1-B-DFCM Performance References Form 2.5.25.docx
DOCX document 55 KB Posted
- Solicitation number
- MP27007
- Issued by
- Utah
About this file
This is a Past Performance References Form for the Division of Facilities Construction and Management (DFCM) of the State of Utah, used to evaluate contractor qualifications for the Programming & Design services contract for Utah Valley University's Student Athletic Center renovation project. Contractors must submit references for up to five projects completed within the past five years where they served as the prime contractor with direct contract authority. The form requires comprehensive documentation for each reference, including the project name and number, point of contact information, project location, completion date, construction cost, description of work performed, and key personnel involved. All submitted information must be complete and accurate, with attachments and hyperlinks prohibited; failure to comply with reference requirements will result in contractor disqualification from the selection process.
The related contract opportunity involves Programming & Design services for the repair and remodel of the recently purchased SAELA building to enhance its longevity and utility for the Athletics Department at Utah Valley University. The construction budget for this project is $3,100,000.00. The form itself contains no pricing information, set-asides, incumbent data, or funding source details, as it is solely a reference verification document for evaluating contractor past performance and capability on projects of comparable scope and complexity.
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Text version
DFCM PAST PERFORMANCE REFERENCES
Provide references only for projects completed within the past five years where you served as the prime Contractor and held the contract directly with the stakeholder. It is the Contractors responsibility to ensure that all submitted information is complete and accurate. Failure to comply with the reference requirements will result in disqualification from the selection process. Attachments and hyperlinks are not permitted.
DFCM Project Name & Number: Click to enter text
Firm Name: Click to enter text
| Firm Contact Name: Click to enter text |
| Contact Info: Click to enter text |
REFERENCE NO. 1
| Project Name: Click to enter text |
| Point of Contact Name: (person able to answer questions about the project) |
| Click to enter text |
| Project Location (city, state): |
| Click to enter text |
| Point of Contact’s Role for the Project: |
| Click to enter text |
| Project Completion Date: |
| Click to enter text |
(month and year)
| Point of Contact Email: |
| Click to enter text |
Project Construction Cost:
| Click to enter text |
| Point of Contact Phone Number: |
Click to enter text
Brief Description of the work performed: Click to enter text
Key individuals who worked on the project: Click to enter text
REFERENCE NO. 2
| Project Name: Click to enter text |
| Point of Contact Name: (person able to answer questions about the project) |
| Click to enter text |
| Project Location (city, state): |
| Click to enter text |
| Point of Contact’s Role for the Project: |
| Click to enter text |
| Project Completion Date: |
| Click to enter text |
(month and year)
| Point of Contact Email: |
| Click to enter text |
Project Construction Cost:
| Click to enter text |
| Point of Contact Phone Number: |
Click to enter text
Brief Description of the work performed: Click to enter text
Key individuals who worked on the project: Click to enter text
REFERENCE NO. 3
| Project Name: Click to enter text |
| Point of Contact Name: (person able to answer questions about the project) |
| Click to enter text |
| Project Location (city, state): |
| Click to enter text |
| Point of Contact’s Role for the Project: |
| Click to enter text |
| Project Completion Date: |
| Click to enter text |
(month and year)
| Point of Contact Email: |
| Click to enter text |
Project Construction Cost:
| Click to enter text |
| Point of Contact Phone Number: |
Click to enter text
Brief Description of the work performed: Click to enter text
Key individuals who worked on the project: Click to enter text
REFERENCE NO. 4
| Project Name: Click to enter text |
| Point of Contact Name: (person able to answer questions about the project) |
| Click to enter text |
| Project Location (city, state): |
| Click to enter text |
| Point of Contact’s Role for the Project: |
| Click to enter text |
| Project Completion Date: |
| Click to enter text |
(month and year)
| Point of Contact Email: |
| Click to enter text |
Project Construction Cost:
| Click to enter text |
| Point of Contact Phone Number: |
Click to enter text
Brief Description of the work performed: Click to enter text
Key individuals who worked on the project: Click to enter text
REFERENCE NO. 5
| Project Name: Click to enter text |
| Point of Contact Name: (person able to answer questions about the project) |
| Click to enter text |
| Project Location (city, state): |
| Click to enter text |
| Point of Contact’s Role for the Project: |
| Click to enter text |
| Project Completion Date: |
| Click to enter text |
(month and year)
| Point of Contact Email: |
| Click to enter text |
Project Construction Cost:
| Click to enter text |
| Point of Contact Phone Number: |
Click to enter text
Brief Description of the work performed: Click to enter text
Key individuals who worked on the project: Click to enter text
--For DFCM Internal Use Only--
DFCM Project Number: Click to enter text
Due date and time: Click to enter text
Number of references needed: Click to enter text
Verified references on file with DFCM: ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5
DFCM Construction Performance References Form, 2.5.25 image1.jpeg
File details come from the government source that posted it. Updated .