ESBD_360569_1716562465540_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf

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Richmond SSLC seeks Wound Care Specialist
Solicitation number
HHS0014761
Issued by
Fort Bend County, Texas

About this file

This document is the Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity. It requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope of services provided within the last five years. The form requests details on the business name, point-of-contact, address, phone, email, whether services were performed as the prime contractor or subcontractor, and a description of the services provided. Additionally, the form requests information on the bidder's company, including the number of years in business, office address, number of permanent full-time and part-time employees, geographic limits of operations, industry certifications/qualifications/training programs, and applicable licenses held by staff. Bidders must also provide a narrative describing their experience and qualifications as it applies to the contract requirements, as well as a written description of their company's size, scope of operations, number of employees available for customer service, order fulfillment, and safe shipping and handling, and the number of supervisors for each location.

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Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24

Exhibit D – Bidder Reference Form & Contractor Qualifications Form

Bidders must provide a minimum of three (3) verifiable references for contracts of similar size and scope of services within the last five years.

For each reference, provide the following and attach to the Response any documentation to support the information regarding current or prior contracts.

1. Business Name:

Point-of-Contact Name and Title:

Address (City, State, Zip):

Phone:

Email address:

Services Performed as Prime Contractor or as Subcontractor?

[Prime Contractor] or [Subcontractor]

Description and Dates of Services Provided:

2. Business Name:

Point-of-Contact Name and Title:

Address (City, State, Zip):

Phone:

Email address:

Services Performed as Prime Contractor or as Subcontractor?

[Prime Contractor] or [Subcontractor]

Description and Dates of Services Provided:

3. Business Name:

Point-of-Contact Name and Title:

Address (City, State, Zip):

Phone:

Email address:

Services Performed as Prime Contractor or as Subcontractor?

[Prime Contractor] or [Subcontractor]

Description and Dates of Services Provided:

Additional Company Information:

Number of Years in Business:

Office Address:

Current Number of Permanent, Full-Time Employees:

Current Number of Permanent, Part-Time Employees:

Current Total Number of Employees:

Geographic Limits of Operations:

List any Industry Certifications/Qualifications/Formal Training Programs that your staff (who will be servicing this account) have been certified in:

Name Certifications/Qualifications/Formal Training

List any applicable licenses currently held by staff that will service this account:

Name License Number

Bidder’s Minimum Experience and Qualifications- Section 7.1.5

Provide a narrative (maximum of one page) describing the bidder’s experience and qualifications as it applies to this Section.

Demonstration of the Ability to Perform

Provide a written description of the size and scope of all operations, including the number of Bidder’s employees available to provide customer service, order fulfillment, safe shipping and handling of product and the number of supervisors for each location, as applicable.

Exhibit D – Bidder Reference Form & Contractor Qualifications Form

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