Firm Information Project Years Year Year Year Year Discipline with Capacity Year Year Year Year Cost, Cost, Cost, Cost, Staff Name and / Role Current , Cost, Cost, Cost, Cost, Cost, Registration For This Firm / Title Title, Title, /Credential Project Years Title, Title, Title, Title, Complete Complete Complete Completed (see keys, with 4 5 5 5 5 Project Project Project Other Project for Firm Add’l Add’l Add’l Section Section Section Section Section Add’l Filing) 6. 7. 8 9. 1. 2. 3. 4. 5. Substantial Substantial Substantial Substantial Firm Name City, State MBE/DVB Firm Name City, State MBE/DVB Firm Name City, State MBE/DVB Firm Name City, State MBE/DVB See page 15 of this document for Project Disciplines and Roles. 4. Qualifying Project To fulfill the requirements of WIS ADM Code 20.02 (6) (d), your firm must claim Prime Responsibility for a Qualifying project as described in Requirements” on page 4. “Qualification Project Title, City, State: 1. Capacity of the COMBINED CHILLED WATER PLANT AND UNDERGROUND CHILLED WATER PIPING SYSTEM at substantial completion: 2. Unescalated construction cost of the qualifying COMBINED CHILLED WATER PLANT AND UNDERGROUND $ CHILLED WATER PIPING SYSTEM at substantial completion: 3. Substantial completion date of the qualifying COMBINED CHILLED PLANT AND UNDERGROUND CHILLED WATER PIPING SYSTEM by 6/23/2017: Year 4. Firm or individual with another firm that as the Prime on the BOILER EQUIPMENT PROJECT from design through substantial completion, as well as the services provided and the individual’s role in the project: a. Firm & Location: b. Name of Individual: d. Individual’s Project Architect /Engineer c. Associated Firm & Location: Responsibility: Design Architect/Engineer Principal
Firm Information Staff Name and Registration /Credential Project Discipline / Role For This Project (see keys, for Filing) Years with Current Firm / Years with Other Firm 1. Section 4 Title, Cost, Capacity 2. Section 5 Title, Cost, Year 3. Section 5 Title, Cost, Year 4. Section 5 Title, Cost, Year 5. Section 5 Cost, Year 6. Add’l Project Cost, Year Substantial Complete 7. Add’l Project Title , Cost, Year Substantial Complete 8 Add’l Project Title, Cost, Year Substantial Complete 9. Add’l Project Title, Cost, Year Substantial Completed Firm Name City, State MBE/DVB Firm Name City, State MBE/DVB Firm Name City, State MBE/DVB Firm Name City, State MBE/DVB See page 15 of this document for Project Disciplines and Roles. 4. Qualifying Project To fulfill the requirements of WIS ADM Code 20.02 (6) (d), your firm must claim Prime Responsibility for a Qualifying project as described in “Qualification Requirements” on page 4. Project Title, City, State: 1. Capacity of the COMBINED CHILLED WATER PLANT AND UNDERGROUND CHILLED WATER PIPING SYSTEM at substantial completion: 2. Unescalated construction cost of the qualifying COMBINED CHILLED WATER PLANT AND UNDERGROUND CHILLED WATER PIPING SYSTEM at substantial completion: $ 3. Substantial completion date of the qualifying COMBINED CHILLED PLANT AND UNDERGROUND CHILLED WATER PIPING SYSTEM by 6/23/2017: Year 4. Firm or individual with another firm that as the Prime on the BOILER EQUIPMENT PROJECT from design through substantial completion, as well as the services provided and the individual’s role in the project: a. Firm & Location: b. Name of Individual: c. Associated Firm & Location: d. Individual’s Responsibility: Project Architect /Engineer Design Architect/Engineer Principal
17E2E_Qualification_Solicitation.docx