Form#3 Reference Survey



Form#3 Reference Survey-6667550165Lee County Procurement ManagementReference SurveySolicitation #CN-160170Professional Services: North Fort Myers & Bonita Springs LibrariesSection 1FROM:BUYER: Lori DeLoachCOMPANY:DATE: 03/15/2016PHONE #:TOTAL # PAGES:1FAX #:PHONE #: 239-533-5450FAX #: 239-485-5460EMAIL:BUYER EMAIL: LDeLoach@SUBJECT:Reference for work completed regarding (Proposer project name):You as an individual or Your company has been given as a reference on a project identified above. Description of Lee County Project: Conduct an engineering study to develop alternatives and to design improvements at the intersection of Lee Boulevard and GunneryRoad to relieve traffic congestion in a manner compatible with the proposed Mixed Use Activity Center that is currently underdevelopment.Section 2Proposer name (reference is being provided for): Section 3Indicate:“YES” OR “NO”1.Was the scope of work performed similar in nature?2.Did this company have the proper resources and personnel by which to get the job done?3.Were any problems encountered with the company’s work performance?4.Were any change orders or contract amendments issued, other than owner initiated?5.Was the job completed on time?6.Was the job completed within budget?7.On a scale of one to ten, ten being best, how would you rate the overall work performance, considering professionalism; final product; personnel; resources.Rate from 1 to 10. (10 being highest)8. If the opportunity were to present itself, would you rehire this company?9. Please provide any additional comments pertinent to this company and the work performed for you:Section 4PLEASE COMPLETE AND RETURN TO THE ATTENTION OF: Lori DeLoach Email LDeLoach@ or FAX # 239-485-5460 Please submit non-Lee County employees as referencesReference Name (Print Name)Lee County EmployeesReference Signature ................
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