Qualification Questionnaire Subconsultant.pdf
PDF 287 KB Posted
- Solicitation number
- RFP 360 2026052 3
- Issued by
- Palm Beach County, Florida
About this file
This is a Sub Consultant Qualification Questionnaire form used by Palm Beach County, Florida for the Street Lighting Professional Continuing Services Contract. The form serves as a standardized submission document for subconsultants seeking to participate in Palm Beach County projects. Subconsultants must provide detailed information including firm name, business structure, number of employees, office location, primary contact information, and scope of work description. The form requires identification of the prime consultant and project details, along with specification of the subconsultant's total project participation percentage and the portion of work to be performed locally within Palm Beach County offices versus non-locally.
The questionnaire includes sections for documenting Small Business Enterprise (SBE) certification from Palm Beach County and Minority/Women Business Enterprise (M/WBE) certification from the State of Florida, with copies of valid certifications required at the time of submission. Subconsultants must provide a volume of work history listing all projects awarded by the Palm Beach County Board of County Commissioners across four fiscal year periods (October 1 to September 30), with fees weighted by a declining factor based on recency: current year at 1.00, previous year at 0.75, year twice removed at 0.50, and year thrice removed at 0.25. The form requires certification by an authorized representative of the subconsultant firm, including signature, printed name, title, and date, with space provided for multiple pages of documentation as needed.
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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 | ||
| RFI Form.pdf | ||
| Qualification Questionnaire Prime.pdf | ||
| 2026052 Pre Proposal Sign In Sheet.pdf | ||
| OSBD Schedules and Instructions.pdf |
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Text version
SUB 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: _______________________________________________________________
SUB CONSULTANT (Subconsultant)
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
Subconsultant’s Scope of Work: ____________________________________________________
(A) ________% of Team: Subconsultant’s Total Project Participation (TPP)
(B) ________% Local: Portion of Subconsultant’s TPP to be performed in PBC office(s)
(C) ________% Non-Local: Portion of Subconsultant’s TPP to be performed outside of PBC office(s)
Note: (A) = (B)+ (C) [(A) will never equal 100%]
SUB 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 Subconsultant’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 as a prime, minus fees subcontracted out by consultant to sub-consultant, plus any fees for which the consultant is a sub-consultant.
CERTIFICATION
Sub Consultant Firm: ____________________________________________________________
Signature: _____________________________________________________________________
Printed Name: _________________________________________________________________
Title: _________________________________________________________________________
Date: _________________________________________________________________________
| Untitled |
| PROJECT |
SUB CONSULTANT (Subconsultant)
SBE CERTIFICATION
SCOPE OF SERVICE
VOLUME OF WORK
CERTIFICATION
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