3-C-DFCM Performance References Form 2.5.25.docx
DOCX document 55 KB Posted
- Attached to
- DFCM Construction - VBS Design Build - DNR/DWR - Logan Fish Hatchery Residence - 24437520
- Solicitation number
- DA27007
- 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 use in evaluating contractor qualifications on the DNR/DWR Logan Fish Hatchery Residence Design-Build project. The form requires bidding contractors to provide up to five references for projects completed within the past five years where the contractor served as the prime contractor and held the contract directly with the stakeholder. Each reference must include the project name, location, completion date, construction cost, point of contact information (including name, title, email, and phone number), a brief description of work performed, and key individuals involved in project delivery. Contractors must submit all information directly on the form without attachments or hyperlinks; failure to provide complete and accurate references will result in disqualification from the selection process.
The form is designed for DFCM's internal use to verify contractor past performance capabilities prior to award. References must be substantive and verifiable, allowing DFCM staff to conduct due diligence on contractor experience with similar projects. The form accommodates verification of one through five references, with checkboxes for DFCM staff to confirm which references have been verified and placed on file. This reference documentation supports the evaluation of contractor qualifications for the Logan Fish Hatchery Residence project, a design-build effort with a maximum budget of $500,000 for construction of a 2,000-square-foot single-story residential structure.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .