Attachment 4 - Reference Form, FM27-10, Septic Pump Station Repairs.pdf

62 KB Posted

Attached to
Septic Pump Station Repairs
Solicitation number
BPM058677
Issued by
Calvert County, Maryland

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This is a Contractor Reference Form (Attachment 4) for the Septic Pump Station Repairs project (FM27-10) issued by Jefferson Patterson Park & Museum (JPPM) in Maryland. The form requires bidders to provide organizational background information, including years in business, vendor contact details, and website information. Contractors must submit three completed project references with detailed information including project names, addresses, contract duration, client names, and client contact information. A mandatory prebid meeting is scheduled for September 15, 2026, at 9:00 am at the Maintenance Office located at 10505 Mackall Road. Attendance at this prebid meeting is mandatory, and any bids received from offerors who did not attend will not be accepted. The project involves repairs to the septic pump station located near the MAC Lab.

The reference form must be completed and signed by an authorized representative who certifies the truth and accuracy of all submitted statements. This form is one of several required submission documents, which also include a Bid/Proposal Affidavit (Attachment 1), Conflict of Interest Affidavit and Disclosure (Attachment 2), sample contract (Attachment 3), and a No Reply Form (Attachment 5). Preference for award is given to Certified Small Business and Veteran-Owned Small Business Enterprises. No specific pricing information, funding amounts, or contract term details are provided in this reference form document.

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Other files

File Type Posted
2 - SPECIFICATION, Septic Pump Station Repairs.pdf PDF
Attachment 1 - Bid Proposal Affidavit (26).pdf PDF
3 - IFB FM27-10, Septic Pump Station Repairs.pdf PDF
1 - Project Cover Sheet, FM27-10, Septic Pump Station Repairs.pdf PDF
JPPM Map, Directions to Maint (15).pdf PDF
Attachment 2 - Conflict of Interest Affidavit and Disclosure (27).pdf PDF
Attachment 3 - JPPM All Procurements Contract Template (1).pdf PDF

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Contractor Reference Form

Project: FM27-10, Septic Pump Station Repairs Vendor Name Address City, State, ZIP

Phone / Fax Website Contact Name, Title Email How many years has your organization been in business?

REFERENCES: Please list three projects with client references. We may contact your references.

1. Project Name

Project Address Contract Years Client Name Client Phone or Email

2. Project Name Project Address Contract Years Client Name Client Phone or Email

3. Project Name Project Address Contract Years Client Name Client Phone or Email

The undersigned certifies the truth and correctness of all statements.

Prepared by: Title:

Signature:

ATTACHMENT 4 - REFERENCE FORM, FM27-10, SEPTIC PUMP STATION REPAIRS

Vendor Name:
Address:
City State ZIP:
Phone Fax:
Website:
Contact Name Title:
Email:
How many years has your organization been in business:
1 Project Name:
Project Address:
Contract Years:
Client Name:
Client Phone or Email:
2 Project Name:
Project Address_2:
Contract Years_2:
Client Name_2:
Client Phone or Email_2:
3 Project Name:
Project Address_3:
Contract Years_3:
Client Name_3:
Client Phone or Email_3:
Prepared by:
Title:

File details come from the government source that posted it. Updated .