statement of qualifications questionnaire for architects ... · statement of qualifications...

OPRPM FORM 112 (Rev. 0802)

U N I V E R S I T Y O F H A W A I ‘ I

OFFICE OF PROCUREMENT AND REAL PROPERTY MANAGEMENT

STATEMENT OF QUALIFICATIONS

QUESTIONNAIRE

FOR

ARCHITECTS AND ENGINEERS

INSTRUCTIONS

1. Responses to questionnaire shall be typewritten. Individuals or firms should submit a letter of interest and completed Statement(s) of Qualifications, OPRPM FORM 112, to:

University of Hawai‘i Office of Procurement and Real Property Management

1400 Lower Campus Road, Room 15 Honolulu, Hawaii 96822

2. In multi-discipline firms (A&E), each discipline (Architect, Structural Engineering, Mechanical Engineering, etc.) shall be provided on a separate questionnaire. It is recognized that personnel in a multi-discipline firm are often shifted where most needed. In such instances, the number of personnel should be indicated in proportion to the amount of time that such personnel normally spend within such discipline. (Example, a full-time draftsman may spend 0.3 of his time in work related to Architecture and 0.7 of his time to Civil Engineering.)

3. Personal history statements of Technical Personnel shall include only Architects, Engineers, Draftsmen, Specification Writers, Estimators, Landscape Architects, Planners, Land Surveyors, Aerial Surveyors, and Real Property Appraisers.

4. All questions pertaining to this questionnaire may be directed to the Office of Procurement and Real Property Management, telephone (808) 956-8687.

OPRPRM FORM 112 (Rev. 0802)

(LIST DISCIPLINE)

OTHER QUESTIONAIRES SUBMITTED (LIST DISCIPLINES)

UNIVERSITY OF HAWAI‘I

ESTABLISHED FIRM NAME

YEAR

STATE

TYPE OF ORGANI-ZATION

INDIVIDUAL

PARTNERSHIP

CORPORATION

JOINT VENTURE

OTHER

YEAR ESTABLISHED IN HAWAII BUSINESS ADDRESS AND TELEPHONE NO. OF HAWAII OFFICE

PRESENT BRANCH

OFFICE(S)

ADDRESS

TELEPHONE NO.

NAME OF PERSON IN CHARGE

PRINCIPALS OF

FIRM

NAMES

ASSOCIATE MEMBERS OF FIRM

NAMES

NUMBER OF PERSONNEL IN YOUR PRESENT ORGANIZATION

PRINCIPALS/KEY PERSONNEL OTHER PERSONNEL

ENGINEERS LOCATED AT ARCH

ENG OTHER ARCH

MECH. ELEC. CIVIL OTHER

DRAFTS-MEN

SPEC. WRITERS

ESTIMA-TORS

INSPEC-TORS

SURVEY-ORS BALANCE TOTALS

HOME OFFICE

BR

AN

CH

OFF

ICE

IN

TOTALS

NUMBER OF PERSONNEL IN YOUR ORGANIZATION DURING THE LAST 5 YEARS MAXIMUM NO.

YEAR

NORMAL STRENGTH

(1)


OUTSIDE ASSOCIATES AND CONSULTANTS USUALLY EMPLOYED BY YOUR FIRM CATEGORY NAME OF FIRM OR INDIVIDUAL CATEGORY NAME OF FIRM OR INDIVIDUAL

ARCHITECTS MECHANICAL ENGINEERS

LAND SCAPE ARCHITECTS ELECTRICAL

ENGINEERS

CIVIL ENGINEERS PLANNERS

STRUCTURAL ENGINEERS ESTIMATORS

SANITARY ENGINEERS

OTHER CONSULTANT AFFILIATIONS

INDICATE IN ORDER OF PREFERENCE THE TYPES OF PROJECTS IN WHICH YOUR FIRM SPECIALIZES

(2)


PERSONAL HISTORY STATEMENT OF PRINCIPALS WITHIN YOUR FIRM

NAME

NAME

RESIDENT OF HAWAII

YEARS OF EXPERIENCE

AS PRINCIPAL IN THIS FIRM

AS PRINCIPAL IN OTHER FIRMS

OTHER THAN PRINCIPAL

RESIDENT OF HAWAII YEARS OF

EXPERIENCE AS PRINCIPAL IN THIS FIRM



YES NO YES NO

EDUCATION (COLLEGE, DEGREE, SPECIALIZATION)


REGISTRATION (TYPE, YEAR, STATE)


FAMILIARITY WITH ANUNDERSTANDING OF FEDERAL REQUIRMENETS GOVERNING PROFESSIONAL DESIGN SERVICES

YES NO


YES NO

MEMBERSHIP IN PROFESSIONAL ORGANIZATIONS


NAME

NAME

RESIDENT OF HAWAII

YEARS OF EXPERIENCE

AS PRINCIPAL IN THIS FIRM



RESIDENT OF HAWAII YEARS OF

EXPERIENCE AS PRINCIPAL IN THIS FIRM



YES NO YES NO






YES NO


YES NO



(3)


PERSONAL HISTORY STATEMENT OF ASSOCIATES WITHIN YOUR FIRM

NAME

NAME

TITLE OR POSITION

FULL TIME

PART TIME

TITLE OR POSITION

FULL TIME

PART TIME

RESIDENT OF HAWAII YEARS OF EXPERIENCE RESIDENT OF HAWAII YEARS OF EXPERIENCE

YES NO WITH THIS FIRM

OTHER FIRMS


OTHER FIRMS





FAMILIARITY WITH AND UNDERSTANDING OF FEDERAL REQUIREMENTS GOVERNING PROFESSIONAL DESIGN SERVICES

YES NO


YES NO

NAME

NAME

TITLE OR POSITION

FULL TIME

PART TIME

TITLE OR POSITION

FULL TIME

PART TIME

RESIDENT OF HAWAII YEARS OF EXPERIENCE RESIDENT OF HAWAII YEARS OF EXPERIENCE


OTHER FIRMS


OTHER FIRMS






YES NO


YES NO

(4)


PRESENT ACTIVITIES ON WHICH YOUR FIRM IS DESIGNATED THE PRIME ARCHITECT OR ENGINEER

PERCENT COMPLETED NAME AND TYPE OF PROJECT LOCATION NAME OF OWNER ESTIMATED CONSTRUCTION COST

DESIGN FIELD SUP.

TOTAL NUMBER OF PRESENT PROJECTS: TOTAL ESTIMATED CONSTRUCTION COST:

(5)


PRESENT ACTIVITIES ON WHICH YOUR FIRM IS ASSOCIATED WITH OTHERS (INDICATE PHASE OF WORK FOR WHICH YOUR FIRM IS RESPONSIBLE)

ESTIMATED CONSTRUCTION COST OF PERCENT OF ENTIRE PROJECT COMPLETED NAME OF PROJECT

AND PHASE OF WORK

LOCATIONS

OWNERENTIRE

PROJECT

WORK FOR WHICH YOUR FIRM IS RESPONSIBLE

DESIGN FIELD SUP.

FIRM ASSOCIATED

WITH

TOTAL NUMBER OF PRESENT PROJECTS: TOTAL ESTIMATED CONSTRUCTION COST OF WORK FOR WHICH YOUR FIRM IS RESPONSIBLE:

(6)


COMPLETED WORK ON WHICH YOUR FIRM WAS DESIGNATED THE PRIME ARCHITECT OR ENGINEER DURING THE LAST 5 YEARS

NAME AND TYPE OF PROJECT LOCATION

YEAR YOUR WORK

COMPLETED

NAME OF OWNER ESTIMATED

CONSTRUCTION COST

CON-STRUCTED (YES OR

NO)

TOTAL NUMBER OF COMPLETED PROJECTS: TOTAL ESTIMATED CONSTRUCTION COST:

(7)


IN THE EVENT SPACES PROVIDED ON THE FORM ARE NOT SUFFICIENT FOR ENTRIES, OR IF YOU WISH TO FURNISH ADDITIONAL INFORMATION, IT MAY BE INSERTED HERE, AND ON THE NEXT PAGE WITH APPROPRIATE REFERENCES.

As of this date: the foregoing is a true statement of facts.

NAME OF FIRM OR INDIVIDUAL SUBMITTING QUESTIONAIRE

TYPE NAME AND TITLE OF PERSON SIGNING

SIGNATURE

NOTE: It will be to a firm's advantage to maintain its experience record on a current basis. This may be accomplished by periodically forwarding current data.

(8)

ADDITIONAL INFORMATION IF NECESSARY

OPRPRM FORM 112 SUPPLEMENT A (Rev. 0802)

ASBESTOS PROJECTS Submit only if interested in this type of project.

1. Check area(s) of interest below:

ACM-1 Inspection and management planning (planning phase)

ACM-2 Abatement design (project design phase)

ACM-3 Abatement project inspection and monitoring (project construction phase)

2. Provide information for key personnel on staff: ACCREDITATION (Y or N) DATE ACCREDITATION EXPIRES

NAME* EPA Des EPA Insp/Mgmt EPA Des EPA Insp/Mgmt

3. For ACM-1 and/or ACM-3, indicate the following:

Testing Laboratory In-House

Affiliated (provide name of laboratory and location)

4. For ACM-2, identify persons responsible for construction drawings and specifications:

NAME* Arch./Eng. Discipline License No. Date of License

* If subcontractor, add (S) after the person's name. If Name(s) not known, so state and give subcontractor's name with a statement that the person(s) to

be assigned will have the appropriate current accreditation and/or qualifications.

Name of Firm

Typed Name and Title of Person Signing

Signature

OPRPRM FORM 112 SUPPLEMENT B (Rev. 0802)

LEAD CONTAINING PAINT PROJECTS Submit only if interested in this type of project.


LCP-1 Lead containing paint surveys (planning phase)

LCP-2 Lead containing paint disturbance design (project design phase)

LCP-3 Lead containing paint disturbance project inspection and monitoring (project construction phase)

2. Provide names of person(s) responsible for this work. Indicate how knowledge of HUD, EPA, and OSHA regulations regarding lead containing paint was acquired. If by formal training, provide name(s) of course(s) and date(s). If by work experience state number of years in this work.

3. For LCP-1 and/or LCP-3, indicate the following:

Testing Laboratory(ies) In-House

Affiliated (provide name of laboratory(ies) and location(s))

If participating in an accreditation program, give name of program:

4. For LCP-2, and if project plans and specs are required, identify persons responsible for this work:




Name of Firm


Signature

OPRPRM FORM 112 ATTACHMENT 1 (Rev. 0802)

UNDERGROUND STORAGE TANK (UST) PROJECTS Submit only if interested in this type of project.


UST-1 New tank design, or modification of existing tank.

UST-2 Corrosion control design for a tank.

UST-3 existing tank. Release response, corrective action, removal or closure.

2. For UST-1, provide name or responsible Mechanical or Civil Engineer:

Name License No. Date of License Expertise in Federal Regulations and UG tanks acquired by/through:

3. For UST-2, provide name of responsible corrosion engineer as defined in Federal Regulation 40 CFR 280, and provide qualifications including type or certification and/or license and State:

4. For UST-3, provide name of responsible person(s) and degree of knowledge of Federal Regulation 40 CFR 280 and State Department of Health's Technical Guidance Manual for Underground Storage Tank Closure and Release Response. Also provide laboratory name and location:

5. Geotechnical engineer and/or Civil Engineer to be engaged for design, investigation or monitoring. (Engineer license as appropriate will be required):




Name of Firm


Signature

OPRPRM FORM 112 ATTACHMENT 1 (Rev. 0802)

MINIMUM CRITERIA FOR ASBESTOS CONTAINING MATERIALS, LEAD CONTAINING PAINT AND UNDERGROUND STORAGE TANK PROJECTS

ASBESTOS CONTAINTING MATERIALS (ACM) PROJECTS

LEAD CONTAINING PAINT (LCP) PROJECTS

UNDERGROUND STORAGE TANK (UST) PROJECTS

ACM-1 (Asbestos inspection and management planning)

Mandatory Requirements: Current EPA asbestos abatement building inspector and management planner accreditation and affiliation with a testing laboratory accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) for bulk asbestos fiber analysis and capable of determining air and surface fiber levels using methods mandated or recommended by EPA.

LCP-1 (lead containing paint disturbance design) and/or

UST-1 (New tank design, or modification of existing tank)

Mandatory Requirements: Hawaii Professional Engineer, mechanical or electrical engineer license, expertise in underground tanks and knowledge of Federal Regulation 40 CFR 280.

ACM-2 (Asbestos abatement project design)

Mandatory Requirement: Current EPA asbestos abatement project designer accreditation.

LCP-2 (Lead containing paint surveys) and/or

UST-2 (Corrosion control design)

Mandatory Requirements: Corrosion Engineer as defined in Federal Regulation 40 CFR 280.

ACM-3 (Asbestos abatement project inspection and air monitoring for asbestos or other asbestos related work requiring laboratory analysis)

Mandatory Requirements: Current EPA asbestos abatement project designer status and affiliation with a testing laboratory accredited by the National Institute of Standards and Technology's National Voluntary Laboratory Accreditation Program (NVLAP) for bulk asbestos fiber analysis and capable of determining air and surface fiber levels using methods mandated or recommended by EPA.

LCP-3 (Lead containing paint disturbance project inspection and ari monitoring)

Mandatory Requirements: Knowledge of HUD,EPA, and OSHA regulations regarding lead containing paint design, inspection, testing, air monitoring and analysis, controlling lead emissions and hazardous waste disposal. Affiliation with a testing laboratory regularly engaged in performance of lead containing paint analysis, air and soil monitoring for lead and other lead paint related testing including determining whether lead containing paint wastes are hazardous wastes. Laboratories accredited under EPA's National Lead Laboratory Accreditation Program (NLLAP) will be considered better qualified than a laboratory that does not have this accreditation.

UST-3 (Existing tank work. Release response, corrective action, removal and closure)

Mandatory Requirements: Knowledge of Federal Regulation 40 CFR 280 and State Department of Health's Technical Guidance Manual for Underground Storage Tank Closure and Release Response. Also affiliation with laboratory regularly engaged in the analysis of soil contaminates including Total Petroleum Hydrocarbons

If the project includes architectural or engineering design, a Hawaii Professional Architect or Engineer license as appropriate will also be required. Projects required only simple site and location plans and the related specifications are not included in these requirements. All drawings shall conform to Architectural drafting and/or CADD standards.

If the project includes architectural or engineering design, a Hawaii Professional Architect or Engineer license as appropriate will also be required. Projects required only simple site and location plans and the related specifications are not included in these requirements. All drawings shall conform to Architectural drafting and/or CADD standards.

If the project requires a geotechnical engineer or civil engineering design, a Hawaii Professional Engineer license as appropriate will also be required.

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