7-Attachment G - Experience Form.docx
DOCX document 19 KB Posted
- Solicitation number
- RFP 26/0004
- Issued by
- Harris County, Texas
About this file
This is an Experience Form attachment for Harris Health's RFP 26/0004 seeking qualified vendors to provide Inpatient Psychiatric Services for adult and adolescent patients in Texas. The form requires vendors to document their experience delivering services within the last three years, with particular emphasis on experience with Inpatient Psychiatric Services for entities of comparable size to Harris Health. Vendors must provide detailed information for up to four client references, including organization names, contact information, service dates, whether the client is a healthcare organization or hospital system, and a comprehensive description of services rendered. The contract term begins on or about July 1, 2026, and continues for twelve months thereafter, with the primary objective of ensuring timely access to Inpatient Behavioral Health services for eligible patients when Harris Health facilities lack capacity.
The form serves as a qualification and evaluation tool to assess vendor capabilities and track records in delivering psychiatric inpatient services while maintaining compliance with state and federal healthcare regulations. Vendors are encouraged to prioritize experience with healthcare organizations and hospital systems comparable in scope and complexity to Harris Health to demonstrate their ability to manage similar service volumes and organizational requirements. This document is a standard component of the procurement process used to evaluate bidder eligibility and past performance before contract award.
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Text version
ATTACHMENT G – EXPERIENCE FORM
Responses provided should be for services rendered within the last three (3) years. Vendors are encouraged to include experience with services provided for Inpatient Psychiatric Services for entities comparable in size with Harris Health.
Client #1
Organization Name:
Contact Name/Telephone No.:
E-mail Address:
Address:
Dates services began and ended: (Month/Year to Month/Year or present) Is this client a healthcare organization or hospital system? (Yes/No, if Yes, which) Please describe in detail what kind of services were rendered:
Client #2
Organization Name:
Contact Name/Telephone No.:
E-mail Address:
Address:
Dates services began and ended: (Month/Year to Month/Year or present) Is this client a healthcare organization or hospital system? (Yes/No, if Yes, which) Please describe in detail what kind of services were rendered:
Client #3
Organization Name:
Contact Name/Telephone No.:
E-mail Address:
Address:
Dates services began and ended: (Month/Year to Month/Year or present) Is this client a healthcare organization or hospital system? (Yes/No, if Yes, which) Please describe in detail what kind of services were rendered:
Client #4
Organization Name:
Contact Name/Telephone No.:
E-mail Address:
Address:
Dates services began and ended: (Month/Year to Month/Year or present) Is this client a healthcare organization or hospital system? (Yes/No, if Yes, which) Please describe in detail what kind of services were rendered:
File details come from the government source that posted it. Updated .