Attachment_3_Reference_Request_Form.pdf
PDF 64 KB Posted
- Attached to
- Equitable Services for Private Schools
- Solicitation number
- 019-MJ-0326
- Issued by
- Polk County, Florida
About this file
This is a Reference Request Form used by the School Board of Polk County, Florida in connection with an RFP for equitable services delivery to private schools. The form requires proposers to provide three references from previous clients who can evaluate their performance on tutoring and educational service contracts. Proposers must complete the top section with their company information and then distribute the form to their three selected references for completion. The references are asked to return the completed forms along with the proposer's RFP submission.
The Reference Request Form evaluates proposers across three performance categories: Service Performance, Management Performance, and Customer Satisfaction. Service Performance factors include lesson plan development and execution, tutoring schedule adherence, academic progress communication, student learning plan completion, student needs assessment accuracy, and instructional material quality. Management Performance factors assess invoice accuracy and timeliness, program manager responsibilities, service delivery to all eligible students, end-of-program reporting accuracy, tutor qualification capabilities, and staff training provisions. Customer Satisfaction ratings address overall contract performance, the proposer's professionalism and student-centered approach, and relationships with private school and District personnel. References provide numerical ratings on a scale of six (excellent) to one (unsatisfactory) with an N/A option, identify the contract dollar amount, and indicate whether they would use the proposer again.
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Text version
Attachment 3, Reference Request Form
(Reproduce as required)
Proposer: Please complete the information in the top box, REFERENCE REQUEST, then have your three (3) references complete the remainder of the information. Send this Reference Request Form to your references ALONG WITH YOUR RFP Submission.
REFERENCE REQUEST
PROPOSER COMPANY NAME:
REFERENCE COMPANY NAME:
REFERENCE COMPANY ADDRESS:
REFERENCE CONTACT PERSON:
PHONE NUMBER: EMAIL:
CONTRACT/PROJECT DESCRIPTION:
SERVICE PERFORMANCE
EXCELLENT UNSATISFACTORY
FACTORS/RATINGS 6 5 4 3 2 1 N/A
Lesson plans developed, maintained, and executed appropriately by tutors.
Tutoring schedules are developed and executed.
Academic progress is communicated on a timely basis to the required parties.
Student learning plans describing academic results and planned interventions are completed in a timely manner.
Assessment of student needs are accurate and timely.
Instructional materials meet student needs.
MANAGEMENT PERFORMANCE
EXCELLENT UNSATISFACTORY
FACTORS/RATINGS 6 5 4 3 2 1 N/A
Invoices are accurate and presented in a timely manner.
Program managers perform responsibilities as required.
All eligible students as identified by the District were provided services tailored to their academic need.
End of program reporting is accurate and completed on time.
Proposer can provide qualified tutors.
Proposer provides adequate training to allow effective job performance.
CUSTOMER SATISFACTION
EXCELLENT UNSATISFACTORY
FACTORS/RATINGS 6 5 4 3 2 1 N/A
How would you rate the Proposer’s overall performance on this contract?
How would you rate the Proposer’s ability to be cooperative, professional, and concerned with interest of the students?
How would you rate the Proposer’s relationship with private school and District personnel?
Total Dollar Amount of Contract
Additional Comments
Would you use this Proposer again?
YES NO
Services provided from:
through
Attachment 3, Reference Request Form
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