STANDARD FORM (SF) 254	Architect-Engineer and Related Services Questionnaire		Form Approved OMB No. 9000-0004
Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the FAR Secretariat (VRS), Off ice of Federal Acquisition and Regulatory Policy, GSA, Washington, D.C. 20405; and to the Office of Management and Budget, Paperwork Reduction Project (9000-0004), Washington, D.C. 20503.
Purpose: The policy of the Federal Government in acquiring architectural, engineering, and related professional services is to encourage firms lawfully engaged in the practice of those professions to submit annually a statement of qualifications and performance data. Standard Form 254, “Architect-Engineer and Related Services Questionnaire,” is provided for that purpose. Interested A-E firms (including new, small, and/or minority firms) should complete and file SF 254’s with each Federal agency and with appropriate regional or district offices for which the A-E is qualified to perform services. The agency head for each proposed project shall evaluate these qualification resumes, together with any other performance data on file or requested by the agency, in relation to the proposed project. The SF 254 may be used as a basis for selecting firms for discussions, or for screening firms preliminary to inviting submission of additional information. Definitions: “Architect-Engineer Services” are defined in Part 36 of the Federal Acquisition Regulation. “Parent Company” is that firm, company, corporation, association or conglomerate which is the major stockholder or highest tier owner of the firm completing this questionnaire; i.e., Firm A is owned by Firm B which is, in turn, a subsidiary of Corporation C. The “parent company” of Firm A is Corporation C. “Principals” are those individuals in a firm who possess legal responsibility for its management. They may be owners, partners, corporate officers, associates, administrators, etc. “Discipline,” as used in this questionnaire, refers to the primary technological capability of individuals in the responding firm. Possession of an academic degree, professional registration, certification, or extensive experience in a particular field of practice normally reflects an individual’s primary technical discipline. “Joint Venture” is a collaborative undertaking by two or more firms or individuals for which the participants are both jointly and individually responsible. “Consultant,” as used in this questionnaire, is a highly specialized individual or firm having significant input and responsibility for certain aspects of a project and possessing unusual or unique capabilities for assuring success of the finished work. “Prime” refers to that firm which may be coordinating the concerted and complementary inputs of several firms, individuals or related services to produce a completed study or facility. The “prime would normally be regarded as having full responsibility and liability for quality of performance by itself as well as by subcontractor professionals under its jurisdiction.		“Branch Office” is a satellite, or subsidiary extension, of a headquarters office of a company, regardless of any differences in name or legal structure of such a branch due to local or state laws. “Branch offices” are normally subject to the management decisions, bookkeeping, and policies of the main office. Instructions for Filing (Numbers below correspond to numbers contained in form): 1. Type accurate and complete name of submitting firm, its address, and zip code. 1a. Indicate whether form is being submitted in behalf of a parent firm or a branch office. (Branch office submissions should list only personnel in, and experience of, that office.) 2. Provide data the firm was established under the name shown in question 1. 3. Show date on which form is prepared. All information submitted shall be current and accurate as of this date. 4. Enter type of ownership, or legal structure, of firm (sole proprietor, partnership, corporation, joint venture, etc.) Check appropriate boxes indicating if firm is (a) a small business concern; (b) a small business concern owned and operated by socially and economically disadvantaged individuals; and (c) Woman-owned (See 48 CFR 19.101 and 52.219-9). 5. Branches of subsidiaries of large or parent companies, or conglomerates, should insert name and address of highest-tier owner. 5a. If present firm is the successor to, or outgrowth of, one or more predecessor firms, show name(s) of former entity(ies) and the year(s) of their original establishment. 6. List not more than two principals from submitting firm who may be contacted by the agency receiving this form. (Different principles may be listed on forms going to another agency.) Listed principals must be empowered to speak for the firm on the policy and contractual matters. 7. Beginning with the submitting office, list name, location, total number of personnel, and telephone numbers for all associated or branch offices, (including any headquarters or foreign offices) which provides A-E and related services. 7a. Show total personnel in all offices. (Should be sum of all personnel, all branches.) 8. Show total number of employees, by discipline, in submitting office. (*If form is being submitted by main headquarters office, firm should list total employees, by discipline, in all offices.) While some personnel may be qualified in several disciplines, each person should be counted only once in accord with his or her primary function. Include clerical personnel as “administrative.” Write in any additional disciplines—sociologists, biologists, etc.—and number of people in each, in blank spaces.

NSN 7540-01-152-8073 254-104 STANDARD FORM 254 (REV. 11-92)

Previous edition not usable. Prescribed by GSA – FAR (48 CFR) 53.236-(b)

STANDARD FORM (SF) 254	Architect-Engineer and Related Services Questionnaire
9. Using chart (below) insert appropriate index number to indicate range of professional services fees received by submitting firm each calendar year for last five years, most recent year first. Fee summaries should be broken down to reflect the fees received each year for (a) work performed directly for the Federal Government (not including grant and loan projects) or as a sub to other professionals performing work directly for the Federal Government; (b) all other domestic work, U.S. and possessions, including Federally-assisted projects, and (c) all other foreign work. Ranges of Professional Services Fees INDEX INDEX 1. Less than $100,000 5. $1 million to $2 million 2. $100,000 to $250,000 6. $2 million to $5 million 3. $250,000 to $500,000 7. $5 million to $10 million 4. $500,000 to $1 million 8. $10 million or greater 10. Select and enter, in numerical sequence, not more than thirty (30) “Experience Profile Code” numbers from the listing (next page) which most accurately reflect submitting firm’s demonstrated technical capabilities and project experience. Carefully review list. (It is recognized some profile codes may be part of other services or projects contained on list; firms are encouraged to select profile codes which best indicate type and scope of services provided on past projects .) For each code number, show total number of projects and gross fees (in thousands) received for profile projects performed by firm during past few years. If firm has one or more capabilities not included on list, insert same in blank spaces at end of list and show numbers in question 10 on the form. In such cases, the filled-in listing must accompany the complete SF 254 when submitted to the Federal agencies. 11. Using the “Experience Profile Code” numbers in the same sequence as entered in item 10, give details of at least one recent (within the last five years) representative project for each code number, up to a maximum of thirty (30) separate projects, or portions of projects, for which firm was responsible. (Project examples may be used more than once to illustrate different services rendered on the same job. Example: a dining hall may be part of an auditorium or educational facility.) Firms which select less than thirty “profile codes” may list two or more project examples (to illustrate specialization) for each code number so long as total of all project examples does not exceed thirty (30). After each code number in question 11, show: (a) whether firm was “P,” the prime professional, or “C,” a consultant, or “JV,” part of a joint venture on that particular project (new firms, in existence less than five (5) years may use the symbol “IE” to indicate “Individual Experience” as opposed to		firm experience); (b) provide name and location of the specific project which typifies firm’s (or individual’s) performance under that code category; (c) give name and address of the owner of that project (if government agency indicate responsible office); (d) show the estimated construction cost (or other applicable cost) for that portion of the project for which the firm was primarily responsible. (Where no construction was involved, show approximate cost of firm’s work); and (e) state year work on that particular project was, or will be, completed. 12. The completed SF 254 should be signed by a principal of the firm, preferably the chief executive officer. 13. Additional data, brochures, photos, etc. should not accompany this form unless specifically requested. NEW FIRMS (not recognized or recently-amalgamated firms) are eligible and encouraged to seek work from the Federal Government in connection with performance of projects for which they are qualified. Such firms are encouraged to complete and submit Standard Form 254 to appropriate agencies. Questions on the form dealing with personnel or experience may be answered by citing experience and capabilities of individuals in the firm, based on performance and responsibility while in the employee of others. In so doing, notation of this fact should be made on the form. In question 9, write in “N/A” to indicate “not applicable” for those years prior to firm’s organization.

STANDARD FORM 254 PAGE 2 (REV. 11-92)

Experience Profile Code Numbers for use with questions 10 and 11	042 Harbors; Jetties; Piers; Ship Terminal Facilities 043 Heating; Ventilating; Air Conditioning 044 Health Systems Planning 045 High-rise; Air-Rights-Type Buildings 046 Highways; Streets; Airfield Paving; Parking Lots 047 Historical Preservation 048 Hospital and Medical Facilities 049 Hotels; Models 050 Housing (Residential; Multi-Family; Apartments; Condominiums) 051 Hydraulics and Pneumatics 052 Industrial Buildings; Manufacturing Plants 053 Industrial Processes; Quality Control 054 Industrial Waste Treatment 055 Interior Design; Space Planning 056 Irrigation; Drainage 057 Judicial and Courtroom Facilities 058 Laboratories; Medical Research Facilities 059 Landscape Architecture 060 Libraries; Museums; Galleries 061 Lighting (Interiors; Display; Theatre, etc.) 062 Lighting (Exteriors; Streets; Memorials; Athletic Fields, etc.) 063 Materials Handling Systems; Conveyors; Sorters 064 Metallurgy 065 Microclimatology; Tropical Engineering 066 Military Design Standards 067 Mining and Mineralogy 068 Missile Facilities (Silos; Fuels; Transport) 069 Modular Systems Design; Pre-Fabricated Structures or Components 070 Naval Architecture; Off-Shore Platforms 071 Nuclear Facilities; Nuclear Shielding 072 Office Buildings; Industrial Parks 073 Oceanographic Engineering 074 Ordnance; Munitions; Special Weapons 075 Petroleum Exploration 076 Petroleum and Fuel (Storage and Distribution) 077 Pipelines (Cross-Country – Liquid and Gas) 078 Planning (Community, Regional, Areawide and State) 079 Planning (Site, Installation, and Project) 080 Plumbing and Piping Design 081 Pneumatic Structures; Air-Support Buildings 082 Postal Facilities 083 Power Generation; Transmission; Distribution 084 Prison and Correctional Facilities 085 Product; Machine and Equipment Design	086 Radar; Sonar; Radio and Radar Telescope 087 Railroad; Rapid Transit 088 Recreation Facilities (Parks; Marinas, etc.) 089 Rehabilitation (Buildings; Structures; Facilities) 090 Resource Recovery; Recycling 091 Radio Frequency Systems and Shieldings 092 Rivers; Canals; Waterways; Flood Control 093 Safety Engineering; Accident Studies; OSHA Studies 094 Security Systems; Intruder and Smoke Detection 095 Seismic Designs and Studies 096 Sewage Collection; Treatment; Disposal 097 Soils and Geologic Studies; Foundations 098 Solar Energy Utilization 099 Solid Wastes; Incineration; Landfill 100 Special Environments; Clean Rooms, etc. 101 Structural Design; Special Structures 102 Surveying; Platting; Mapping; Flood Plain Studies 103 Swimming Pools 104 Storm Water Handling and Facilities 105 Telephone Systems (Rural; Mobile; Intercom, etc.) 106 Testing and Inspection Services 107 Traffic and Transportation Engineering 108 Towers (Self-Supporting and Guyed Systems) 109 Tunnels and Subways 110 Urban Renewals; Community Development 111 Utilities (Gas and Steam) 112 Value Analysis; Life-Cycle Costing 113 Warehouses and Depots 114 Water Resources; Hydrology; Ground Water 115 Water Supply; Treatment and Distribution 116 Wind Tunnels; Research/Testing Facilities Design 117 Zoning; Land Use Studies 201 Environmental Program and Compliance Auditing 202 Environmental Program Development_ 203 UST Assessment/Remediation Program Mgmt. 204 Environmental Plans___________________ 205 ________________________________________
001 Acoustics, Noise Abatement 002 Aerial Photogrammetry 003 Agricultural Development; Grain Storage; Farm Mechanization 004 Air Pollution Control 005 Airports; Navaids; Airport Lighting; Aircraft Fueling 006 Airports; Terminals and Hangers; Freight Handling 007 Arctic Facilities 008 Auditoriums and Theatres 009 Automation; Controls; Instrumentation 010 Barracks; Dormitories 011 Bridges 012 Cemeteries (Planning and Relocation) 013 Chemical Processing and Storage 014 Churches; Chapels 015 Codes; Standards; Ordinances 016 Cold Storage; Refrigeration; Fast Freeze 017 Commercial Building (low rise); Shopping Centers 018 Communications Systems; TV; Microwave 019 Computer Facilities; Computer Service 020 Conservation and Resource Management 021 Construction Management 022 Corrosion Control; Cathodic Protection; Electrolysis 023 Cost Estimating 024 Dams (Concrete; Arch) 025 Dams (Earth; Rock); Dikes; Levees 026 Desalinization (Process and Facilities) 027 Dining Halls; Clubs; Restaurants 028 Ecological and Archeological Investigations 029 Educational Facilities; Classrooms 030 Electronics 031 Elevators; Escalators; People-Movers 032 Energy Conservation; New Energy Sources 033 Environmental Impact Studies, Assessments, or Statements 034 Fallout Shelters; Blast-Resistant Design 035 Field Houses; Gyms; Stadiums 036 Fire Protection 037 Fisheries; Fish Ladders 038 Forestry and Forest Products 039 Garages; Vehicle Maintenance Facilities; Parking Decks 040 Gas Systems (Propane; Natural, etc.) 041 Graphic Design

STANDARD FORM 254 PAGE 3 (REV. 11-92)

STANDARD FORM (SF) 254 Architect-Engineer And Related Services Questionnaire

1. Firm Name/Business Address: Epes Environmental and Consulting, PLLC 410 N. Main Street Water Valley, MS 38965 1a. Submittal is for [X] Parent Company Branch or Subsidiary Office

2. Year Present Firm Established 2002

3. Date Prepared:

4. Specify type of ownership and check below, if applicable.

X

A. Small Business (Hubzone qualified)

B. Small Disadvantaged Business

C. Woman-owned Business

5. Name of Parent Company, if any:

5a. Former Parent Company Name(s), if any, and Year(s) Established:

6. Names of not more than Two Principals to Contact: Title/Telephone 6A. Dun&Bradstreet No. 132930640 1) Pierce Epes, P.E., Principal Engineer/Owner, Tel (662)473-9800 www.EpeseEnviro.com Fax(662)473-3179 e-mail: Pierce.Epes@epesenviro.com

7. Present Offices: City / State / Telephone / No. Personnel Each Office 7a. Total Personnel 2 Water Valley, MS Tel: (662)473-9800 / 2 personnel Fax (662)473-3179

8. Personnel by Discipline: (List each person only once, by primary function.)

_1_ Administrative ___ Architects ___ Chemical Engineers ___ Civil Engineers ___ Construction Inspectors ___ Draftsmen ___ Ecologists ___ Economists

___ Electrical Engineers ___ Estimators ___ Geologists ___ Hydrologists ___ Interior Designers ___ Landscape Architects ___ Mechanical Engineers ___ Mining Engineers

___ Oceanographers ___ Planners: Urban/Regional ___ Sanitary Engineers ___ Soils Engineers ___ Specification Writers ___ Structural Engineers ___ Surveyors ___ Transportation Engineers

__2 Environmental Engineer_ ___ ________________________ ___ ________________________ ___ ________________________ ___ ________________________ ___ ________________________ ___ ________________________ ___ ________________________

9. Summary of Professional Services Fees Received: (Insert index number) Last 5 Years (most recent year first)

Ranges of Professional Services Fees INDEX 1. Less than $100,000 2. $100,000 to $250,000 3. $250,000 to $500,000 4. $500,000 to $1 million 5. $1 million to $2 million 6. $2 million to $5 million 7. $5 million to $10 million 8. $10 million or greater

Direct Federal contract work, including overseas All other domestic work All other foreign work *

1999 ___N/A_____N/A_____N/A__

1999 ___N/A______N/A___ __N/A__

1999 ___N/A______N/A_____N/A__

1999 ___N/A_____N/A_____N/A__

2003 ___N/A______1______N/A_

*Firms interested in foreign work, but without such experience, check here: Xx

STANDARD FORM 254 PAGE 4 (REV. 11-92)

10. Profile of Firm’s Project Experience, Last 5 Years

Profile

Code

1) 021

2) 032

3) 033

4) 043