MANDATORY REFERENCE FORM.doc

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General Services Administration

Pacific Rim Region

JOB REFERENCE FORM

Use of this format is mandatory.

OFFEROR NAME:____________________________________________________

PROJECT NAME:_____________________________________________________________

PROJECT LOCATION:_________________________________________________________

CLIENT NAME (Company or Agency)_____________________________________

CLIENT POC (Name, Phone):___________________________________________

DOLLAR VALUE OF OFFEROR'S CONTRACT: $___________________________

ELEMENTS YOU CLAIM THIS REFERENCE SUPPORTS (check those that apply):

___Installation of controls, same product line as proposed ___Installation of controls in San Francisco Bay Area ___Complex project with substantial customized programming

DESCRIPTION OF WORK PERFORMED; SUPPORT ELEMENTS CLAIMED:

_1177752835.doc

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