18-Vendor Reference Verification - PNC2131324P1.docx
DOCX document 45 KB Posted
- Solicitation number
- PNC2131324P1
- Issued by
- Broward County, Florida
About this file
This is a Vendor Reference Verification Form template issued by Broward County, Florida for solicitation PNC2131324P1, an Airport Safety Assessment project at North Perry Airport (HWO). Vendors responding to this Request for Proposal must submit a minimum of three non-Broward County Board of County Commissioners' references, or as otherwise specified in the evaluation criteria. The form requires vendors to have their reference organizations complete and return the verification form with their submittal. If reference forms are not provided at time of submission 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 project information including the reference organization name, contact details, project name, contract number, service dates, project amount, and the vendor's role as either prime or subcontractor.
The form requires references to rate their experience with the vendor across multiple performance categories including quality of service (responsiveness, accuracy, deliverables), organizational factors (staff expertise, professionalism, turnover), timeliness (project completion and deliverable delivery), budget performance, and cooperation with the reference firm, subcontractors, and regulatory agencies. References must indicate whether they would use the vendor again and provide narrative descriptions of services rendered. The County reserves the right to verify all information provided and explicitly reserves the authority to reject proposals, rescind awards, terminate contracts, or initiate debarment proceedings if vendors submit inaccurate, untruthful, or incorrect statements in their responses.
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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: PNC2131324P1 Airpor Safety Assessment – North Perry Airport (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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