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MDX PROCUREMENT /CONTRACT NO.: RFQ -11.08 MDX WORK PROGRAM NO.: 87409.050 MDX PROJECT /SERVICE TITLE: CONSTRUCTION ENGINEERING AND INSPECTION (CE&II SERVICES FOR THE i DESIGN -BUILD PROJECT FOR SR 874 MAINLINE RECONSTRUC IPA Proposers shall have this form completed by each proposed reference and include in their Proposal. Proposers shall ensure the form is completed in its entirety. MDX may verify the information provided herein. Please note: In order to avoid violation of the Cone of L Silence, Proposers that wish to use MDX, or its representatives, including the members of the Technical Evaluation Committee (TEC) as a reference, shall fill out and submit in the Proposal this form with the Personnel, Reference, and Contract Information completed. MDX will perform an internal verification of the reference thereafter. L I k- J PERSONNEL INFORMATION Proposer: Cima Engineering Corp Name of Proposed Personnel: Jose Gonzalez, P . E Proposed Role for this Contract (i.e. Project Manager etc.): Project Engineer Employed by (Company Name if not Proposer): Cima Engineering Corp REFERENCE INFORMATION Name of Reference (person completing form & available for follow -up): I sa Nunez , P . E Title: Resident Engineer Phone Number: (305)499 -2370 E -Mail Address: Isa.Nunez@dot.state.fl.us CONTRACT INFORMATION Agency Work Performed for: Florida Department of Transportation Contract Title /Name: Perimeter Road Reconstruction Brief Description of Services Performed Full CEI Management,Claims Review,As- Builts, work Orders, Correspondence, Public Relations, Utility Coordination and Troubleshooting. Role Performed (i.e. Project Manager etc.) Project Engineer Services performed as a Prime or as a Subconsultant: Prime ® Subconsultant ❑ to Type of Agency (Government, State, Local etc.): State of Florida Start Date Individual Worked on Contract (Month /Year): June /2009 End Date Individual Worked on Contract (Month /Year): June /2 010 Contract Amount: $4.8 Million TECHNICAL ABILITY INFORMATION Level of Experience for Services Performed: Outstandingtt_ Excellent ❑ Good ❑ Fair ❑ Poor ❑ Quality of the Services Performed: Outstanding [S Excellent ❑ Good ❑ Fair ❑ Poor ❑ Personnel's Ability to Meet Contracted Time Frames: Outstanding r&I_ Excellent ❑ Good ❑ Fair ❑ Poor ❑ Personnel's Response to Special Requests: Outstanding` Excellent ❑ Good ❑ Fair ❑ Poor ❑ Additional Comments f J �0 cur Signature from Reference: Date: � RATING SCALE: Outstanding 90 —100 (7xse4len�,t--8WO�— 8 Good-30 - 79 Fair 66 69 Poor 65 and below Personnel Reference Information Form