Contractor Reference form (54).pdf

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Attached to
Fire Suppression-DOT Storage & Sherriff Department IT and Electrical Rooms
Solicitation number
PE-64800-NONST-2026-000000077
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 serves as a submission requirement for contractors bidding on county contract opportunities. Contractors are required to provide a minimum of three professional references from recent clients who can verify the contractor's experience and ability to perform the products or services specified in the solicitation. Each reference entry requires the contact name, company name, complete address, phone number, and email address. The form must be completed and signed by an authorized company representative and includes spaces for dating the submission.

The form does not specify pricing terms, set-asides, contract amounts, or other financial details, as it is designed solely to collect reference information for evaluation purposes. This document functions as a qualification and verification tool rather than a pricing or terms document. Contractors must ensure all reference information is accurate and current, as the references will be contacted directly by the county to assess the bidder's capability and past performance on similar work.

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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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