Attachment 4 - Reference Form , FM26-16.pdf

This is a Contractor Reference Form (FM26-16) for the Jefferson Patterson Park & Museum Dry Dam Repair project in Maryland. The project involves furnishing all labor, overhead, equipment, materials, parts, incidentals, tests, supervision, and services necessary to repair the slope on a dry dam located at Jefferson Patterson Park and Museum (JPPM), 10515 Mackall Road, Saint Leonard, Maryland 20685. Proposals must be submitted by 3:00 pm on December 19, 2025, to one of three designated contacts: Dimitrios Papadakis (Maintenance Director), Eric Frere (Assistant Director), or Derek Mathieson (Maintenance Chief). Contractors are required to submit the completed reference form along with their bid, bid/proposal affidavit, conflict of interest affidavit and disclosure, company certificates of insurance, and acknowledgement of receipt of any amendments. Any bids submitted without required paperwork, after the due date, or without the completed IFB will be deemed non-responsive.

The reference form requests that contractors provide three project references with client information, including project name, address, contract years, client name, and contact information. Contractors must also indicate the number of years their organization has been in business and certify the accuracy of all statements provided. The form serves as a qualification document to assess contractor experience and references, allowing JPPM to contact previous clients to verify performance history and capability to complete the dry dam slope repair work.