Contractor Reference form (31).pdf

PDF 135 KB Posted

Attached to
3rd Party Transportation Operator
Solicitation number
PE-64800-NONST-2025-000000058
Issued by
Douglas County, Georgia

About this file

This is a Contractor Reference and Release Form issued by the Douglas County Board of Commissioners, Purchasing Department, located in Douglasville, Georgia. The form is a standardized submission document designed to collect contractor references as part of the solicitation and bid evaluation process. The form requires bidding contractors to provide a minimum of three recent references from different organizations, with each reference entry requiring the contact name, company name, complete address, phone number, and email address to verify the contractor's experience and capability to perform the specific products or services outlined in the corresponding solicitation.

The form includes signature and date sections for an authorized company representative to certify the accuracy and completeness of the submitted information. No specific pricing terms, contract amounts, funding sources, set-asides, or other financial requirements are outlined within this reference form, as it serves solely as a qualification and verification document. Contractors must complete all required fields legibly and provide current, verifiable contact information for the referenced organizations to facilitate the evaluation of contractor qualifications during the bid review process.

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Text version

CONTRACTOR REFERENCE AND RELEASE FORM

List below at least three recent different (3) references, including company name, contact name, address, email address and telephone numbers who can verify your experience and ability to perform the type(s) of product(s)/ service(s) listed in the solicitation.

Reference No. 1

Contact Name:

Contact Company:

Address:

Phone Number: Email Address:

Reference No. 2

Contact Company:

Reference No. 3

Contact Company:

Name of Authorized Company Representative (Type or Print Legibly):_____________________________

Signature of Authorized Company Representative____________________________________________

Date Signed _________________________________________________________________________

Douglas County Board of Commissioners 8700 Hospital Drive, Purchasing Department, Douglasville, GA 30134

Contact Name:
Contact Company 1:
Contact Company 2:
Phone Number:
Email Address:
Contact Name_2:
Contact Company 1_2:
Contact Company 2_2:
Phone Number_2:
Email Address_2:
Contact Name_3:
Contact Company 1_3:
Contact Company 2_3:
Phone Number_3:
Email Address_3:
Name of Authorized Company Representative Type or Print Legibly:
Date Signed:

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