18-PCR030_Reference_Info.doc

REFERENCE INFORMATION

SOLICITATION Number

70Z08318BPCR03000

Date company information (Company name, address)

(PROVIDE REFERENCES FOR SIMILAR WORK PERFORMED IN LAST 3 YEARS.)

telephone number

FORMCHECKBOX

work hours

FORMCHECKBOX

NON-WORK HOURS

facsimile number

1. List experience in this type of work

2. Have you ever been terminated from any job? (If YES, give reason)

3. do you anticipate any difficulties finishing this job on time? (If YES, give reason)

4. percentage of work to be subcontracted

5. are your prevailing wages in accordance with the davis bacon wage act?

6. REFERENCES (LIST THREE)

6a.

Reference #1:

Company name

Person to contact

Address

Telephone no.

Project

6b.

Reference #2:

6c.

Reference #3:

Previous versions are useable CEU CLEVELAND REFERENCE INFORMATION FORM (Rev. 9-99)