11-3202600042 Form3.pdf
PDF 95 KB Posted
- Solicitation number
- 3202600042
- Issued by
- Texas
About this file
This is a References and Past Project Performance form (Form 3) for an RFP issued by the Texas Workforce Commission (TWC) for Unemployment Insurance Appeals Mentoring and Support Services (RFP No. 3202600042). The form requires respondents to provide a minimum number of references from entities for which they have performed similar services within a specified timeframe. References should preferably be from state, federal, and/or local governmental entities, though TWC itself cannot be listed as a reference. For each reference, respondents must document the project description, contact information for the reference, the organization served, contract amounts (original and final), types of services provided, contract status, and project timelines including start date, projected completion date, and actual completion date.
The form also requires respondents to disclose any sanctions, liquidated damages, or other monetary remedies assessed under existing or past contracts during the preceding five years, along with detailed explanations. Respondents must also report any threatened, pending, or resolved disciplinary actions for substandard work or unethical practices, as well as any orders, judgments, or decrees from federal or state authorities that would limit their right to conduct business. Additionally, respondents must disclose involvement in civil or criminal litigation, compromise agreements, settlements, consent decrees, or judgments related to contract performance or relevant to the services sought. Finally, respondents must indicate whether any projects have been terminated, stopped mid-project, or terminated for default or convenience within the past five years, with full details required if applicable.
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Text version
REFERENCES AND PAST PROJECT PERFORMANCE
FORM 3 – REFERENCES AND PAST
PROJECT PERFORMANCE SHEET
Must Be Completed and Returned.
RFP No. 3202600042 Unemployment Insurance Appeals Mentoring & Support
Services
Respondent must provide a minimum of [number] [(#)] references who are willing and able to provide documentation about Respondent’s ability to perform similar requested services. These references must relate to similar contracts or projects performed as described in Section 2.2 of the RFP within the last [number] [(#)] years, and [choose one: (1) must or (2) it is preferable they]be from state, federal, and/or local governmental entities.
Do not include TWC as a reference.
[IF MORE THAN THREE REFERENCES ARE BEING REQUESTED, ADD
ADDITIONAL BOXES TO THE TABLE]
#1-Project Description:
Contact Name:
Name of the organization to which the service was provided:
Reason for contract termination/expiration, if contract is no longer in effect:
Contact Number: Contact E-Mail Address:
Original Contract Amount: Final Contract Amount:
Types of services directly provided by the Respondent and whether the Respondent was the contractor or Subcontractor:
#2-Project Description:
Name of the organization to which the service was provided:
Reason for contract termination/expiration, if contract is no longer in effect:
Original Contract Amount: Final Contract Amount:
#3-Project Description:
Name of the organization to which the service was provided:
Reason for contract termination/expiration, if contract is no longer in effect:
Contact Number: Contact E-Mail Address:
Original Contract Amount: Final Contract Amount:
Start Date: Projected Completion Date: Actual Completion Date:
The Respondent has been assessed any Sanctions, including liquidated damages or other such monetary remedies, under any existing or past contracts during the last five (5) years, and, if so, note the reason for and the amount assessed or paid for each incident.
The Respondent was the subject of (i) any threatened, pending, or resolved disciplinary action for substandard work and/or unethical practices; or (ii) any order, judgment or decree of any federal or state authority barring, suspending or otherwise limiting the right of the Respondent to engage in any business, practice, or activity, during the last five (5) years.
The Respondent has been involved in any civil or criminal litigation and/or entered into any compromise agreement, settlement agreement, or resulting consent decree or judgements, if applicable, related to contract performance, the goods and/or services sought by this Solicitation, or that a reasonable person knowledgeable of the applicable industry would consider relevant to the work under the Contract. Respondents are not required to violate any confidentiality provision but must provide information not prohibited from disclosure.
Indicate if your company has had a project terminated, stopped in the middle, contract terminated for default or convenience within the past five
(5) years. Yes or No, If yes, provide explanation full details including the others party’s name, address, and telephone number.
FORM 3 – REFERENCES AND PAST PROJECT PERFORMANCE SHEET
File details come from the government source that posted it. Updated .