2. FIRM NAME: PHONE NO: ___________________ 3. ADDRESS OF OFFICE WHERE WORK WILL BE PERFORMED:_____________________________________________ ZIP : ___________ INDICATE SERVICE(S) TO BE PROVIDED ON THE PROJECT IN THE BASIC SERVICES LISTED BELOW: APPLICANT PROPOSED OUTSIDE CONSULTANTS SERVICE(S) BOARD REG. NO. SERVICE(S) FL BOARD REG. OFFERED & CHARTER NO. NAME, ADDRESS, PHONE OFFERED NO. & NAME, ADDRESS, PHONE (X) (X) CHARTER NO. PE/PG PE/PG REG # REG # ( ) ( ) CH # CH # PE/PG PE/PG REG # REG # ( ) ( ) CH # CH # RA REG # RA REG # ( ) ( ) CH # CH # LAC REG # LAC REG # ( ) ( ) CH # CH # LAC LAC REG # REG # ( ) ( ) CH # CH # CIH REG # CIH REG # ( ) ( ) CH # CH # 4. WORKLOAD FOR APPLICANT FIRM ONLY: (Do not include PROPOSED Indicate each project the OUTSIDE CONSULTANTS.) APPLICANT will be handling as of the DEADLINE DATE for the submittal on THIS PROJECT and the professional fees under contract for APPLICANT firm only. EXCLUDE WORKLOAD SUBCONTRACTED TO PROPOSED OUTSIDE CONSULTANTS. Specify number of all principals and technical staff that will be assigned to or available for this project WITHIN THE APPLICANT FIRM ONLY, EXCLUDING PROPOSED OUTSIDE CONSULTANTS.
2. FIRM NAME: PHONE NO: ___________________ 3. ADDRESS OF OFFICE WHERE WORK WILL BE PERFORMED:_____________________________________________ ZIP : ___________ INDICATE SERVICE(S) TO BE PROVIDED ON THE PROJECT IN THE BASIC SERVICES LISTED BELOW: APPLICANT PROPOSED OUTSIDE CONSULTANTS SERVICE(S) OFFERED (X) BOARD REG. NO. & CHARTER NO. NAME, ADDRESS, PHONE SERVICE(S) OFFERED (X) FL BOARD REG. NO. & CHARTER NO. NAME, ADDRESS, PHONE PE/PG ( ) REG # PE/PG ( ) REG # CH # CH # PE/PG ( ) REG # PE/PG ( ) REG # CH # CH # RA ( ) REG # RA ( ) REG # CH # CH # LAC ( ) REG # LAC ( ) REG # CH # CH # LAC ( ) REG # LAC ( ) REG # CH # CH # CIH ( ) REG # CIH ( ) REG # CH # CH # 4. WORKLOAD FOR APPLICANT FIRM ONLY: (Do not include PROPOSED OUTSIDE CONSULTANTS.) Indicate each project the APPLICANT will be handling as of the DEADLINE DATE for the submittal on THIS PROJECT and the professional fees under contract for APPLICANT firm only. EXCLUDE WORKLOAD SUBCONTRACTED TO PROPOSED OUTSIDE CONSULTANTS. Specify number of all principals and technical staff that will be assigned to or available for this project WITHIN THE APPLICANT FIRM ONLY, EXCLUDING PROPOSED OUTSIDE CONSULTANTS.