Standard Form 255 – Fill Out and Use This PDF

This f orm is a supplement t o t he " Archit ect -Engineer and Relat ed Services Quest t ionnaire" (SF254). Its purpose is t o provide addit ional inf ormat ion regarding t he qualif icat ions of int erest ed f irms t o undert ake a specif ic Federal A-E project . Firms, or branch of f ices of f irms, submit t ing this f orm should enclose (or already have on f ile w it h t he appropriat e of f ice of t he agency) a current (w it hin t he past year) and accurat e copy of t he SF254 f or t hat of f ice.

The procurement of f icial responsible f or each proposed project may request submission of t he SF255 " Archit iect -Engineer and Relat ed Services Quest ionnaire f or Specif ic Project " in accord

w it h applicable civilian and milit ary procurement regulat ions and shall evaluat e such submissions, as w ell as relat ed inf ormat ion cont ained on t he St andard Form 254, and any ot her perf ormance dat a on f ile w it h t he agency, and shall select f irms f or subsequent discussions leading t o cont ract aw ard in conf ormance w it h Public Law 92 -582 . This f orm should only be f iled by an

archit ect -engineer or relat ed services f irm w hen request ed t o do so by t he agency or by a public announcement s. Responses should be as complet e and accurat e as possible, cont ain dat a relat ive t o t he specif ic project f or w hich you w ish t o be considered, and should be provided, by t he required due dat e, t o t he of f ice specif ied in t he request or public announcement .

This f orm w ill be used only f or t he specif ied project . Do not ref er t o this submit t al in response t o ot her request s or public announcement s.

Definitions:

"Archit ect -Engineer Services" are def ined in Part 36 of t he Federal Acquisit ion Regulat ion.

"Principals" are t hose individuals in a f irm w ho possess legal responsibilit y f or its management .

They may be ow ners, part ners, corporat e of f icers, associat es, administ rat ors, et c.

"Discipline," as used in this quest ionnaire, ref ers t o t he primary t echnological capabilit y of individuals in t he responding f irm. Possession of an academic degree, prof essional regist rat ion, cert if icat ion, or ext ensive experience in a part icular f ield of pract ice normally ref lect s an individual' s primary t echnical discipline.

"Joint Vent ure" is a collaborat ive undert aking by t w o or more f irms or individuals f or w hich t he part icipant s are bot h joint ly and individully responsible.

"Key Persons, Specialist s, and Individual Consult ant s, " as used in t hi squest ionnnaire, ref er t o

individuals w ho w ill have major project responsibilit y or w ill provide unusual or unique capabilit ies f or t he project under considerat ion.

1 . Give name and locat ion of t he project f or w hich this f orm is being submit t ed.

2 . Provide appropriat ed dat a f rom t he Commerce Business Daily (CBD) ident if ying t he part icular project f or w hich this f orm is being f iled.

2a. Give t he dat e of t he Commerce Business Daily in w hich t he project announcement appeared, or indicat e " not applicable" (N/A) if t he source of t he announcement is ot her t han t he CBD.

2b. Indicat e Agency ident if icat ion or cont ract number as provided in t he CBD announcement .

3 . Show name and address of t he individual or f irm (or joint vent ure) w hich is submit t ing this f orm f or t he project .

3a. List t he name, t it le, and t elephone number of t hat principal w ho w ill serve as t he point of cont act . Such an individual must be empow ered t o speak f or t he f irm on policy and cont ract ual mat t ers and should be f amiliar w it h t he programs and procedures of t he agency t o w hich this f orm is direct ed.

3b. Give t he address of t he specif ic of f ice w hich w ill have responsibilit y f or perf orming t he announced w ork.

4 . Insert t he number of consult ant personnel by discipline proposed f or subject project on line (A). Insert t he number of in-house personnel by discipline proposed f or subject project on line (B). While some personnel may be qualif ied in several disciplines, each person should be count ed only once in accord w it h his or her primary f unct ion. Include clerical personnel as " administ rat ive." Writ e in any addit ional disciplines-- sociologist s, biologist s, et c.--and number of people in each, in blank spaces.

5 . Answ er only if this f orm is being submit t ed by a joint vent ure of t w o or more collaborat ing f irms. Show t he names and addresses of all individuals or organizat ions except ed t o be included as part of t he joint vent ure and describe t heir part icular areas of ant icipat ed responsibilit y (ie., t echnical disciplines, administ rat ion, f inancial, sociological, environment , et c.).

5a. Indicat e, by checking t he appropriat e box, w het her this part icular joint vent ure has w orked t oget her on ot her project s.

Each f irm part icipat ing in t he joint vent ure should have a St andard Form 254 on f ile w it h t he

cont ract ing of f ice receiving this f orm. Firms w hich do not have such f orms on f ile should provide same immediat ely along w it h a not at ion at t he t op of page 1 of t he f orm regarding t heir associat ion w it h this joint vent ure submit t al.

St andard Form 255

General Services Administ rat ion Washingt on, D.C. 20405

6 . If respondent is not a joint vent ure, but int ends t o use out side (as opposed t o in-house or permanent ly and formally affiliated) consult ant s or associat es, he should provide names and addresses of all such individuals or f irms, as w ell as their particular areas of t echnical/prof essional expertise, as it relates t o t his project . Exist ence of previous w orking relat ionships should be not ed. If more eight out side consult ant s or associates are ant icipat ed, attach an addit ional sheet cont aining request ed

inf ormat ion.

7 . Regardless of w het her respondent is a joint venture or an independent f irm, provide brief resumes of key personnel expected t o participate on t his project . Care should be taken t o limit resumes t o only t hose personnel and specialists w ho w ill have major project responsibilit ies. Each resume must include: (a) name of each key person and specialist and his or her t it le, (b) t he project assignment or role w hich t hat person w ill be expected t o f ulf ill in connect ion w it h t his project , (c) t he name of t he firm or organizat ion, if any, w it h w hom t hat individual is present ly associat ed, (d) years of relevant experience w it h present firm and ot her f irms, (e) t he highest academic degree achieved and t he discipline covered (if more t han one highest degree, such as t w o Ph.D.' s, list bot h), t he year received and t he particular t echnical/prof essional discipline w hich t hat individual w ill bring t o t he project , (f ) if registered as an architect, engineer, surveyor, et c., show only t he f ield of regist rat ion and t he year t hat such regist rat ion w as first acquired. If registrered in several st at es, do not list st at es, and

(g)a synopsis of experience, t raining, or ot her qualit ies w hich reflect individual' s pot ent ial cont ribut ion t o t his project . Include such data as: familiarity w it h Government or agency procedures, similar t ype of w ork perf ormed in t he past , management abilit ies, familiarity w it h t he geographic area, relevant f oreign language capabilit ies, etc. Please limit synopsis of experience t o directly relevant inf ormat ion.

8 . List up t o t en projects w hich demonst rat e t he f irm' s or joint vent ure' s competence t o perf orm w ork similar t o t hat likely t o be required on t his project . The more recent such project s, t he bet t er. Prime considerat ion w ill be given t o projects w hich illustrate respondent ' s capability f or perf orming w ork similar t o t hat being sought . Required

inf ormat ion must include: (a) name and locat ion of project , (b) brief descript ion of t ype and extent of services provided f or each project (submissions by joint vent ures should indicate w hich member of t he joint venture w as t he prime on t hat particular project and w hat role it played), (c) name and address of t he ow ner of t hat project (if Government agency, indicate responsible of f ice), and name and phoone number of individual t o contact f or reference (preferably t he project manager), (d) complet ion date (actual w hen available, ot herw ise est imat ed), (e) t ot al const ruct ion cost of complet ed project (or w here no const ruct ion w as involved, t he approximat e cost of your w ork) and t hat port ion of t he cost of t he project f or w hich t he named firm w as/is responsible.

9 . List only t hose projects w hich t he A -E firm or joint vent rue, or members of t he joint vent ure, are currently perf orming under direct contract w it h an agency or depart ment of t he Federal Government . Exclude any grant or loan projects being f inanced by t he Federal Government but being perf ormed under contract t o ot her non-Federal Government ent it ies. Inf ormat ion provided under each heading is similar t o t hat request ed in t he preceding It em 8, except f or (d) " Percent Complet e." Indicat e in t his item t he percentage of A -E w ork complet ed upon f iling t his f orm.

10 . Through narrative discussion, show reason w hy t he firm or joint venture

submit t ing t his quest ionnaire believes it is especially qualif ied t o undertake t he project . Inf ormat ion provided should include, but not be limit ed t o, such data as: specialized equipment available f or t his w ork, any aw ards or recognit ion received by a firm or individuals f or similar w ork, required security clearances, special approaches or concept s developed by t he firm relevant t o t his project , etc. Respondent s may say anyt hing t hey w ish in support of their qualif icat ions. When appropriat e, respondent s may supplement t his proposal w it h graphic material and phot ographs w hich best demonst rat e design capabilities of t he team proposed f or t his project .

11 . Complet ed f orms should be signed by t he chief executive officer of t he joint venture (t hereby at t est ing t o t he concurrence and commit ment of all members of t he joint vent ure), or by t he architect -engineer principal responsible f or t he conduct of t he w ork in t he event it is aw arded t o t he organizat ion submit t ing t his f orm. Joint

vent ures selected f or subsequent discussions regarding t his project must make available a statement of part icipat ion signed by a principal of each member of t he joint vent ure. ALL INFORMATION CONTAINED IN THE FORM SHOULD BE CURRENT AND FACTUAL.

5a. Has this Joint -Venture previously w orked together?

Yes

No

f . Active Registration: Year First Registered/Discipline

f . Active Registration: Year First Registered/Discipline

g. Other Experience and Qualifications relevant to the proposed project:

g. Other Experience and Qualifications relevant to the proposed project:

11. The foregoing is a statement of facts.

Signature:

Typed Name and Title:

Date: