EDGE Participation / Intent to Perform A/E Agreement (General Contracting Project) Suite 101 Harbourt Hall • 615 Loop Road • PO Box 5190 • Kent, Ohio 44242-0001 v: 330-672-3880 • f: 330-672-2648 • web site: www.kent.edu/universityarchitect OFFICE OF THE UNIVERSITY ARCHITECT Architect/Engineer (A/E) Information A/E KSU Project No. Project Name Date , 20 Certified EDGE Business Enterprise (EBE) (for project agreement at ANY tier) EDGE-certified business Phone Address Fax City, State, Zip Federal Tax I.D. Contact Person e-Mail Address Briefly describe services, work or supplies to be provided by the certified EBE (may use industry codes) Identify the Stage(s) of Design in which this EDGE Business Enterprise will be involved: Project Stage: Predesign Schematic Design Design Development Construction Documents Bidding and Award Conformed Documents Construction Administration Project Closeout Additional Services: % of EDGE Fee Comments Breakdown of EBE Fee: % % % % % % % % $ $ $ $ $ $ $ $ % % $ $ % % $ $ Reimbursable Expenses: Percentage of proposed EBE participation:* Anticipated total fee payable to EBE firm: $ *If indicating less than 5 percent EDGE participation, the Associate must provide a “Demonstration of Good Faith Effort” (form attached) that the A/E attempted to meet the 5 percent participation goal established for this project by the Director of Kent State University Office of the University Architect pursuant to Section 123.152 of the Ohio Revised Code. Certified by EDGE Business Enterprise and by the A/E The named A/E certifies that it intends to contract with the EDGE-certified business for the portion of the agreement described above related to this project. The named EDGE-certified business certifies that it intends to contract with the named A/E and intends to provide the portion of the A/E’s scope of services as described above and for the anticipated cost or fee as indicated above. If the named A/E is not selected to provide professional design services for this Project, this Statement of Intent shall be null and void. Submitted as a part of the: Technical Proposal EDGE-certified Business Architect/Engineer Name Signature KSU-OUA 09/2012 Fee Proposal Name Date Signature Date Page 1 of 1