Attachment A References Form.docx
DOCX document 28 KB Posted
- Attached to
- VPA HIP 6 Projects
- Solicitation number
- 82230
- Issued by
- Brunswick County, Virginia
About this file
This document is a References Form (Attachment A) that requires vendors to provide details for at least four current or recent accounts where they have provided similar site alteration services. The form requests comprehensive information for each reference, including company names, contact information, specific services provided, site size in acres, completion dates, and project values.
The form includes a mandatory certification section requiring the vendor's signature, printed name, title, and date to verify the accuracy of the provided reference information. All four reference forms and the signed certification must be included with the vendor's bid submission. No additional contract terms, pricing requirements, or set-aside information is provided in this document.
View the file
Other files
Show all 32
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
References Sheet
Indicate below a listing of at least four (4) current or recent accounts, either commercial or governmental, that your company has provided similar services. Include the length of service and the name, address, and telephone number of the point of contact.
| A. |
| Company Name that you provided site alteration services for: |
Contact Name:
Phone Number
Fax Number
Services provided
Size of site in acres if less than 1 acre use tenths
Date of completion of order (insert date: month day year)
$ Value of the project:
| b |
| Company Name that you provided site alteration services for: |
Contact Name:
Phone Number
Fax Number
Services provided
Size of site in acres if less than 1 acre use tenths
Date of completion of order (insert date: month day year)
$ Value of the project:
| C. |
| Company Name that you provided site alteration services for: |
Contact Name:
Phone Number
Fax Number
Services provided
Size of site in acres if less than 1 acre use tenths
Date of completion of order (insert date: month day year)
$ Value of the project:
Required vendor reference information continues on to the next page.
| D. |
| Company Name that you provided site alteration services for: |
Contact Name:
Phone Number
Fax Number
Services provided
Size of site in acres if less than 1 acre use tenths
Date of completion of order (insert date: month day year)
$ Value of the project:
Required vendor reference information continues on to the next page.
IMPORTANT: Certification of this data and your signature is required on the next page certifying the accuracy of this information.
IMPORTANT: Certification of this data and your signature is required below:
I certify the accuracy of this information.
Signature
Printed name of person signing
Title of person signing
Date signed
IMPORTANT: The completed reference forms (four reference) and this signature form above certifying the correct information must be completed and attached to your firm’s bid submission.
File details come from the government source that posted it. Updated .