Qualifications of Architect

Instructions: Qualification forms must be completed by an authorized officer of the organization. Submit the completed qualification form to mhfa.app@state.mn.us through Partner Login on Minnesota Housing’s website.

Architect Information 	
Full Legal Name of Architect	     	
Address	     	
City, State, Zip	     ,             	
Website 	     	
Telephone Number	     	
Fax Number (If applicable)	     	
Contact Person	     	
Contact Person Email Address	     	

1.	Year firm established:      

2.	List principals of the firm, professional field (e.g., landscape architecture; planning; engineering – civil, structural, sanitary, mechanical, electrical) and registration information (type, year, state):

Principal Name	Professional Field	Professional License #	% of Interest	
     	     	     	     	
     	     	     	     	
     	     	     	     	
     	     	     	     	
     	     	     	     	
Total Percentage	     	     	100%	

3.	Is the organization at least 51% led or owned by a woman or women?	
 Yes     No

4.	Is the organization at least 51% led or owned by a person or people who are Black, Indigenous, or people of color*?  (*includes Native and Indigenous North and South American, Black and African-descent, Hispanic or Latinx, Asian and Pacific Islander, and other non-white communities) 
	 Yes     No
If other race/ethnicity that what is listed above, please state:      
	
5.	List other members of the firm and professional fields:      

6.	List areas of work that are typically sub-contracted:      

7.	Has the firm been involved in any litigation within the last five years?	
	 Yes    No
a.	If yes, please give details:      

8.	Does the firm have Errors and Omissions Insurance in the minimum amount of $500,000?
 Yes    No
a.	If yes, please indicate which insurance company:      
b.	If no, please give details:      

I,      , hereby certify that the information set forth, and in any supporting attachments, is true, correct, and complete to the best of my knowledge and belief.

     		     	
Name of Firm		Signature 	
			
     	     	     	
Printed Authorized Signatory	Title of Authorized Signatory	Date 	

	Multifamily Development Experience	

Name of Architect of Record:      

Instructions: List multifamily developments in which the firm is the Architect of Record. If you have the information requested below available in a separate document, you may submit your existing document instead of using the form that follows.

Name and Address of Development	Name and Address of Developer	Elderly or Family?	No. of Units	Construction
Cost	Date Completed or % Completed 
To-Date	Building Type(s) and Number of Stories	Type of Financing (Conventional, Federal or State Agency)	“Green” Project Experience and/or Additional Information