15-Vendor Reference Verification PNC2131298P1.docx
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- Solicitation number
- PNC2131298P1
- Issued by
- Broward County, Fort Lauderdale City, Florida
About this file
This is a Vendor Reference Verification Form template issued by Broward County, Florida for solicitation PNC2131298P1, which seeks consulting services for environmental compliance at Fort Lauderdale-Hollywood International Airport (FLL) and North Perry Airport (HWO). The solicitation seeks up to two consultants to provide environmental compliance services, with potential work falling under two groupings: Environmental Regulatory Compliance and Response Services. Vendors are required to submit a minimum of three non-Broward County Board of County Commissioners' references or as specified in the evaluation criteria. The form must be completed by reference organizations and submitted with the vendor's proposal response through the BPRO electronic system by the stated closing date and time. If references are not provided with the initial submittal or cannot be verified, vendors must submit completed forms within three business days of the County's written request.
The Vendor Reference Verification Form requests detailed information about the vendor's performance on referenced projects, including project name, contract number, date range, project amount, and vendor's role as either prime or subconsultant/subcontractor. Reference organizations are asked to evaluate vendor performance across multiple categories including quality of service, organizational capabilities, timeliness, project budget management, and cooperation with internal and external stakeholders, with rating options of Needs Improvement, Satisfactory, Excellent, or Not Applicable. All information provided is subject to County verification, and vendors acknowledge that inaccurate or untruthful statements may result in proposal rejection, contract rescission, termination, or vendor debarment pursuant to the Broward County Procurement Code.
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Text version
VENDOR REFERENCE VERIFICATION
REQUEST FOR PROPOSAL, REQUEST FOR QUALIFICATION, OR REQUEST FOR LETTER OF INTEREST
Vendor should provide a minimum of three (3) non-Broward County Board of County Commissioners’ references or as per Evaluation Criteria instructions. Vendor should provide the Vendor Reference Verification Form to its reference organization/firm to complete and return to the Vendor’s attention.
Completed Vendor Reference Verification Forms should be submitted with submittal. If not provided with submittal, or if reference is not able to be verified, the Vendor must submit form(s) (or a new Vendor Reference Verification Form) within three business days after the County's written request.
VENDOR REFERENCE VERIFICATION FORM (RFP/RLI/RFQ)
Solicitation No. & Title: PNC2131298P1 Environmental Compliance Services at FLL and HWO
| Reference For (hereinafter, “Vendor”): |
| Click or tap here to enter text. |
| Reference Date: |
| Click or tap here to enter text. |
| Organization/Firm Providing Reference: |
| Click or tap here to enter text. |
| Contact Name: |
| Click or tap here to enter text. |
| Contact Title: |
| Click or tap here to enter text. |
| Contact Email: |
| Click or tap here to enter text. |
| Contact Phone: |
| Click or tap here to enter text. |
| Name of Referenced Project: |
| Click or tap here to enter text. |
| Contract Number: |
| Click or tap here to enter text. |
| Date Range of Services Provided: |
| Start Date: |
| End Date: |
| Project Amount: |
| Click or tap here to enter text. |
| Vendor’s Role in Project: |
| ☐ Prime |
| ☐ Subconsultant/Subcontractor |
| Would you use this Vendor again? |
| ☐ Yes |
| ☐ No |
If you answered no to the question above, please specify below: (attach additional sheet if needed) Click or tap here to enter text.
Description of services provided by Vendor, please specify below: (attach additional sheet if needed) Click or tap here to enter text.
| Please rate your experience with the referenced Vendor via checkbox: |
| Needs Improvement |
| Satisfactory |
| Excellent |
| Not Applicable |
Vendor’s Quality of Service:
| Responsive: | |||
| ☐ | ☐ | ☐ | ☐ |
| Accuracy: | |||
| ☐ | ☐ | ☐ | ☐ |
| Deliverables: | |||
| ☐ | ☐ | ☐ | ☐ |
| Vendor’s Organization: |
| Staff Expertise: | |||
| ☐ | ☐ | ☐ | ☐ |
| Professionalism: | |||
| ☐ | ☐ | ☐ | ☐ |
| Turnover: | |||
| ☐ | ☐ | ☐ | ☐ |
| Timeliness of: |
| Project: | |||
| ☐ | ☐ | ☐ | ☐ |
| Deliverables: | |||
| ☐ | ☐ | ☐ | ☐ |
| Project completed within budget: | |||
| ☐ | ☐ | ☐ | ☐ |
| Cooperation with: |
| Your Firm: | |||
| ☐ | ☐ | ☐ | ☐ |
| Subcontractor(s)/Subconsultant(s): | |||
| ☐ | ☐ | ☐ | ☐ |
| Regulatory Agency(ies): | |||
| ☐ | ☐ | ☐ | ☐ |
| All information provided to Broward County is subject to verification. Vendor acknowledges that inaccurate, untruthful, or incorrect statements made in support of this response may be used by the County as a basis for rejection, rescission of the award, or termination of the contract and may also serve as the basis for debarment of Vendor pursuant to the Broward County Procurement Code. |
***THE SECTION BELOW IS FOR COUNTY USE ONLY***
| Verified via: | |
| Verified by: | |
| Click or tap here to enter text. | Division: |
| Click or tap here to enter text. |
☐ Verbal
| Date: |
| Click or tap here to enter text. |
Vendor Reference Verification Form – RFP/RLI/RFQ Form Date 4/1/25 image1.png
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