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PART II - GENERAL QUALIFICATIONS (If a firm has branch offices, complete for each specific branch office seeking work.) <br />a. SIGNATURE <br />ARCHITECT-ENGINEER QUALIFICATIONS <br />2a. FIRM (OR BRANCH OFFICE) NAME <br />2b. STREET <br />2c. CITY 2d. STATE 2e. ZIP CODE <br />3. YEAR ESTABLISHED 4. DUNS NUMBER <br />5. OWNERSHIP <br />b. Discipline <br />c. No. of Employees <br />10. PROFILE OF FIRM'S EXPERIENCE <br />AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS <br />b. Experience <br />c. Revenue IndexNumber(see below) <br />1. SOLICITATION NUMBER (If any) <br />8a. FORMER FIRM NAME(S) (If any)8b. YR. ESTABLISHED <br />9. EMPLOYEES BY DISCIPLINE <br />Total <br />(1) FIRM (2) BRANCH <br />1.Less than $100,000 <br />2.$100,00 to less than $250,000 <br />3.$250,000 to less than $500,000 <br />4.$500,000 to less than $1 million <br />5.$1 million to less than $2 million <br />11. ANNUAL AVERAGE PROFESSIONAL <br />SERVICES REVENUES OF FIRM <br />FOR LAST 3 YEARS <br />(Insert revenue index number shown at right) <br />7. NAME OF FIRM (If block 2a is a branch office) <br />6a. POINT OF CONTACT NAME AND TITLE <br />6c. E-MAIL ADDRESS <br />8c. DUNS NUMBER <br />a. Federal Work <br />b. Non-Federal Work <br />c. Total Work <br />12. AUTHORIZED REPRESENTATIVE <br />The foregoing is a statement of facts. <br />b. DATE <br />c. NAME AND TITLE <br />a. Function <br />Code <br />a. Profile <br />Code <br />6b. TELEPHONE NUMBER <br />a. TYPE <br />b. SMALL BUSINESS STATUS <br />PROFESSIONAL SERVICES REVENUE INDEX NUMBER <br />6.$2 million to less than $5 million <br />7.$5 million to less than $10 million <br />8.$10 million to less than $25 million <br />9.$25 million to less than $50 million <br />10.$50 million or greater <br />Other Employees <br />AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 330 (REV. 8/2016) PAGE 6 <br />15 N/A