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M E <br />0 'a <br />u <br />Miami -Dade County Public Schools <br />Department of A/E Selection & Negotiations <br />PROJECT REFERENCE FORM <br />(This form is to be submitted with the RFQ Response) <br />instructions to Proposer: Semi a seoarare Project Reference Form for sect, p.•gecf Wad M Me procaser's .RFD Response. It s Me Proposer's :espensdudy to <br />: r rid Own r fitted under sections 1 2 6 J do not fill in section <. <br />crovee <br />accurate. tuner, m.crma. for each a e u : <br />1• <br />NAME OF PROPOSER (PRIME FIRM): R. E. Chisholm Architects, Inc. <br />SOLICITATION FOR: kfE of Rccord (proiect specific) A/EPC or SPC (continuing contract.) <br />Des :gn /Builder ` CM at -RSk (project - specific) ` CM at -Risk (continuing contract) <br />` Program Manager Land Surveyor ` GedtechnIcal Lab <br />` HVAC T &B ` Cost Estmating ` Construction Scheduling <br />2.1 <br />PROJECT NAME & TITLE: Gulliver Acacemy <br />FOR AlE. AE PC & SPC: <br />EXAMPLE PROJECT KEY NUMBER <br />Building C; Classroom Addition <br />(SF 330. Section'F): <br />xm:rients <br />PROJECT LOCATION (Address City B State): 12595 Red Road, Coral Gables, FL 33156 <br />PROJECT VALUE: $ 500.000 <br />1 SUBST. COMPLETION DATE: 2012 <br />PROPOSER'S CONTRACTURAL RELATIONSHIP TO OWNER ON THIS PROJECT: A!E of Record <br />pct, Jii <br />3. <br />PROJECT OWNER: Gulliver Schools <br />OWNER'S REPRESENTATIVE: Mr. Jamie Prosper <br />TITLE: Senior Director-Construction <br />OFFICE 1 DEPARTMENT: Construction <br />PHONE NO.: 786.281.0111 <br />ADDRESS (.Address City d State): 6575 North Kendall Or. Miami, Flonda 33156 <br />E -MAIL: prosoerj @pdbusiness.com <br />(The folto wings ection is to be completed by the Owner's representative) <br />statement to Owner's Representative: In an efton to MUM a nigh standard of eualay on our designhonstruc6on projects (or mnstrJction- related services), we <br />are seeking irformatbri from you on this firm's oerfonrIance or, the soeciec p ocf listed above. We have asked each proposer to secure retare'xes from foe owner <br />on each. prq'e_* submitted as related experience end as an example o! Me fxm's work The authority making reference must be a key member of the project team <br />rid -t 0or of the ' 1(or =structica- teleled services <br />wno <br />was fwsl involve, wile ,he de <br />n a cons ry <br />. .. <br />_. _ <br />xm:rients <br />fF :- T!r. ;G ^ -ri <br />•�'JC'L' <br />F�lii <br />pct, Jii <br />.al$li :; artlina!ien•v : ;h, pro)- t teant, msmE : =_rs. <br />.. J^; ritlyo ',. <i�.�T :I ;C <br />:' ?=_,-1•a: <_xr c; 3tJ5.:a" <br />YES i <br />NO <br />[AfE' <br />�. 3: ?Li .,'SJ I'. �' S - :- <br />:_... YI': •'ll ^y ttil$ IJi(1 ( ^..IJ7 ti' ,� \�`;/ Vl,/ <br />.� <br />Eyn =p: c <br />Oar: <br />�.'3'j <br />Owner: Please return this form via email within 5 business days <br />2,viceCms !or Sel�laatcf +iciaees and Engreen <br />FM -7516 (10-13) <br />