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City of Sunny Isles Beach |Request for Qualifications No. 18-11-01 27 <br />PROJECT VERIFICATION FORM <br />Respondent must have completed the design and permitting of at least two (2) pump station projects in <br />the past ten (10) years. The completed projects meeting this minimum qualification may have been <br />performed by the individual, firm, or project manager assigned to the Work. <br />1)Name of Client Entity: ______________________________________________ <br />Address: __________________________________________________________ <br />City/State/Zip: ______________________________________________________ <br />Contact: __________________________________________________________ <br />Title: _____________________________________________________________ <br />Email Address:____________________________________________________ <br />Telephone: ________________________________________________________ <br />Scope of Work: _____________________________________________________ <br />Contract Start/End Dates: _____________________________________________ <br />Consultant Contract Amount: $_________________________________________ <br />2)Name of Client Entity: ______________________________________________ <br />Address: __________________________________________________________ <br />City/State/Zip: ______________________________________________________ <br />Contact: __________________________________________________________ <br />Title: _____________________________________________________________ <br />Email Address:____________________________________________________ <br />Telephone: ________________________________________________________ <br />Scope of Work: _____________________________________________________ <br />Contract Start/End Dates: _____________________________________________ <br />Consultant Contract Amount: $_________________________________________ <br />3)Name of Client Entity: ______________________________________________ <br />Address: __________________________________________________________ <br />City/State/Zip: ______________________________________________________ <br />Contact: __________________________________________________________ <br />Title: _____________________________________________________________ <br />Email Address:_____________________________________________________ <br />Telephone: ________________________________________________________ <br />Scope of Work: _____________________________________________________ <br />Contract Start/End Dates: _____________________________________________ <br />Consultant Contract Amount: $_________________________________________ <br />END OF SECTION <br />City of Oakland Park <br />Oakland Park, FL 33334 <br />Albert Carbon <br />Director of Engineering and Community Development <br />AlbertC@OaklandParkFL.gov <br />954.630.4477 <br />2013-2017 <br />City of Dania Beach <br />Dania Beach, FL 33004 <br />Brad Kaine <br />Public Services Director <br />BKaine@DaniaBeachFL.gov <br />954.924.3740 <br />2007-2014 <br />City of Hallandale Beach <br />630 NW 2nd Street <br />100 W. Dania Beach Boulevard <br />5399 N. Dixie Highway, #3 <br />Hallandale, FL 33009 <br />Project Manager <br />MPitiriciu@Broward.org <br />Mariana Pitiriciu <br />954.359.6273 <br />2017-Present <br />960,873 <br />Expansive - please see the relevant SF330 project sheet in section 5 <br />Engineering, Surveying, Permitting, Environmental Construction Services <br />$236,000 <br />Civil/Electrical/Geotechnical Engineering, Surveying, Landscape Architecture <br />782,395 <br />144