EXAMPLE-LIMITED Home Office TENNESSEE DEPARTMENT OF TRANSPORTATION ARCHITECT - ENGINEER QUALIFICATIONS

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1 EXAMPLE-LMTED Home Office TENNESSEE DEPARTMENT OF TRANSPORTATON ARCHTECT - ENGNEER QUALFCATONS QUALFCATON TYPE LMTED PART 1- GENERAL QUALFCATONS (f a firm has branch offices, complete for each specific branch office seeking work) 2a. FRM (OR BRANCH OFFCE) NAME 2b. STREET ABC Consultants, nc 1234 Main Street, Suite 1 2e. CTY 2d. STATE 2e ZP CODE Anytown TN a. PONT OF CONTACT NAME AND TTLE John Q. Doe, CEO & President 6b. TELEPHONE & FAX NUMBER 6e. E MAL ADDRESS / jqdoe@abcconsultants.com 8a. FORMER FRM NAME(S) (if any) 3. YEAR ESTABLSHED 4. DUNS NUMBER a. TYPE 1984 N/A Partnership 5. OWNERSHP b. DSADVANTAGED BUSNESS ENTERPRSE (DBE) X YES o NO 7. TYPE OF OFFCE Home Office 8b. YR. ESTABLSHED 8e. DUNS NUMBER N/A a. Function Code EMPLOYEES BY DSCPLNE 10. PROFLE OF FRM'S EXPERENCE AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS b. Discipline c. No. of Employees a. Profile Revenue ndex b. Experience Number (1) FRM (2) OFFCE Code (see below) Administrative Dams 5 Civil Engineer 7 2 G04 Geographic nformation System Services 3 Technician/Analyst 18 9 MOl Mapping Location!Addressing Systems 3 Other Employees 7 3 S05 Soils and Geologic Studies; Foundations 4 Other EmDlovees Total PROFESSONAL SERVCES REVENUE NDEX NUMBER 1. Less than $100, $2 million to less than $5 million 2. $100,000 to less than $250, $5 million to less than $10 million 3. $250,00 to less than $500, $10 million to less than $25 million 4. $500,000 to less than $1 million 9. $25 million to less than $50 million 5. $1 million to less than $2 million 10. $50 million or greater 11. AUTHORZED REPRESENTATVE The foregoing is a statement of facts. a. SGNATURE b. DATE January 12, 2010 c. NAME AND TTLE John Q. Doe, CEO & President

2 EXAMPLE-LMTED Branch Office) TENNESSEE DEPARTMENT OF TRANSPORTATON ARCHTECT - ENGNEER QUALFCATONS 1 auallfcatontype LMTED PART 1- GENERAL QUALFCATONS (f a firm has branch offices, complete for each specific branch office seeking work) 2a. FRM (OR BRANCH OFFCE) NAME ABC Consultants, nc 2b. STREET 1234 First Street, Suite 1 2e. CTY 2d. STATE 2e ZP CODE Anytown NY 22/11 6a. PONT OF CONTACT NAME AND TTLE Jane M. Doe, Vice President 6b. TELEPHONE & FAX NUMBER 6e. E MAL ADDRESS / jmdoe@abcconsultants.com 8a. FORMER FRM NAME(S) (if any) 3. YEAR ESTABLSHED 4. DUNS NUMBER a. TYPE 1984 N/A Partnership 5. OWNERSHP b. DSADVANTAGED BUSNESS ENTERPRSE (DBE) X YES o NO 7. TYPE OF OFFCE Branch Office 1 8b. YR. ESTABLSHED 8e. DUNS NUMBER N/A a. Function Code EMPLOYEES BY DSCPLNE 10. PROFLE OF FRM'S EXPERENCE AND ANNUAL AVERAGE REVENUE FOR LAST 5 YEARS b. Discipline c. No. of Employees a. Profile Revenue ndex b. Experience Number (1) FRM (2) OFFCE Code (see below) Administrative Civil Engineer Technician/Analyst Other Employees G04 MOl S05 Dams Geographic nformation System Services Mapping Location/Addressing Systems Soils and Geologic Studies; Foundations Other Emolovees Total PROFESSONAL SERVCES REVENUE NDEX NUMBER Less than $100, $2 million to less than $5 million $100,000 to less than $250, $5 million to less than $10 million $250,00 to less than $500, $10 million to less than $25 million $500,000 to less than $1 million 9. $25 million to less than $50 million $1 million to less than $2 million 10. $50 million or greater 11. AUTHORZED REPRESENTATVE The foregoing is a statement of facts. a. SGNATURE b. DATE January 12, 2010 C. NAME AND TTLE Jane M. Doe, Vice President

3 EXAMPLE ABC Consultants, nc. John Q. Doe PRESDENT As of September 1, 20 10

4 EXAMPLE-Engineer _1_of RESUMES OF KEY PERSONNEL (Complete one page for each key person.) NAME ROLE TTLE YEARS EXPERENCE John Q. Doe FRM NAME AND LOCATON (City and State) ABC Consultants, nc. EDUCATON (DEGREE AND SPECALZATON) MBNUniversity of Tennessee M.S. Civil EngineeringlUniversity of Tennessee B.S. Civil Engineering/Tennessee Tech University CEO & President OTHER PROFESSONAL QUALFCATONS (Publications, Organizations, Training, Awards, etc.) Tennessee Society of Professional Engineers American Society of Civil Engineers a. b. TOTAL WTH CURRENT FRM CURRENT PROFESSONAL REGSTRATON (STATE AND DSCPLNE) Professional Engineer (Civil) in Tennessee RELEVANT PROJECTS (1) TTLE AND LOCATON (County) Monterey Railroad Museum Monterey, TN 2010 Ongoing (3) BREF DESCRPTON (Brief scope, size, cost, etc,) AND SPECFC ROLE Z Check if project performed with current firm Project Engineer for a new railroad museum and parking area for the City of Monterey. This project is one of the trail heads for the Rails for Trails which will connect Cookeville and Monterey with approximately 19 miles of multiuse hiking and biking trails. This project was a TOOT Transportation Enhancement Project. (1) TTLE AND LOCATON (County) Beckwith Farms Distribution Facility Mt Juliet, TN to 2010 (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE 181 Check if project performed with current firm Project Engineer for site plan and infrastructure on a new development consisting of four Class A buildings totaling 3.33 Million square feet. Detailed plans and site design for roads, drainage facilities and grading were provided. Coordination with utility and local government for approval of layout and design was obtained as part of services. c. d. (1) TTLE AND LOCATON (County) The Pinnacle at Symphony Place Office Building Nashville, TN (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE Z Check if project performed with current firm Prepared the site plans for a new 1.1 million square foot, 28-story office building in downtown Nashville. Detailed design provided for the site construction plans included drainage, grading, utilities and a foundation drainage system. The project included development of a five level, below grade parking garage. The project was a LED accredited design. (1) TTLE AND LOCATON (County) (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE e. (1) TTLE AND LOCATON (County) (3) BREF DESCRPTON (Brief scope, size, cost, elc.) AND SPECFC ROLE

5 EXAMPLE-Engineer 12. RESUMES OF KEY PERSONNEL (Complete one page for each key person.) 2of~ NAME ROLE TTLE YEARS EXPERENCE TOTAL WTH CURRENT FRM Jane M. Doe FRM NAME AND LOCATON (City and State) ABC Consultants, nc. Vice-President EDUCATON (DEGREE AND SPECALZATON) M.S. Civil EngineeringlUniversity of Tennessee B.S. Civil Engineering/Tennessee Tech University CURRENT PROFESSONAL REGSTRATON (STATE AND DSCPLNE) Professional Engineer (Civil) in Tennessee OTHER PROFESSONAL QUALFCATONS (Publications. Organizations, Training, Awards, etc.) Tennessee Society of Professional Engineers a. b. C. d. RELEVANT PROJECTS (1) TTLE AND LOCATON (County) Coretech ndustries Campus PROFESSONAL SERVCES CONSTRUCTON (f aoolicable) Lebanon, TN Ongoing (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE ~ Check if project performed with current firm Provided engineering services for site design including grading, drainage, storm sewer design and associated details. Overall plan development included master planning for the 50 acre Research Park which is designed to be the first true green technology research and development business park in America. Design also included off-site utilities and roadway improvements. (1) TTLE AND LOCATON (County) PROFESSONAL SERVCES CONSTRUCTON (f aoolicable) The Pinnacle at Symphony Place Office Building Nashville, TN (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE ~ Check if project performed with current firm Prepared the site plans for a new 1.1 million square foot, 28-story office building in downtown Nashville. Detailed design provided for the site construction plans included drainage, grading, utilities and a foundation drainage system. The project included development of a five level, below grade parking garage. The project was a LED accredited design. (1) TTLE AND LOCATON (County) Music Row Roundabout Nashville, TN (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE ~ Check if project performed with current firm Project manager and project engineer for Nashville's first modern roundabout. Managed multi-disciplined design team for this $3 million dollar streetscape and roadway improvement project. Project included design and construction administration for a roundabout to replace a six street intersection in an urban setting. (1) TTLE AND LOCATON (County) PROFESSONAL SERVCES CONSTRUCTON (f aoolicable) (3) BREF DESCRPTON (Brief scope, size, cost, etc.) AND SPECFC ROLE e. (1) TTLE AND LOCATON (County) (3) BREF DESCRPTON (Brief scope, size, cost. etc.) AND SPECFC ROLE

6 TO ACCOMPANY TOOT'S FORM OT-0330 BALANCE SHEET FOR DECEMBER 2009 (End of Frm's Fiscal Vear) ABC Consultants, nc Name of Firm l Cash: On Hand n Banks Certified Checks on Deposit for Bids Notes Receivable (Less Discount) Accounts Receivable Slocks and Bonds nventories nterest Receivable Accrued on Notes, Securities. etc. Life nsurance Total Current Assets _.. ASSETS CURRENT ~ ASSETS LABLTES AND NET WORTH CURRENT LABLTES Judgements & Accounts Payable $ 73, $ 157, Notes Payable (a) To banks for certified checks (b) To banks for payoffs $ 1, $ 166, (c) To material companies (d) To equipment companies (e) To other (exclusive of equipment) Owing Subcontractors Accrued taxes Accrued Salaries and Payoffs Accrued nterest Payable $ 24, $ $ 325, Total Current Liabilities $ 97, Plant and Equipment Real Estate Total Fixed Assets Real Estate - Not used in business - FXED ASSETS NET BOOK VALUE FXED AND OTHER LABLTES $ 14, Mortgage on Plant Equipment $ 125, $83, Mortgage on Real Estate Other Liabilities $ 139, $83, Total Fixed and Other Liabilities OTHER ASSETS NET WORTH j --- ndividual Partnership Retained Earnings $ 130, $ 2, Capital Stock $ 151, Total Other Assets $ 2, Surplus $ 5, and, Bldg., mprovement. etc Misc. Assets TOTAL ASSETS The Financial Statement above presents fairly the financial position of the subject firm in the noted period. $ 467, TOTAL LABLTES AND NET WORTH $ 467, Name (Signature) Title Revised 9/17/