Form_4_Reference_Questionnaire.pdf
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- Attached to
- CONSTRUCTION ENGINEERING AND INSPECTION SERVICES FOR PINE RIDGE ROAD CORRIDOR IMPROVEMENTS
- Solicitation number
- 26-8674
- Issued by
- Collier County, Florida
About this file
Form 4 Reference Questionnaire for Pine Ridge Road Corridor Improvements Project
This is a Form 4 Reference Questionnaire document associated with the Construction Engineering and Inspection (CEI) Services procurement for the Pine Ridge Road Corridor Improvements Project in Florida. The questionnaire is designed to gather reference information from bidders regarding their qualifications and experience. The project encompasses road and intersection improvements along approximately one mile of Pine Ridge Road, extending from west of the Pine Ridge Road and Livingston Road intersection to east of Whippoorwill Lane, plus approximately one-half mile of improvements along Livingston Road. The project scope includes a new "Jug-Handle" intersection design at the Pine Ridge Road/Livingston Road intersection to manage left-turning southbound traffic through a loop ramp configuration, a conventional intersection at Pine Ridge Road/Whippoorwill Lane, drainage improvements, sidewalk construction, and traffic signal installation. The form functions as a reference verification tool to evaluate bidder experience and past performance on comparable projects.
The questionnaire serves as a due diligence mechanism for the contracting agency to verify bidder qualifications through reference checks from previous clients. This document type is typically completed by proposing firms and submitted as part of their bid package to demonstrate relevant experience and capability to successfully deliver CEI services on complex transportation infrastructure projects. The reference questionnaire helps establish bidder credibility and track record in managing similar construction engineering and inspection work, which is critical for a project involving multiple intersection improvements and traffic management components.
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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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