal to approximately 20 percent of the construction funding limitation to ensure construction award within program budget limitations. The number of deductive alternates shall be a minimum of two. 9. Construction Estimate: AE shall provide an estimate of construction project costs for all work required for the base bid and the bid alternatives. Cost estimates shall be revised for each design submittal. AE shall prepare cost estimate in accordance with PG-18-15 A/E Submission Requirements. 10. Equipment List: The design shall require that the construction/installation contractor provide a complete report containing the list of items installed in the project which will require periodic maintenance or observation, the frequency of required maintenance/observation, details of the maintenance, and any other information necessary to inform future maintenance activities of the Medical Center maintenance staff. The A/E shall provide for a complete review of this report submittal as part of Construction Period Services rendered by the A/E and shall coordinate this report/list with Logistics Services to insure all applicable items are addressed for future maintenance and proper registry of the items into the Medical Center s tracking systems for maintenance and property disposition. 11. Construction Schedule and Phasing Requirements: Contractor shall provide a construction schedule IAW AE submission PG 18-15 for the project. 12. Deliverables: Quantities of design review materials for each design submission are provided below. Schematic Design, Design Development, and Construction Document Submissions: One (1) set design drawings, complete set bound with all disciplines, Arch D (24 x 36) size. One (1) set design drawings, separated and bound by each discipline, Arch D (24 x 36) size. Three (3) sets design drawings, complete set bound with all disciplines, Arch C (18 x 24) size. One (1) hardcopy copy, edited/marked-up VA Master Specifications of each discipline with VA Master Specification Table of Contents. One (1) hardcopy, Cost Estimate One (1) hardcopy copy, AE Preliminary Schedule One (1) hardcopy, design narratives and investigative reports. One (1) Electronic copy on CD, BIM Model and Drawing Files in BIM Software format. One (1) electronic copy of all design deliverables listed above in (pdf format). Final Construction Document Submission: One complete set (1) Arch D (24 x 36) size sets of the design drawings. Three (3) Arch C (18 x 24) size sets of the design drawings. Two (2) sets complete typed reproducible specifications (unbound) plus a copy on CD ROM in Word format. Note: The specification sections shall be one document on the CD ROM, not individual documents. These shall also incorporate Sections edited by the Salem VAMC in Sections 00 and 01. (ADD NOTE for PDF specifications to have sections AND ONLY the sections book marked.) Two (2) copies of typed Final cost and schedule estimates, plus a copy on CD ROM in Excel format. One (1) hardcopy of design narratives and investigative reports. One (1) electronic set of all design deliverables in (pdf format). BIM Model and drawing files in BIM Software format. One (1) copy of the final scope of work and including base bid and all deduct alternates in Microsoft Word Format. Each bid item and deducts shall have the estimated cost and duration included for that item of work based on the final AE cost estimate and preliminary schedule. Two (2) sets of final digital/hardcopy engineering calculations (if applicable). List of sole source items with justification (if applicable). List of Or-equal items with justification (if applicable). 14. Schedule of Deliverables: All deliverables are required 140 days from NTP. This schedule is provided for planning purposes only. The selected A/E must be able to deliver on this timeline; dates subject to change based on actual NTP. The A/E shall develop a design schedule and provide monthly progress updates throughout the design process. AE Project Schedule of Deliverables Facility Wide Security Camera Upgrade Duration 140 days NTP 0 days Design Charette* 7 days Schematic Design 14 days VA Review 14 days Schematic Design Review Meeting 1 day Design Development 14 days VA Review 14 days Design Development Review Meeting 1 day Construction Document Development 14 days VA Review 14 days Construction Document Review Meeting 1 day Final Construction Documents 14 days Total Duration 140 days * Design Charette shall be scheduled within 7 days of NTP. Notes: Durations provided above are shown in calendar days. Design Charrette shall be scheduled within 7 calendar days following receipt of NTP. All activities are scheduled using finish to start relationships. Total contract duration was calculated using CPM scheduling software and is based on a 5 day work week w/ standard federal holidays. 15. As-Builts: Upon completion of construction and incorporation of all revisions required to complete the Building Information Model and record drawings, the following items shall be submitted: Two (2) sets, reproducible hard copy as-built plans, Arch E1 (30 X 42 ) One (1) electronic copy on CD-ROM, as-built drawings in AutoCAD format, current release. One (1) electronic copy on CD-ROM, complete Building Information Model. PROJECT DESCRIPTION: The A/E shall provide design services for Minor construction project 658-20-105, Facility Wide Security Camera Upgrade . Design shall comply with VA guidelines and specifications. Design manuals and specifications can be found at http://www.cfm.va.gov/TIL/. Proposed work is located at Salem VA Medical Center. Project shall be designed and constructed to meet all VA sustainability, green and energy initiatives. Project targets reduced energy consumption by 30%. A/E is responsible for all documentation and correspondence necessary for final certification and ensuring all regulatory requirements are met for certification. This is a cradle to grave process ensuring certifications and approvals are documented and submitted. Guidance is available at http://www.cfm.va.gov/til/sustain.asp. DESIGN COSTS: All offerors are advised that in accordance with VAAR 836.606-73(a) the total cost of the architect or engineer services contracted for must not exceed six percent (6%) of the estimated cost of the construction project plus any fees for related services and activities. Additionally, FAR 52.236-22 Design Within Funding Limitations, will be applicable to this procurement action. Design limitation costs will be provided to the most highly rated AE firm(s) selected in accordance with the process outlined below. SDVOSB SET-ASIDE: This request for A-E firm qualifications packages is 100% set-aside for Service-Disabled Veteran Owned Small Business (SDVOSB) concerns under VAAR 852.219-10, VA Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside (Dec 2009). LIMITATIONS ON SUBCONTRACTING: In accordance with VAAR 852.219-10, VA Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside and 13 CFR 125.6, a service disabled veteran-owned small business concern (SDVOSB) agrees that, in the performance of the contract, it will not pay more than 50% of the amount paid by the government to it, to firms that are not similarly situated. Firms that are similarly situated are those that are also CVE-registered SDVOSBs. SELECTION PROCESS: The agency has convened an evaluation board for the evaluation of responses to this notice. Responses will be evaluated in accordance with the Selection of Architects and Engineers Statute (Public Law 92-582), formerly known as the Brooks Act, and implemented in Federal Acquisition Regulation (FAR) 36.6. Specifically, SF 330 submissions will be evaluated to identify the most highly qualified firms, using the selection criteria identified below. Discussions will be held with at least three (3) of the most highly qualified firms. Interviews may be conducted. The processes at FAR 36.602-4 and FAR 36.606 will then be followed. DUE DATE FOR SF330 QUALIFICATIONS SUBMISSIONS: Firms that meet the requirements listed in this announcement are invited to electronically submit the completed Standard Form (SF) 330 (Parts I and II) packages to [email protected] no later than 11:00am EST, July 14, 2020. Submissions should be encrypted and may require multiple emails. The single email limit for file attachments is 10MB per email. Late proposal rules found in FAR 15.208 will be followed for late submittals. Acknowledgement of receipt will be provided, which will include the number of emails and number of attachments received. Twenty-One (21) calendar days are being provided from date of issuance to respond to this notice. All SF 330 submissions shall be clearly marked with the subject line displaying the Solicitation Number 36C246200659. The SF 330 form may be downloaded from https://www.gsa.gov/reference/forms, and is also provided as an attachment to this notice. Completed SF 330 shall include the primary firms, subcontractor firms, and any consultants expected to be used on the project. Selection Criteria in their SF 330 s and additional documents/submittals. THIS IS NOT A REQUEST FOR PROPOSAL. THERE ARE NO SOLICITATION DOCUMENTS AVAILABLE. This is a request for SF 330, Architect/Engineer Qualifications packages only. Any requests for a solicitation will not receive a response. EVALUATION FACTORS FOR AWARD THIS SECTION IS FOR SOLICITATION PURPOSES ONLY. THIS SECTION WILL BE PHYSICALLY REMOVED FROM ANY RESULTANT AWARD, BUT WILL BE DEEMED INCORPORATED BY REFERENCE. The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer conforming to the solicitation will be most advantageous to the Government, and other factors considered. The following factors shall be used to evaluate offers: Professional Qualification Specialized Experience and Technical Competence Capacity Past Performance Locations Quality Control Plan Experience in Construction Period Services The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer conforming to the solicitation will be most advantageous to the Government, and other factors considered. Boards will evaluate firms' qualifications strictly on the basis of the announced selection criteria and their stated order of importance. The criteria will be applied as follows: Professional Qualifications (FAR 36.602-1(a)(1)). A board will evaluate, as appropriate, the education, training, registration, certifications (see paragraph 3-4.d(4)), overall and relevant experience, and longevity with the firm of the key management and technical personnel. This criterion is primarily concerned with the qualifications of the key personnel and not the number of personnel, which is addressed under the capacity criterion. The lead designer in each discipline must be registered as required by FAR 36.609-4 and 52.236-25 but does not have to be registered in the particular state where the project is located. Specialized Experience and Technical Competence (FAR 36.602-1(a)(2)). Offerors will be evaluated based on the specialized experience of a firm on similar projects and the technical capabilities (such as design quality management procedures, CADD/BIM, and equipment resources,) of the prime firm and any subcontractors. Evaluation will be based on the information presented in the Architect-Engineer Qualifications - Standard Form 330 (SF330). A minimum of three (3) and maximum of five (5) example projects may be submitted for consideration under SF330, Part I, Section F. Example projects should be designs completed within six (6) years of solicitation closing date. Capacity (FAR 36.602-1(a)(3)). A firm s capacity will be evaluated based on their experience with similar size projects, the available capacity of key disciplines to perform the work in the required time, and a primary design schedule. The volume of work awarded during the previous 12 months, based on data extracted from the Federal Procurement Data System, will be considered when evaluating capacity. Additionally, the full potential value of any current indefinite delivery contracts that a firm has been awarded will be considered when evaluating capacity. Past Performance (FAR 36.602-1(a)(4)). Offerors will be evaluated based on terms of cost control, quality of work, and compliance with performance schedules. Knowledge of the Locality (FAR 36.602-1(a)(5)). Firms will be evaluated on their knowledge of the locality such as knowledge of local historical features, climatic conditions, and local construction methods that are unusual or unique to the area with a 500 mile radius. Design Quality Control Plan. Firms will be evaluated on their approach to ensure technical quality and accuracy of work products. A firm's approach to resolve issues of quality will be analyzed to determine its ability to provide quality design products. Describe and define the processes of the firm's quality control plan and list, by name and position, all key personnel responsible for its execution. Quality control information shall also address safety measures particularly with respect to field work and site investigations. Information describing Quality Management may be presented in SF330, Part I, Section H. A design quality control plan shall be submitted as part of the proposal. Experience in Construction Period Services. Firms will be evaluated on their experience in providing construction period services to include professional field inspections during construction, review of construction submittals, support in answering request for information, and support of construction contract changes to include drafting statements of work and preparing cost estimates. Adjectival Rating Definitions Exceptional Meets all requirements and exceed majority of requirements. Overall the proposal meets and significantly exceeds, in all aspects, the standards for evaluation: very high probability of success: no significant weaknesses. Very Good Meets all requirements and exceed some requirements. The proposal meets and, in some cases, exceeds the standards for evaluation; high probability of success; no significant weaknesses and only minor correctable deficiencies. Satisfactory The proposal meets the standard for evaluation; good probability of success; only minor weaknesses and correctable deficiencies. Marginal Lacks material information. The proposal fails to meet some of the standards for evaluation; low probability of success; major weaknesses and/or uncorrectable. Unacceptable Lacks material information. The proposal fails to meet some or all of the standards for evaluation; need major revision to a new submission to make if acceptable or may contain uncorrectable deficiencies. Sub-Factor 1 Professional Qualification: CRITERIA: This factor will evaluate the Offeror s professional qualification in education, training, registration, certifications overall and relevant experience, and longevity with the firm of the key management and technical personnel. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standard of acceptability is met when the Offeror provides: Offeror must provide key personnel and not the number of personnel, which is addressed under FAR 36.602-1(a)(1) the professional qualification criteria. The Offeror must provide a Resume for the following Key Personnel: Project/Design Manager: Must have a minimum of five (5) years experience successfully managing design projects that meet the criteria for similar projects as defined in evaluation factor 3 above. Electrical/Telecommunication Engineers: Must have a minimum of five (5) years experience successfully designing projects that meet the criteria for similar projects as defined in evaluation factor 3 above. Other Disciplines proposed by the Offeror: Must have a minimum of three (3) years experience successfully designing projects that meet the criteria for similar projects as defined in evaluation factor 3 above. All Resumes must include the following information and may not exceed two (2) pages per Resume, and must explain how the proposed key personnel s experience meets the minimum qualification requirements for this contract, as described above: Name and title Project assignment Name of firm with which associated Sub-Factor 2 Specialized Experience: CRITERIA: This factor will evaluate the Offeror s technical competence, based on successful completion of projects, in the design of HVAC systems in a hospital environment. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standard of acceptability is met when the Offeror provides a minimum of three (3) and a maximum of five (5) examples of their choice of completed projects or in progress of similar contracts in size and scope. In describing the experience, provide the following information: Project title, location and brief description including the building use (Medical Facility, etc.) and contracting method (design build, design bid construct, CM at risk, Turnkey, etc). Project owner and name and telephone number of owner s contact person. Indicate your firm s role as a prime contractor or subcontractor, etc. Project Prime Contractor and Major Subcontractors and name and telephone number of contact person(s). Project Statistics including start and completion dates (original vs. actual) for design; cost (with brief explanation of what is included in the cost); square footage; and any awards (prizes) received. Sub-Factor 3 Capacity: 1. CRITERIA: This factor evaluates the Offerors demonstrated experience with similar projects and their ability to perform the work in the required time and primary design schedule. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standard of volume work awarded during the previous 12 months, based on data extracted from the Federal Procurement Data System, will be considered when evaluating capacity. Additionally, the full potential value of any current indefinite delivery contracts that a firm has been awarded will be considered when evaluating capacity. Sub-Factor 4 Past Performance: CRITERIA: This factor evaluates the offeror s demonstrated past performance of projects in order to determine the offeror s ability to perform the contract successfully and help determine responsibility. Recency Assessment: An assessment of the past performance information will be made to determine if it is recent. To be recent, the effort must be ongoing or must have been performed during the past 6 years from the date of issuance of this solicitation. Past performance information that fails this condition will not be evaluated. Relevancy Assessment: An evaluation of all recent performance information obtained to determine whether the provided design performed under those contracts relate to a similar size and scope as those required by this solicitation. In determining the relevancy of effort performed under individual past performance contracts, the Government will consider the specific effort or portion consistent with that proposed by the prime contractor and/or subcontractors. The past performance information obtained from sources will be used to establish the relevancy of past performance. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standard of acceptability is met when the Offeror provides minimum of three (3) and a maximum of five (5) references of their choice of projects of similar contracts in size and scope in which the Offeror adhered to period of performances. The Offeror must provide for each reference the reference's company name, POCs, address, contact information to include phone number and e-mail address, project description, dollar value and period of performance. The Government will consider and evaluate Offeror's past performance information, to include the references, which are deemed recent and relevant for the requirements of this RFP. Sub-Factor 5 Location: CRITERIA: This factor will evaluate the Offeror s ability to perform both the design and construction period services. The Offeror shall demonstrate that is has the capacity to accomplish the work in the required time. Additionally, the Offeror shall show that it can perform the required site investigations, design services, and construction period services without adversely affecting the project schedule. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standard of acceptability is met when the Offeror provides: Offeror must provide a proposed design schedule not to exceed 140 calendar days. Prepare and submit a practicable design schedule laying out all necessary performance elements needed to complete this project identified in the solicitation in the proposed period of performance. The schedule must be in the form of a progress chart of suitable scale to indicate appropriately the percentage of work scheduled for completion by any given date during the performance period. In addition, the schedule must be submitted in the Microsoft Project format. Offerors should only include the work elements necessary to complete the required work. It is the Offeror s responsibility to identify all necessary project/work elements and the proposal adequately identifies acceptable critical path elements. Sub-Factor 5 Design Quality Control Plan: CRITERIA: The plan shall identify personnel, design review procedures, site investigation/confirmation of existing conditions plan, tests proposed, and forms to be used. A finalized, more detailed Design Quality Control Plan (QCP) will be required to be submitted and approved after contract award. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standards of acceptability are met when the Offeror provides: A description of the quality control system, including a chart showing lines of authority and acknowledgement that the Design Manager shall implement control measures for verification of all design activities. The names, qualifications (in resume format), duties, responsibilities, and authorities of each person assigned as Design Quality Control (QC) manager. Any replacements must have similar qualifications in dealing with projects of similar size and scope. Sub-Factor 6 - Experience in Construction Period Services: CRITERIA: Identify example projects that demonstrate the firms experience providing construction period services. will be evaluated on their experience in providing construction period services to include professional field inspections during construction, review of construction submittals, support in answering request for information, and support of construction contract changes to include drafting statements of work and preparing cost estimates. MINIMUM STANDARD OF ACCEPTABILITY: The minimum standard of acceptability is met when the Offeror provides a minimum of three (3) and a maximum of five (5) examples of their choice of completed projects of similar contracts in size and scope for which construction period services were provided. ARCHITECT-ENGINEER QUALIFICATIONS OMB Control Number: 9000-0157 Expiration Date: 12/31/2020 Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0157. We estimate that it will take 29 hours (25 hours for part 1 and 4 hours for Part 2) to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405. 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 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. 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. 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. 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. 8/2016) PAGE 1 OF INSTRUCTIONS Prescribed by GSA - FAR (48 CFR) 53.236-2(b) STANDARD FORM 330 (REV. 8/2016) PAGE 3 OF INSTRUCTIONS SAMPLE ENTRIES FOR SECTION G (MATRIX) 26. NAMES OF KEY 27. ROLE IN THIS 28. EXAMPLE PROJECTS LISTED IN SECTION F PERSONNEL CONTRACT (Fill in "Example Projects Key" section below first, before (From Section E, Block 12) (From Section E, Block 13) 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 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 UMBER 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 N 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. Year Established. Enter the year the firm (or branch office, if appropriate) was established under the current name. Unique Entity Identifier. Insert the unique entity identifier issued by the entity designated at SAM. See FAR part 4.6. Ownership. Type. Enter the type of ownership or legal structure of the firm (sole proprietor, partnership, corporation, joint venture, etc.). 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. 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). 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. 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. 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. List of Disciplines (Function Codes) Code Description Code Description 01 Acoustical Engineer 32 Hydraulic Engineer 02 Administrative 33 Hydrographic Surveyor 03 Aerial Photographer 34 Hydrologist 04 Aeronautical Engineer 35 Industrial Engineer 05 Archeologist 36 Industrial Hygienist 06 Architect 37 Interior Designer 07 Biologist 38 Land Surveyor 08 CADD Technician 39 Landscape Architect 09 Cartographer 40 Materials Engineer 10 Chemical Engineer 41 Materials Handling Engineer 11 Chemist 42 Mechanical Engineer 12 Civil Engineer 43 Mining Engineer 13 Communications Engineer 44 Oceanographer 14 Computer Programmer 45 Photo Interpreter 15 Construction Inspector 46 Photogrammetrist 16 Construction Manager 47 Planner: Urban/Regional 17 Corrosion Engineer 48 Project Manager 18 Cost Engineer/Estimator 49 Remote Sensing Specialist 19 Ecologist 50 Risk Assessor 20 Economist 51 Safety/Occupational Health Engineer 21 Electrical Engineer 52 Sanitary Engineer 22 Electronics Engineer 53 Scheduler 23 Environmental Engineer 54 Security Specialist 24 Environmental Scientist 55 Soils Engineer 25 Fire Protection Engineer 56 Specifications Writer 26 Forensic Engineer 57 Structural Engineer 27 Foundation/Geotechnical Engineer 58 Technician/Analyst 28 Geodetic Surveyor 59 Toxicologist 29 Geographic Information System Specialist 60 Transportation Engineer 30 Geologist 61 Value Engineer 31 Health Facility Planner 62 Water Resources Engineer STANDARD FORM 330 (REV. 8/2016) PAGE 6 OF INSTRUCTIONS List of Experience Categories (Profile Codes) 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 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 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 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 List of Experience Categories (Profile Codes continued) 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 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 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 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 List of Experience Categories (Profile Codes continued) 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 STANDARD FORM 330 (REV. 8/2016) PAGE 8 OF INSTRUCTIONS ARCHITECT - ENGINEER QUALIFICATIONS PART I - CONTRACT-SPECIFIC QUALIFICATIONS CONTRACT INFORMATION 1. TITLE AND LOCATION (City and State) 2. PUBLIC NOTICE DATE 3. SOLICITATION OR PROJECT NUMBER NAME AND TITLE ARCHITECT-ENGINEER POINT OF CONTACT NAME OF FIRM 6. TELEPHONE NUMBER 7. FAX NUMBER 8. E-MAIL ADDRESS PROPOSED TEAM (Complete this section for the prime contractor and all key subcontractors.) (Check) 9. FIRM NAME 10. ADDRESS 11. ROLE IN THIS CONTRACT PRIME J-V PARTNER SUBCON- TRACTOR 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 ORGANIZATIONAL CHART OF PROPOSED TEAM AUTHORIZED FOR LOCAL REPRODUCTION (Attached) STANDARD FORM 330 (REV. 8/2016) STANDARD FORM 330 (REV. 8/2016) PAGE 2 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) 16. EDUCATION (Degree and Specialization) 17. CURRENT PROFESSIONAL REGISTRATION (State and Discipline) OTHER PROFESSIONAL QUALIFICATIONS (Publications, Organizations, Training, Awards, etc.) 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. 8/2016) 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) PROJECT OWNER'S INFORMATION a. PROJECT OWNER b. POINT OF CONTACT NAME c. POINT OF CONTACT TELEPHONE NUMBER BRIEF DESCRIPTION OF PROJECT AND RELEVANCE TO THIS CONTRACT (Include scope, size, and cost) 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. 8/2016) PAGE 4 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 EXAMPLE PROJECTS KEY 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 N ADDITIONAL INFORMATION PROVIDE ANY ADDITIONAL INFORMATION REQUESTED BY THE AGENCY. ATTACH ADDITIONAL SHEETS AS NEEDED. AUTHORIZED REPRESENTATIVE 31. SIGNATURE 32. DATE The foregoing is a statement of facts. 33. NAME AND TITLE 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 (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. E-MAIL 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 Less than $100,000 6. $2 million to less than $5 million $100,000 to less than $250,000 7. $5 million to less than $10 million $250,000 to less than $500,000 8. $10 million to less than $25 million $500,000 to less than $1 million 9. $25 million to less than $50 million $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 a. SIGNATURE b. DATE The foregoing is a statement of facts. NAME AND TITLE STANDARD FORM 330 (REV. 8/2016) PAGE 6