Purpose: The policy of the City of Council Bluffs in procuring engineering, architectural, and related professional services is to establish a pre-
qualified firm list. This form is provided for that purpose. Interested firms must complete and submit this form to the City of Council Bluffs
Engineering Division at the address above.
Instructions:
Standard Work Categories
Please indicate the type(s) of work your firm has experience and is interested in doing by placing a checkmark in the appropriate box or boxes.
Numbers below correspond to numbers contained on the form.
1) Firm name and address of primary office providing services to the City of Council Bluffs.
a) Indicate whether this form is being submitted on behalf of a parent firm or a branch office. (Branch office submissions must list only
personnel in, and experience of, that office.)
b) Firm’s Federal Identification Number.
2) Date the firm was established under the name shown in item 1.
3) Type of ownership, or legal structure, of the firm (sole proprietor, partnership, corporation, joint venture, etc.)
a) Certified Disadvantaged Business Enterprise.
4) Branches or subsidiaries of larger or parent companies, or conglomerates, should insert the name and address of the highest tier owner.
Note: If the present firm is the successor to, or outgrowth of, one or more predecessor firms, show the name(s) of former entity(ties) and the
year(s) of their original establishment.
5) Legal qualifications.
6) Name, title, email address, and telephone number of two primary contacts.
7) Total number of employees, by discipline, in the submitting office. While some personnel may be qualified in several disciplines, each person
should be counted only once in accordance with his or her primary function. Include clerical personnel as “administrative.” Write in any
additional disciplines and the number of people for each in the spaces provided.
8) List of Projects. Attach additional pages if necessary.
9) Include resumes for key personnel within the firm.
