Section J Att 010 - General References.pdf

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Attached to
REHAB CLOVER CREEK WASTEWATER TREATMENT PLANT
Solicitation number
140P8620R0010
Issued by

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This document contains a general references form required as part of a solicitation for the rehabilitation of the Clover Creek Wastewater Treatment Plant, dump stations, and vault toilets. Offerors must provide references including their surety company, two corporate banks including account types and numbers, an insurance company including policy types, and three each of subcontractors, material suppliers specifying areas of work or types of materials supplied. The solicitation is issued by the National Park Service Pacific West Region under number 140P8620R0010 to rehabilitate the specified facilities.

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RFP No. 140P8620R0010 Section J – Attachment No. 010

Form 4: General References

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 for the Submission of Offers and Other Information” (Section L). Include Area Codes with all telephone numbers. Fill in the information by typing or printing legibly.

It is especially important that the offeror disclose instances in which their relationships with the references may be considered less than fully satisfactory. The offeror should tell their side of the story and describe remedial corrective action that has been taken or will be taken to correct the deficiency. Failure to do so may result in a determination that an offeror has been less than candid with the Government, which could result in an unfavorable assessment of the offeror’s past performance record. Provide explanations on separate sheets as necessary.

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:

Types of Policies:

RFP No. 140P8620R0010 Section J – Attachment No. 010

Form 4: General References

SUBCONTRACTOR

Name:

Address:

Name of Contact:

Area of Specialized Work:

SUBCONTRACTOR

Address:

Name of Contact:

SUBCONTRACTOR

Address:

Name of Contact:

MATERIAL SUPPLIER

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:

Types of Material:

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