Reference Information Form.docx

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Attached to
70Z03024QCLEV0005 - USCG AIR STATION TRAVERSE CITY SNOW REMOVAL
Solicitation number
70Z03024QCLEV0005
Issued by

About this file

This document is a reference information form for solicitation number 70Z03024QCLEV0005 to provide snow removal services at the US Coast Guard Air Station in Traverse City, Michigan. The form requests company information and references for similar work experience. It asks if the contractor has ever been terminated from a job and if they anticipate any difficulties completing the work on time. The contractor must provide the percentage of work to be subcontracted and confirm their prevailing wages comply with the Davis-Bacon Act. Three references are required including the company name, contact person, address, telephone number and project details.

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REFERENCE INFORMATION

SOLICITATION Number Date company information (Company name, address)

(PROVIDE REFERENCES FOR SIMILAR WORK)

telephone number|_| work hours
|_| NON-WORK HOURS
facsimile number

1. List experience in this type of work

2. Have you ever been terminated from any job? (If YES, give reason)

3. do you anticipate any difficulties finishing this job on time? (If YES, give reason)

4. PERCENTAGE OF WORK TO BE SUBCONTRACTED

5. ARE YOUR PREVAILING WAGES IN ACCORDANCE WITH THE DAVIS BACON WAGE ACT?

6. REFERENCES (LIST THREE)

6a.Reference #1:
Company name
Person to contact
Address
Telephone no.
Project
6b.Reference #2:
Company name
Person to contact
Address
Telephone no.
Project
6c.Reference #3:
Company name
Person to contact
Address
Telephone no.
Project

Previous versions are useable CEU CLEVELAND REFERENCE INFORMATION FORM (Rev. 9-99)

File details come from the government source that posted it. Updated .