Contractor Reference form (55).pdf

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Attached to
DOUGLAS COUNTY FLEET MAINTENANCE GENERATOR PROJECT
Solicitation number
PE-64800-NONST-2026-000000079
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, for the Douglas County Fleet Maintenance Generator Project. The form requires contractors to provide at least three recent references from different companies, with each reference including the contact name, company name, complete address, phone number, and email address. These references must be able to verify the contractor's experience and ability to perform the products or services specified in the solicitation. The form requires the signature and date of an authorized company representative.

The underlying contract opportunity involves a turnkey installation of a 100-kilowatt diesel standby generator at the Douglas County Fleet Maintenance Building. The project is partially funded through the FEMA Hazard Mitigation Grant Program (HMGP), and the selected contractor must comply with all federal requirements under 2 C.F.R. Part 200 and FEMA-specific mitigation policies. The project aims to ensure Douglas County can maintain normal operations and continue serving citizens during power outages or other emergency events, as the Fleet Maintenance Building serves all county departments and houses numerous county employees.

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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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