1-C-DA26039 DFCM Performance References Form, 4.21.2026.docx
DOCX document 53 KB Posted
- Attached to
- DFCM Construction - Request for Statement of Qualifications for Prequalified Code Inspection Firms - FY2027
- Solicitation number
- DA26039
- Issued by
- Utah
About this file
This is a Past Performance References Form issued by the State of Utah Division of Facilities Construction and Management (DFCM) for firms seeking prequalification as code inspection service providers. Bidding firms must submit up to six past performance references for projects completed within the past five years where the firm served as the prime contractor. Each reference entry requires comprehensive project documentation including the project name, location, point of contact information, total construction cost, project type, substantial completion date, description of work performed, and key personnel involved. The prequalification is effective July 1, 2026, and expires December 31, 2027, with an 18-month prequalification period. Firms must submit renewal documentation prior to expiration to maintain prequalified status for subsequent 18-month periods.
Non-compliance with reference submission requirements will result in firm disqualification from the selection process. Bidders are strongly encouraged to notify all references in advance that DFCM will be contacting them to verify past performance and discuss project execution. The form emphasizes that it is the firm's responsibility to ensure all submitted information is complete and accurate, as timely access to references is critical to the evaluation process. No specific pricing information, set-asides, or funding amounts are addressed in this reference form, as it serves solely as a supporting document within the broader prequalification solicitation for statewide capital project code inspection services.
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PAST PERFORMANCE REFERENCES
Only provide references on projects completed within the past 5 years where your firm was the PRIME FIRM and held the contract.
It is the firm’s responsibility to submit complete and correct information.
We strongly encourage you to contact the references you are providing to let them know DFCM will be contacting them. It is important we are able to speak with your firm’s references in a timely manner. Non-compliance with reference requirements will result in the firm's disqualification from the selection.
Firm Business Name: Click to enter text
Firm Contact Name: Click to enter text
Contact Email: Click to enter text
Contact Phone: Click to enter text
REFERENCE NO. 1
| Project Name: |
| Click or tap here to enter text. |
| Location (city, state) of project: |
| Click or tap here to enter text. |
| Point of Contact Name (Person able to |
answer questions about the project):
| Click or tap here to enter text. |
| Point of Contact Phone Number: |
| Click or tap here to enter text. |
| Point of Contact Email: |
| Click or tap here to enter text. |
| Total construction cost of the project: |
| Click or tap here to enter text. |
| Project type (school, office, warehouse, etc.): |
| Click or tap here to enter text. |
| Date of Project Substantial Completion: Click or tap here to enter text. |
Brief Description of the work performed:
| Click or tap here to enter text. |
| Key individuals who worked on the project: |
| Click or tap here to enter text. |
| REFERENCE NO. 2 |
| Project Name: |
| Click or tap here to enter text. |
| Location (city, state) of project: |
| Click or tap here to enter text. |
| Point of Contact Name (Person able to |
answer questions about the project):
| Click or tap here to enter text. |
| Point of Contact Phone Number: |
| Click or tap here to enter text. |
| Point of Contact Email: |
| Click or tap here to enter text. |
| Total construction cost of the project: |
| Click or tap here to enter text. |
| Project type (school, office, warehouse, etc.): |
| Click or tap here to enter text. |
| Date of Project Substantial Completion: Click or tap here to enter text. |
Brief Description of the work performed:
| Click or tap here to enter text. |
| Key individuals that worked on the project: |
Click or tap here to enter text.
REFERENCE NO. 3
| Project Name: |
| Click or tap here to enter text. |
| Location (city, state) of project: |
| Click or tap here to enter text. |
| Point of Contact Name (Person able to |
answer questions about the project):
| Click or tap here to enter text. |
| Point of Contact Phone Number: |
| Click or tap here to enter text. |
| Point of Contact Email: |
| Click or tap here to enter text. |
| Total construction cost of the project: |
| Click or tap here to enter text. |
| Project type (school, office, warehouse, etc.): |
| Click or tap here to enter text. |
| Date of Project Substantial Completion: Click or tap here to enter text. |
Brief Description of the work performed:
| Click or tap here to enter text. |
| Key individuals that worked on the project: |
Click or tap here to enter text.
REFERENCE NO. 4
| Project Name: |
| Click or tap here to enter text. |
| Location (city, state) of project: |
| Click or tap here to enter text. |
| Point of Contact Name (Person able to |
answer questions about the project):
| Click or tap here to enter text. |
| Point of Contact Phone Number: |
| Click or tap here to enter text. |
| Point of Contact Email: |
| Click or tap here to enter text. |
| Total construction cost of the project: |
| Click or tap here to enter text. |
| Project type (school, office, warehouse, etc.): |
| Click or tap here to enter text. |
| Date of Project Substantial Completion: Click or tap here to enter text. |
Brief Description of the work performed:
| Click or tap here to enter text. |
| Key individuals that worked on the project: |
Click or tap here to enter text.
REFERENCE NO. 5
| Project Name: |
| Click or tap here to enter text. |
| Location (city, state) of project: |
| Click or tap here to enter text. |
| Point of Contact Name (Person able to |
answer questions about the project):
| Click or tap here to enter text. |
| Point of Contact Phone Number: |
| Click or tap here to enter text. |
| Point of Contact Email: |
| Click or tap here to enter text. |
| Total construction cost of the project: |
| Click or tap here to enter text. |
| Project type (school, office, warehouse, etc.): |
| Click or tap here to enter text. |
| Date of Project Substantial Completion: Click or tap here to enter text. |
Brief Description of the work performed:
| Click or tap here to enter text. |
| Key individuals that worked on the project: |
| Click or tap here to enter text. |
| REFERENCE NO. 6 |
| Project Name: |
| Click or tap here to enter text. |
| Location (city, state) of project: |
| Click or tap here to enter text. |
| Point of Contact Name (Person able to |
answer questions about the project):
| Click or tap here to enter text. |
| Point of Contact Phone Number: |
| Click or tap here to enter text. |
| Point of Contact Email: |
| Click or tap here to enter text. |
| Total construction cost of the project: |
| Click or tap here to enter text. |
| Project type (school, office, warehouse, etc.): |
| Click or tap here to enter text. |
| Date of Project Substantial Completion: Click or tap here to enter text. |
Brief Description of the work performed:
| Click or tap here to enter text. |
| Key individuals that worked on the project: |
Click or tap here to enter text.
DFCM Performance References Form, 4.30.24 image1.jpeg
File details come from the government source that posted it. Updated .