Form 114 "Statement of Qualifications" - Montana

What Is Form 114?

This is a legal form that was released by the Montana Department of Administration - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2018;
  • The latest edition provided by the Montana Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 114 by clicking the link below or browse more documents and templates provided by the Montana Department of Administration.

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Download Form 114 "Statement of Qualifications" - Montana

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STATE OF MONTANA
DEPARTMENT OF ADMINISTRATION
ARCHITECTURE AND ENGINEERING DIVISION
1520 East Sixth Avenue, Rm. 33| P.O. Box 200103| Helena MT 59620-0103 |Phone: 406 444-3104 | Fax: 406 444-3399
website: architecture.mt.gov
general e-mail
DoAAEDivision@mt.gov
:
STATEMENT OF QUALIFICATIONS (Form 114) for FY2018-2019
July 1, 2017 – June 30, 2019
Purpose:
Select firms for projects in the nominal range of $1,500,000 and under in accordance with office procedures and in compliance with 18-8-204 MCA.
Three firms will be short-listed on a per-project basis (or grouping of similar projects) and submitted to the director of the Department of Administration for appointment.
FIRM INFORMATION
Firm Name:
Contacts:
Names:
E-mail Addresses:
Primary:
Mailing Address:
Physical Address:
Same as Mailing:
Phone #:
Website:
Year Established:
Primary
Architecture
Landscape Architecture
Discipline:
# Montana Offices:
Engineering
Specialty
FIRM PERSONNEL
Total Personnel:
0
Architect
Mechanical Engineer
Civil Engineer
Commissioning
___________________
A.I.T.
Electrical Engineer
E.I.T.
Production Staff
___________________
Landscape Architect
Structural Engineer
Environmental Engineer
Support Staff
___________________
CATEGORIES OF WORK FOR CONSIDERATION
Master Planning
Mechanical
Civil
Acoustic Analysis
Energy Studies
Historic Restoration
Electrical
Environmental
Commissioning
Geotech, Materials Testing
Interior Design
Structural
AV/Comm/Data/IT
Retro Commissioning
Haz Mat Testing
Site Survey
Water Well Planning
Other (Specify):
Statement of Qualifications (Rev 6/18)
Form 114
Page 1 of 2
Clear Form
STATE OF MONTANA
DEPARTMENT OF ADMINISTRATION
ARCHITECTURE AND ENGINEERING DIVISION
1520 East Sixth Avenue, Rm. 33| P.O. Box 200103| Helena MT 59620-0103 |Phone: 406 444-3104 | Fax: 406 444-3399
website: architecture.mt.gov
general e-mail
DoAAEDivision@mt.gov
:
STATEMENT OF QUALIFICATIONS (Form 114) for FY2018-2019
July 1, 2017 – June 30, 2019
Purpose:
Select firms for projects in the nominal range of $1,500,000 and under in accordance with office procedures and in compliance with 18-8-204 MCA.
Three firms will be short-listed on a per-project basis (or grouping of similar projects) and submitted to the director of the Department of Administration for appointment.
FIRM INFORMATION
Firm Name:
Contacts:
Names:
E-mail Addresses:
Primary:
Mailing Address:
Physical Address:
Same as Mailing:
Phone #:
Website:
Year Established:
Primary
Architecture
Landscape Architecture
Discipline:
# Montana Offices:
Engineering
Specialty
FIRM PERSONNEL
Total Personnel:
0
Architect
Mechanical Engineer
Civil Engineer
Commissioning
___________________
A.I.T.
Electrical Engineer
E.I.T.
Production Staff
___________________
Landscape Architect
Structural Engineer
Environmental Engineer
Support Staff
___________________
CATEGORIES OF WORK FOR CONSIDERATION
Master Planning
Mechanical
Civil
Acoustic Analysis
Energy Studies
Historic Restoration
Electrical
Environmental
Commissioning
Geotech, Materials Testing
Interior Design
Structural
AV/Comm/Data/IT
Retro Commissioning
Haz Mat Testing
Site Survey
Water Well Planning
Other (Specify):
Statement of Qualifications (Rev 6/18)
Form 114
Page 1 of 2
FIRM PROJECTS INFORMATION P
rovide recent projects that are reflective of your firm’s work.
Project Name & Location
Project Description
Gross SF
Cost/SF
Year
Owner Contact Info
Contractor Contact Info
ADDITIONAL RELEVANT INFORMATION
(Use any additional firm information that apply)
SIGNATURE
(Signature should be that of a principal/owner of the firm)
_________________________________________________
_________________________________________________
Name
Signature
_________________________________________________
_________________________________________________
Title
Date
The state of Montana makes reasonable accommodations for any known disability that may interfere with an applicant’s ability to compete in the application and selection process
or that may interfere with an applicant’s ability to perform the essential duties of the job. For the state to make such accommodations, applicants must make known any needed
accommodation to the individual project managers or agency contacts listed. Persons using TDD may call the Montana Relay Service at 1-800-253-4091.
Statement of Qualifications (Rev 6/18)
Form 114
Page 2 of 2
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