Reference Information Sheet.pdf
PDF 213 KB Posted
- Attached to
- 70Z03025QCLEV0034 - U. S. COAST GUARD NINTH COAST GUARD DISTRICT CONSOLIDATED PEST CONTROL SERVICES
- Solicitation number
- 70Z03025QCLEV0034
About this file
This is a reference information form template from the Coast Guard Base Cleveland, dated July 2024, used to collect past performance and company details from potential contractors. The form requests basic company information, contact details including work/non-work hours phone numbers and fax, and requires contractors to provide information about their relevant work experience, termination history, anticipated completion challenges, and percentage of work to be subcontracted.
The form specifically asks contractors to confirm compliance with Davis-Bacon Wage Act requirements and requires three detailed business references, each including company name, contact person, address, telephone number, and project details. This template appears to be related to a pest control services solicitation (70Z03025QCLEV0034) for the Ninth Coast Guard District, though the form itself is a general-purpose reference collection document that could be used for various contracting needs.
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Text version
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 CG BASE CLEVELAND REFERENCE INFORMATION FORM (July 2024)
GABermeo Cross-Out
File details come from the government source that posted it. Updated .