Qualification Questionnaire Prime.pdf
PDF 285 KB Posted
- Solicitation number
- RFP 360 2026052 3
- Issued by
- Palm Beach County, Florida
About this file
This is a Prime Consultant Qualification Questionnaire form used by Palm Beach County, Florida for state and local contract opportunities, specifically in connection with a Street Lighting Professional Continuing Services Contract. The form requires prime consultants to provide detailed information including firm name, business structure, number of employees, office location, and contact information. Consultants must identify their scope of work and specify the percentage of total project participation to be performed locally within Palm Beach County offices versus non-locally. The form also requests documentation of Small Business Enterprise (SBE) certifications, including Palm Beach County Certified SBE status and State of Florida Certified Minority/Women Business Enterprise (M/WBE) designations, with applicants required to attach valid certification letters or certificates.
The questionnaire includes a volume of work section requiring consultants to list all projects awarded contract and supplement fees by the Palm Beach County Board of County Commissioners over a four-year period, with fees weighted by fiscal year proximity (current year at 1.00 factor, previous year at 0.75, fiscal year once removed at 0.50, and fiscal year twice removed at 0.25). The form specifies that fees considered are those awarded to the consultant minus any fees subcontracted to subconsultants, plus fees for which the consultant serves as a subconsultant. All submissions must be signed and certified by an authorized representative of the prime consultant firm, with the completed questionnaire serving as a qualification evaluation tool for the Street Lighting Professional Continuing Services Contract opportunity.
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Other files
| File | Type | Posted |
|---|---|---|
| RFI Form.docx | DOCX document | |
| 2026052 RFP Package.pdf | ||
| Prime Firms SBE Past Participation Statement.pdf | ||
| Conflict of Interest.pdf | ||
| 2026052 - Update 1.pdf | ||
| Qualification Questionnaire Subconsultant.pdf | ||
| RFI Form.pdf | ||
| 2026052 Pre Proposal Sign In Sheet.pdf | ||
| OSBD Schedules and Instructions.pdf |
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Text version
PRIME CONSULTANT QUALIFICATION QUESTIONNAIRE
The detailed data requested here must be submitted in this format only.
Use as many pages as needed to provide the following required information:
PROJECT
Name:___________________________________________________ Proj. # ______________
PRIME CONSULTANT (Prime)
Firm Name: ___________________________________________________________________
The undersigned intends to perform work in connection with the above project as (check one):
an individual a corporation a partnership a joint venture
Number of Employees __________ Website: ________________________________________
Office Location
Street Address: _________________________________________________________________
City, State and Zip Code: _________________________________________________________
Contact Person
Name:____________________________________ Title: _______________________________
Email:______________________________________ Telephone # _______________________
SBE CERTIFICATION
Check all that apply and attach applicable copy of certification letter(s) or certificate(s).
Certifications must be valid on RFP or other type of submittal due date.
Palm Beach County (PBC) Certified Small Business Enterprise (SBE)
State of Florida Certified Minority/Women Business Enterprise (M/WBE)
SCOPE OF SERVICE
Prime’s Scope of Work: __________________________________________________________
(A) ________% of Team: Prime’s Total Project Participation (TPP)
(B) ________% Local: Portion of Prime’s TPP to be performed in PBC office(s)
(C) ________% Non-Local: Portion of Prime’s TPP to be performed outside of PBC office(s)
Note: (A) = (B) + (C) [(A) will only equal 100% if there are no subconsultants]
PRIME CONSULTANT QUALIFICATION QUESTIONNAIRE
VOLUME OF WORK
List all projects with associated contract and supplement fees awarded by the Palm Beach County
Board of County Commissioners in the fiscal years (October 1 to September 30) indicated.
Includes any fees awarded as a subconsultant.
FY Period Prime’s Fee * Factor Fees Considered
(1) Current Fiscal Year: $__________________ x 1.00 = $________________________
(2) Previous Fiscal Year: $__________________ x 0.75 = $________________________
(3) Fiscal Year Once Removed: $__________________ x 0.50 = $________________________
(4) Fiscal Year Twice Removed: $__________________ x 0.25 = $________________________
Total Fees Considered $________________________
* Palm Beach County fees awarded to the consultant, minus fees subcontracted out by consultant to sub-consultant, plus any fees for which the consultant is a sub-consultant.
CERTIFICATION
Prime Consultant Firm: __________________________________________________________
Signature: _____________________________________________________________________
Printed Name: _________________________________________________________________
Title: _________________________________________________________________________
Date: _________________________________________________________________________
| Untitled |
| PROJECT |
PRIME CONSULTANT (Prime)
SBE CERTIFICATION
SCOPE OF SERVICE
VOLUME OF WORK
CERTIFICATION
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