Exhibit D - Project - Client Reference Form v.12.25 (1).pdf

948 KB Posted

Attached to
Lift Station #46 Rehabilitation
Solicitation number
145242
Issued by
Polk County, Florida

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Written by GovTribe AI ·

This is an Exhibit D Project/Client Reference Form for a state and local contract opportunity in Florida related to Lift Station #46 Rehabilitation. The form requires bidders to provide at least three (3) relevant project references completed within the last five (5) years. For each reference, bidders must document the client name, project name, contact information including name, phone number, and email address, the original contract amount, any change order amounts, whether the project was completed on schedule, the actual completion date, and a detailed description of services performed.

The award for the Lift Station #46 Rehabilitation project shall be made to the lowest responsive and responsible bidder based on the combined total price of all line items listed in PlanetBids, though the District reserves the right to award in its best interest. This reference documentation requirement serves to establish bidder experience and reliability, allowing the procuring agency to evaluate contractor qualifications and past performance on similar projects before making the final award determination.

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Please use this form to provide at least three (3) relevant project references completed within the last five (5) years

CLIENT NAME:

PROJECT NAME:

CONTACT NAME, PHONE NUMBER, & EMAIL ADDRESS:

CONTRACT AMOUNT: CHANGE ORDER(S)

AMOUNT(S):

COMPLETED ON

SCHEDULE:

ACTUAL COMPLETION

DATE:

DESCRIPTION OF SERVICES PERFORMED :

v.2 12.25

EXHIBIT D

PROJECT/CLIENT REFERENCE FORM

Please use this form to provide at least three (3) relevant project references completed within the last five (5) years

PROJECT NAME:

CONTACT NAME, PHONE NUMBER, & EMAIL ADDRESS:

CONTRACT AMOUNT: CHANGE ORDER(S)

AMOUNT(S):

COMPLETED ON

SCHEDULE:

ACTUAL COMPLETION

DATE:

DESCRIPTION OF SERVICES PERFORMED:

v.2 12.25

Please use this form to provide at least three (3) relevant project references completed within the last five (5) years

PROJECT NAME:

CONTACT NAME, PHONE NUMBER, & EMAIL ADDRESS:

CONTRACT AMOUNT: CHANGE ORDER(S)

AMOUNT(S):

COMPLETED ON

SCHEDULE:

ACTUAL COMPLETION

DATE:

DESCRIPTION OF SERVICES PERFORMED:

v.2 12.25

CLIENT NAMERow1:
PROJECT NAMERow1:
CONTACT NAME PHONE NUMBER EMAIL ADDRESSRow1:
CONTRACT AMOUNTRow1:
CHANGE ORDERS AMOUNTSRow1:
COMPLETED ON SCHEDULERow1:
ACTUAL COMPLETION DATERow1:
DESCRIPTION OF SERVICES PERFORMED Row1:
DESCRIPTION OF SERVICES PERFORMED Row2:
DESCRIPTION OF SERVICES PERFORMED Row3:
DESCRIPTION OF SERVICES PERFORMED Row4:
DESCRIPTION OF SERVICES PERFORMED Row5:
DESCRIPTION OF SERVICES PERFORMED Row6:
DESCRIPTION OF SERVICES PERFORMED Row7:
DESCRIPTION OF SERVICES PERFORMED Row8:
DESCRIPTION OF SERVICES PERFORMED Row9:
DESCRIPTION OF SERVICES PERFORMED Row10:
CLIENT NAMERow1_2:
PROJECT NAMERow1_2:
CONTACT NAME PHONE NUMBER EMAIL ADDRESSRow1_2:
CONTRACT AMOUNTRow1_2:
CHANGE ORDERS AMOUNTSRow1_2:
COMPLETED ON SCHEDULERow1_2:
ACTUAL COMPLETION DATERow1_2:
DESCRIPTION OF SERVICES PERFORMEDRow1:
DESCRIPTION OF SERVICES PERFORMEDRow2:
DESCRIPTION OF SERVICES PERFORMEDRow3:
DESCRIPTION OF SERVICES PERFORMEDRow4:
DESCRIPTION OF SERVICES PERFORMEDRow5:
DESCRIPTION OF SERVICES PERFORMEDRow6:
DESCRIPTION OF SERVICES PERFORMEDRow7:
DESCRIPTION OF SERVICES PERFORMEDRow8:
DESCRIPTION OF SERVICES PERFORMEDRow9:
DESCRIPTION OF SERVICES PERFORMEDRow10:
CLIENT NAMERow1_3:
PROJECT NAMERow1_3:
CONTACT NAME PHONE NUMBER EMAIL ADDRESSRow1_3:
CONTRACT AMOUNTRow1_3:
CHANGE ORDERS AMOUNTSRow1_3:
COMPLETED ON SCHEDULERow1_3:
ACTUAL COMPLETION DATERow1_3:
DESCRIPTION OF SERVICES PERFORMEDRow1_2:
DESCRIPTION OF SERVICES PERFORMEDRow2_2:
DESCRIPTION OF SERVICES PERFORMEDRow3_2:
DESCRIPTION OF SERVICES PERFORMEDRow4_2:
DESCRIPTION OF SERVICES PERFORMEDRow5_2:
DESCRIPTION OF SERVICES PERFORMEDRow6_2:
DESCRIPTION OF SERVICES PERFORMEDRow7_2:
DESCRIPTION OF SERVICES PERFORMEDRow8_2:
DESCRIPTION OF SERVICES PERFORMEDRow9_2:
DESCRIPTION OF SERVICES PERFORMEDRow10_2:

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