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Appendix c <br />(Sample Evaluation Form for Statements of Qualifications) <br />Name of Project <br />Name of Design Firm <br />Name of Evaluator <br />Rating' Weight" Score <br />Criteria --- - <br />I <br />1. Firm K Individual qualifications _ __J _J _ <br />• Finn's number of vests is business i I x ; (0-0)_ <br />x I (U•.5) <br />• S'irm's back;;t��, d�i� cz�,drience on I i <br />siroilarproiectsx i-- ) <br />• <br />Experience oTi'srm�un'ent I - �� <br />personnel on. similar projects to Project Site <br />3, CCty to Perform Work x _ <br />.44=111 1t ::, irueet sc e u c __. <br />Fi m s e uipn3eni ��acil{ties x (U-5) <br />Y• aF4a'O4'w��vv� -_ ' X <br />• Qual{Cy. pfS„ {gn AX I0.5) �— - <br />'teon innovatio-n ,. ro-61 <br />a <br />• �eeur <br />• Comm <br />tion <br />x U•5 = � <br />; <br />'Dotal Soars = <br />4,1 = Poor, 2 = Fair, 3 - Good, 4 = Excellent, 5 = Superior <br />as Theae weighting factors should be adjusted for each project, according to the needs and priorities <br />of the public authority, <br />D87J <br />