Project Reference Form v.12.25.pdf

1 MB Posted

Attached to
ECEP Cooling Tower Basin Improvements
Solicitation number
146496
Issued by
Polk County, Florida

About this file

Written by GovTribe AI ·

This is a Project Reference Form for the ECEP Cooling Tower Basin Improvements contract opportunity in Florida. Bidders are required to submit at least three relevant project references completed within the last five years, with a mandatory requirement that at least one project involved a centrifugal chiller rated at 2,000 tons or more. For each reference project, bidders must provide comprehensive information including the client name and location, contact information (name, phone number, and email address), equipment manufacturer and model specifications with chiller tonnage rating, contract amount, any change order amounts, whether the project was completed on schedule, actual completion date, and a detailed scope of work performed.

The form contains multiple sections accommodating three or more project references, with each section providing dedicated fields for all required reference information. This documentation requirement allows the contracting agency to evaluate the bidder's relevant experience and capability to successfully execute centrifugal chiller projects of significant scale. No specific pricing terms, set-asides, incumbent information, or funding details are outlined within this reference form itself, as it functions solely as a qualification and experience verification document that bidders must complete as part of their proposal submission.

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

At least one project shall have involved a centrifugal chiller rated at 2,000 tons or more.CLIENT NAME AND LOCATION:

CONTACT NAME, PHONE NUMBER, & EMAIL ADDRESS:

CONTRACT AMOUNT: CHANGE ORDER(S)

AMOUNT(S):

COMPLETED ON

SCHEDULE:

ACTUAL COMPLETION

DATE:

SCOPE OF WORK PERFORMED:

PROJECT REFERENCE FORM

v.2 12.25

EXHIBIT D - PROJECT REFERENCE FORM

EQUIPMENT MANUFACTURER, MODEL AND CHILLER TONNAGE:

CLIENT NAME AND LOCATION:

CONTACT NAME, PHONE NUMBER, & EMAIL ADDRESS:

EQUIPMENT MANUFACTURER, MODEL AND CHILLER TONNAGE:

CONTRACT AMOUNT: CHANGE ORDER(S)

AMOUNT(S):

COMPLETED ON

SCHEDULE:

ACTUAL COMPLETION

DATE:

SCOPE OF WORK PERFORMED:

PROJECT/CLIENT REFERENCE FORM

v.2 12.25

CLIENT NAME AND LOCATION:

CONTACT NAME, PHONE NUMBER, & EMAIL ADDRESS:

EQUIPMENT MANUFACTURER, MODEL AND CHILLER TONNAGE:

CONTRACT AMOUNT: CHANGE ORDER(S)

AMOUNT(S):

COMPLETED ON

SCHEDULE:

ACTUAL COMPLETION

DATE:

SCOPE OF WORK PERFORMED:

PROJECT/CLIENT REFERENCE FORM

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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