General_References.docx

DOCX document 17 KB Posted

Attached to
Devil's Postpile Impacted Soil Remediation Federal contract opportunity
Solicitation number
P15PS00694
Issued by
Department of the Interior National Park Service

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General Reference Form

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General References READ CAREFULLY: The purpose of this form is for the offeror to provide the Government with general references in the spaces provided as described in the Instructions, Conditions, and Notices to Offerors (Section L). Include area codes with all telephone numbers. Fill in the applicable information by typing or printing legibly. Information provided may be used in making a determination of responsibility pursuant to FAR 9.103.

NAME OF CONTRACTOR/OFFEROR: ____________________________________________

SURETY

Name of Surety: ______________________________________________ Address of Surety: ____________________________________________ Name of Agent: ______________________________________________ Telephone Number: ___________________________________________

CORPORATE BANK

Name of Bank: _______________________________________________ Address of Bank: _____________________________________________ Name of Agent: ______________________________________________ Telephone Number: ___________________________________________ Types and Numbers of Accounts: ________________________________

CORPORATE BANK

Name of Bank: _______________________________________________ Address of Bank: _____________________________________________ Name of Agent: ______________________________________________ Telephone Number: ___________________________________________ Types and Numbers of Accounts: ________________________________

INSURANCE COMPANY

Name: _____________________________________________________ Address: ___________________________________________________ Name of Agent: _____________________________________________ Telephone Number: __________________________________________ Types of Policies: ____________________________________________

SUBCONTRACTOR

Name: _____________________________________________________ Address: ___________________________________________________ Name of Contact: ____________________________________________ Telephone Number: __________________________________________ Areas of Specialized Work: ____________________________________

SUBCONTRACTOR

Name: _____________________________________________________ Address: ___________________________________________________ Name of Contact: ____________________________________________ Telephone Number: __________________________________________ Areas of Specialized Work: ____________________________________

SUBCONTRACTOR

Name: _____________________________________________________ Address: ___________________________________________________ Name of Contact: ____________________________________________ Telephone Number: __________________________________________ Areas of Specialized Work: ____________________________________

MATERIAL SUPPLIER

Name: _____________________________________________________ Address: ___________________________________________________ Name of Contact: ____________________________________________ Telephone Number: __________________________________________ Types of Material: ___________________________________________

MATERIAL SUPPLIER

Name: _____________________________________________________ Address: ___________________________________________________ Name of Contact: ____________________________________________ Telephone Number: __________________________________________ Types of Material: ___________________________________________

MATERIAL SUPPLIER

Name: _____________________________________________________ Address: ___________________________________________________ Name of Contact: ____________________________________________ Telephone Number: __________________________________________ Types of Material: ___________________________________________

P15PS00694

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