State of Florida, Board of Regents

Professional Qualifications Supplement (PQS) QUESTION 1 – SERVICES

1. SERVICES to be provided: FIRM Name # of Projects with Arch. Design Applicant Architecture N/A Mechanical Engineering Electrical Engineering Plumbing & Fire Protection Engineering Civil Engineering Structural Engineering Telecommunications* Landscape Architecture Cost Estimating Audio-Visual Design & Integration edit or delete rows as needed Security & Access Control Design/Integration edit or delete rows as needed Laboratory Planning & Design edit or delete rows as needed Programming edit or delete rows as needed Lighting Design edit or delete rows as needed Acoustical Design & Consultation edit or delete rows as needed (other specialty discipline) edit or delete rows as needed

* BICSI Registered Communications Distribution Designer – see instructions

FPC REVISED: NOVEMBER 2009 PAGE 1 OF 2 PAGES Professional Qualifications Supplement (PQS) QUESTION 2 – PERSONNEL 2. PERSONNEL by role and discipline: Name Registered? Disc. Of City of Residence (Yes or No) Reg./Training Principal-In-Charge Design Lead/Principal Project Manager Project Architect (other) (other) Architecture Mechanical Engineering Electrical Engineering Plumbing & Fire Protection Engineering Civil Engineering Structural Engineering Telecommunications Landscape Architecture Cost Estimating Audio-Visual Design & Integration edit or delete rows as needed Security & Access Control edit or delete rows as needed Design/Integration Laboratory Planning & Design edit or delete rows as needed Programming edit or delete rows as needed Lighting Design edit or delete rows as needed Acoustical Design & Consultation edit or delete rows as needed (other specialty discipline) edit or delete rows as needed

FPC REVISED: NOVEMBER 2009 PAGE 2 OF 2 PAGES