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 is a References Form (Attachment A) for a Virginia Department of Wildlife Resources contract opportunity for Habitat and Infrastructure Projects on private lands through the Voluntary Public Access and Habitat Incentive Program in Southwest Virginia. The form requires bidders to provide details for at least four current or recent accounts where they have provided similar site alteration services.
The form requests specific information for each reference, including company name, contact information, services provided, size of site in acres, date of completion, and project value. The document requires certification through signature, printed name, title, and date of signing. All four references and the signed certification must be included with the bid submission for consideration.
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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 .