RFP 25-03_Attachment F.pdf

RFP 25-03

Low-Code Application Development Services

Attachment F: Client Reference Form 1 of 4

Attachment F: Client Reference Form

The Respondent shall complete and submit this entire form. Using the form(s) provided in this Attachment, Respondent shall identify and include three (3) current and/or past clients, either businesses or governmental agencies, to which the Respondent has provided commodities and/or contractual services of similar scope and size as those identified in the RFP within the last five (5) years.

I, _____________________________________ am the ________________________________ of

(Authorized Representative’s Name) (Title)

_______________________________________, (the “Vendor”), and am authorized to represent and

(Vendor’s Legal Name) contractually bind Vendor. Having been duly sworn, I do hereby:

1. Grant permission to the Florida Department of Citrus (the “Department”) to contact the references listed below at a time and using a method convenient to the Department.

2. Waive any claim, either contractual or otherwise, to confidentiality that exists between the listed Client(s) and Vendor regarding Vendor’s performance under the listed contract(s).

3. Release the Client’s Contact(s), or their successors, or designees, to discuss with, and provide any requested information to, the Department concerning Vendor’s performance under the listed contract(s).

4. Release, forever discharge, and hold harmless the Department and the listed Client(s) from any claim or liability that Vendor may make related to the loss, either real or perceived, that may exist due, in whole or in part, to the Department’s evaluation of the information disclosed by the listed Client(s) regarding Vendor’s performance.

I understand that the purpose of this permission and release is for the Department to evaluate and assess Vendor’s eligibility for Contract Award pursuant to the indicated solicitation, and that any such information provided may be subject to disclosure under Chapter 119, F.S., the Florida Constitution, or other authority.

Signature

Date

Attachment F: Client Reference Form 2 of 4

Client #1

Client Name & Internet Address

Client Name:

Webpage Address:

Client Contact Information

Name:

Title:

Street Address:

City, State, and ZIP:

Email Address:

Telephone Number:

Commodity/Service Details

Period of Services: From: To:

Contract Value:

Commodity/Service Description*

*If Respondent has undergone a change of name, ownership, or organization, the name under which the Respondent operated at the time of performance shall be disclosed in this section.

Attachment F: Client Reference Form 3 of 4

Client #2

Client Name:

Webpage Address:

Client Contact Information

Name:

Title:

Street Address:

City, State, and ZIP:

Email Address:

Telephone Number:

Commodity/Service Details

Period of Services: From: To:

Attachment F: Client Reference Form 4 of 4

Client #3

Client Name:

Webpage Address:

Client Contact Information

Name:

Title:

Street Address:

City, State, and ZIP:

Email Address:

Telephone Number:

Commodity/Service Details

Period of Services: From: To: