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<br />City of Sunny Isles Beach |Request for Qualifications No. 18-08-01 27 <br /> <br />PROJECT VERIFICATION FORM <br /> <br />Proposer shall have provided Underground Consultation Services for at least three (3) Projects over the <br />past five (5) years of similar size, nature and complexity with a construction amount exceeding <br />$1,000,000 and provide evidence using the spaces below. <br /> <br /> <br />1) Name of Client Entity: ______________________________________________ <br />Address: __________________________________________________________ <br />City/State/Zip: ______________________________________________________ <br />Contact: __________________________________________________________ <br />Title: _____________________________________________________________ <br />Email Address:____________________________________________________ <br />Telephone: ________________________________________________________ <br />Scope of Work: _____________________________________________________ <br />Contract Start/End Dates: _____________________________________________ <br />Contract Amount: $__________________________________________________ <br /> <br />2) Name of Client Entity: ______________________________________________ <br />Address: __________________________________________________________ <br />City/State/Zip: ______________________________________________________ <br />Contact: __________________________________________________________ <br />Title: _____________________________________________________________ <br />Email Address:____________________________________________________ <br />Telephone: ________________________________________________________ <br />Scope of Work: _____________________________________________________ <br />Contract Start/End Dates: _____________________________________________ <br />Contract Amount: $__________________________________________________ <br /> <br />3) Name of Client Entity: ______________________________________________ <br />Address: __________________________________________________________ <br />City/State/Zip: ______________________________________________________ <br />Contact: __________________________________________________________ <br />Title: _____________________________________________________________ <br />Email Address:_____________________________________________________ <br />Telephone: ________________________________________________________ <br />Scope of Work: _____________________________________________________ <br />Contract Start/End Dates: _____________________________________________ <br />Contract Amount: $__________________________________________________ <br /> <br />END OF SECTION