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1 r C E Miami -Dade County Public Schools Department of A/E Selection & Negotiations PROJECT REFERENCE FORM (This form Is to be submitted with the RFQ Response) instructions to Proposer: Submit a separate Project Reference Form for each project listed in the proposef's RFQ Response. It is the proposer's responsibildy to .. _.._.__ _.e__ r__ ___l rlr ..d n......, u.l.✓...da. edd:v,e 1 92 9 /vin nn1 rrll in mrlinn n. (The Wowing section is to be completed by the Owner's representative) Statement to Owner's Representative: In an effort to assure a high standard of quality on our design/construction projects (or construction- related services), we are seeking information from you on this firm's performance on the specific projed fisted above. We have asked each proposer to secure references Iran the owner on each project submitted as related experience and as an example of the firm's w wk. The authority making reference must be a key member of the project team _ ___d- .I��....d........m tfCnOffbnnnrerl /nr mncfrurfinn- m /afaA <aMfxtl. WW eL4UllWtl, W11W11 Y1IVl /1lp,lw „w aou, u.ry vniw ..wvv....v- .��. +.. _ -- 1 NAME OF PROPOSER (PRIME FIRM): R.E. Chisholm Architects, Inc. SOLICITATION FOR: AIE of Record (project- specific) ` A/EPC or SPC (continuing contract) ` DesigntBulder ` CM at -Risk (project- spedfic) CM al -Risk (continuing contract) ` Program Manager ` Land Surveyor ` Geotechnical Lab ` HVAC T &B ` Cost Estimating ` Construction Scheduling m Quality of the communicationsicoordination with project team, members, 2. PROJECT NAME & TITLE: Miami Dade County Parks and Recreation - Southridge Park Stadium FOR AIE. AIEPC & SPC: EXAMPLE PROJECT KEY NUMBER 'F): m Quality of the project (SF 330, Section PROJECT LOCATION (Address City & State): 11250 SW 192nd St, Miami, FL 33157 PROJECT VALUE: $ 2.498 M. I SUBST. COMPLETION DATE: 2005 -2011 Name of Owner's representative completing this form (print): i I_L iaZ" o 'R PROPOSER'S CONTRACTURAL RELATIONSHIP TO OWNER ON THIS PROJECT: Design Criteria Consultant Sign Date: G G ja 3 PROJECT OWNER: Miami Dade County Parks & Recreation Department (MDCPRD) OWNER'S REPRESENTATIVE: Mr. Guillermo Pena TITLE: Project Manager OFFICE 1 DEPARTMENT: MDCPRD - Design Development Division PHONE NO.: (305) 755 -7914 ADDRESS (Address City & State): 275 NW 2nd Street, 4th Floor Miami, FI 33128 E -MAIL: wiliep @miamidade.gov (The Wowing section is to be completed by the Owner's representative) Statement to Owner's Representative: In an effort to assure a high standard of quality on our design/construction projects (or construction- related services), we are seeking information from you on this firm's performance on the specific projed fisted above. We have asked each proposer to secure references Iran the owner on each project submitted as related experience and as an example of the firm's w wk. The authority making reference must be a key member of the project team _ ___d- .I��....d........m tfCnOffbnnnrerl /nr mncfrurfinn- m /afaA <aMfxtl. WW Wtli l 661 I11VVIYw n,ul ll�a 2 l uiry w..u.... w.v.. v. ...v ._____ - -- - 4 Owner's Representative p irds only as box foreach) If fro•; exptala under a. Is the Information listed In section 2, above, accurate? NO ommeb' ” b. How would you rate the overall performance of this firm In terms of: FAIR I POOR m Timely completion of the project, m Cost effectiveness (was project within budget), m Quality of the communicationsicoordination with project team, members, m Responsiveness to the owner, and m Quality of the project c. Would you do business with this firm again? LCYES I NO MAYBE d Comments? Name of Owner's representative completing this form (print): i I_L iaZ" o 'R Sign Date: G G ja per Please return this form v►a emarr wimm a nus►ness 0a Pmcedures for Sefecifoo of Architects and Engineers FM -7516 (10-13) Page 31 of 58