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RFQ 6000000337 ATTACHMENT 3


The applicant shall not submit this form to the District as part of your response. It is provided for informational
purposes only. Reference contacts should be prepared for the District’s reference calls starting approximately 14
days after opening. It is up to individual applicants to make sure that their respective reference contacts are available
and can be reached during that timeframe.
Respondent’s Name

Client’s Name (Company, Firm or Agency for Whom Services were Provided)

Contact Person:
Telephone Number:
Date of Contact:
Please check which Project Type this reference is for. Please check all that apply:
_____ Pump Station Construction
_____ Water Reservoir Embankment Construction
_____ Roadway and Bridge Construction
_____ Flow Control Structure Construction
_____ Earthwork & Wetlands Construction
_____ Marine Construction
_____ Roofing
_____ Dredging
Briefly describe the scope and size of the project performed by the contractor for your
Overall, did the contractor adhere to the agreed upon schedule?

Was the project completed within the overall budget?

If not, what was the percentage of change orders?
How much of the work (percentage) did the contractor self perform on the project?

Were there delays in work progress due to unavailability of contractor subs/personnel?

Equipment? Permitting?
Did the contractor provide satisfactory and timely responses to your requests for
Did the contractor keep you adequately informed of progress through periodic reports,
phone calls or other methods?
Was the contractor familiar with the technical issues necessary to meet the objectives of
the project with minimal oversight?
How well did the contractor manage the sub-contractors and how would you rate the
overall quality of the sub-contractors utilized (on a scale of 1-5 with 5 being the highest
Did the contractor provide the appropriate level of resources consistent with the
complexity of the work?
Did the contractor’s work require substantial revisions or modifications to scope and/or
approach prior to completion?
Did the contractor keep a safe and neat project site?

On a scale of 1-5 with 5 being the highest rating, please rate the contractor's
documentation and correspondence in regards to submittals, change orders, operations and
maintenance manuals, etc.
On a scale of 1-5 with 5 being the highest rating, how would you rate the overall quality of
the work?

Did the contractor complete the work with a minimal punch list?

If applicable, was the contractor responsive to warranty work?

Based on overall performance, would you hire this contractor again for the same type of

Questionnaire Completed by (signature): ____________________________ Date: __________________

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