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Reference for: <br />Organization/Firm Name providing reference: <br />Contact Name:Reference date: <br />Contact Phone:Contact Email: <br />Name of Referenced Project: <br />Contract No. Date Services Provided:ProjecWAmount: <br />Vendor’s role in Project:Prime Vendor Subconsultant/Subcontractor <br />Would you use this vendor again?Yes No If No, please specify in Additional Comments (below). <br />Description of services provided by Vendor: <br />Please rate your experience with the <br />referenced Vendor: <br />Needs <br />Improvement <br />Satisfactory Excellent Not <br />Applicable <br />1. Vendor’s Quality of Service <br />a. Responsive <br />b. Accuracy <br />c. Deliverables <br />2. Vendor’s Organization: <br />a. Staff expertise <br />b. Professionalism <br />c. Turnover <br />3. Timeliness of: <br />a. Project <br />b. Deliverables <br />4. Project completed within budget <br />5. Cooperation with: <br />a. Your Firm <br />b. Subcontractor(s)/Subconsultant(s) <br />c. Regulatory Agency(ies) <br />Additional Comments:(provide on additional sheet if needed) <br />All information provided to Broward County is subject to verification. Vendor acknowledges that inaccurate, untruthful, or incorrect statements made in support of this response may be used by the <br />County as a basis for rejection, rescission of the award, or termination of the contract and may also serve as the basis for debarment of Vendor pursuant to Section 21.119 of the Broward County <br />Procurement Code. <br />UP <br />7LWOH <br /> 7+,66(&7,21)25&2817<86(21/< <br />9HULILHGYLDBBBB(0$,/BBBB9(5%$/9HULILHGE\BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB'LYLVLRQBBBBBBBBBBBBBBB'DWHBBBBBBBBBBBBB <br />&LW\RI)RUW/DXGHUGDOH <br />;WR0LOOHU/HJJ <br />'DQLHO5H\3(6HQLRU3URMHFW0DQDJHU <br />954-828-4653 <br />%D\YLHZ'ULYH'UDLQDJH,PSURYHPHQW7DVN2UGHUXQGHUD&RQWLQXLQJ6HUYLFHV&RQWUDFW <br />5RVV(QJLQHHULQJ,QF <br />GUH\#IRUWODXGHUGDOHJRY <br />P12019 03/11/2015 09/06/2016 $ 300,000.00 <br />Modeling, Stormwater Calculations, Design, and permitting <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />✔ <br />Vendor Reference Verification Form <br />Page 27