26-8635_Form_4_Reference_Questionnaire.pdf
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- Solicitation number
- 26-8635
- Issued by
- Collier County, Florida
About this file
This is a Reference Questionnaire form issued by Collier County, Florida, Board of County Commissioners, Procurement Services Division, for use in evaluating professional services proposals submitted in response to Solicitation 26-8635 for the South County Water Reclamation Facility (SCWRF) Treatment Technology & Flow Management Improvements project. Proposers are required to submit one completed Form 4 Reference Questionnaire for each reference listed in their proposal, with all forms to be returned with the proposal submittal by the March 9, 2026, 3:00 P.M. EST deadline. The questionnaire requests that references—previous clients for whom the firm has performed work—rate the proposing firm and key personnel across ten performance criteria on a scale of 1 to 10, with 10 representing very satisfied and willingness to hire again, and 1 representing very unsatisfied and unwillingness to hire again. References must provide project-specific information including project description, completion date, project budget, and number of project days, and must score the firm's ability to manage project costs and minimize change orders, maintain project schedule, deliver quality work, provide quality consultative advice, demonstrate professionalism and personnel management, complete project administration tasks, communicate clearly both verbally and in writing, manage risks and unexpected circumstances, follow contract documents and regulations, and overall customer satisfaction. Blank responses are scored as zero.
The Reference Questionnaire is a mandatory evaluation tool under Collier County's selection process for professional services, contributing to the Past Performance scoring criterion worth 25 of the 100 total evaluation points. There are no pricing terms, set-asides, or incumbent information contained in this form, as it functions solely as a reference evaluation instrument. Proposers must ensure all required references complete and return this form as part of their proposal package to avoid non-responsive status.
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Text version
Version 2 9.2.25
Procurement Services Division
Form 4 Reference Questionnaire
(USE ONE FORM FOR EACH REQUIRED REFERENCE – FORM MUST BE FULLY COMPLETED AND RETURNED
WITH PROPOSAL SUBMITTAL)
Solicitation:
Reference Questionnaire for:
(Name of Company Requesting Reference Information)
(Name of Individuals Requesting Reference Information)
Name:
(Evaluator completing reference questionnaire)
Company:
(Evaluator’s Company completing reference)
Email: FAX: Telephone:
Collier County has implemented a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of 1 to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and 1 representing that you were very unsatisfied (and would never hire the firm/indivdiual again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored “0.”
Project Description: ___________________________ Completion Date: _____________________________
Project Budget: _______________________________ Project Number of Days: _______________________
Item Criteria Score (must be completed) 1 Ability to manage the project costs (minimize change orders to scope).
2 Ability to maintain project schedule (complete on-time or early).
3 Quality of work.
4 Quality of consultative advice provided on the project.
5 Professionalism and ability to manage personnel.
6 Project administration (completed documents, final invoice, final product turnover;
invoices; manuals or going forward documentation, etc.)
7 Ability to verbally communicate and document information clearly and succinctly.
8 Abiltity to manage risks and unexpected project circumstances.
9 Ability to follow contract documents, policies, procedures, rules, regulations, etc.
10 Overall comfort level with hiring the company in the future (customer satisfaction).
TOTAL SCORE OF ALL ITEMS
| Text25: |
| Text26: |
| Name of Company Requesting Reference Information: |
| Text27: |
| Text28: |
| Text29: |
| Text30: |
| Text31: |
| Project Description: |
| Completion Date: |
| Project Budget: |
| Project Number of Days: |
| Score must be completedAbility to manage the project costs minimize change orders to scope: |
| Score must be completedAbility to maintain project schedule complete ontime or early: |
| Score must be completedQuality of work: |
| Score must be completedQuality of consultative advice provided on the project: |
| Score must be completedProfessionalism and ability to manage personnel: |
| Score must be completedProject administration completed documents final invoice final product turnover invoices manuals or going forward documentation etc: |
| Score must be completedAbility to verbally communicate and document information clearly and succinctly: |
| Score must be completedAbiltity to manage risks and unexpected project circumstances: |
| Score must be completedAbility to follow contract documents policies procedures rules regulations etc: |
| Score must be completedOverall comfort level with hiring the company in the future customer satisfaction: |
| Score must be completedTOTAL SCORE OF ALL ITEMS: |
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