ESBD_364034_1718995359648_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Solicitation number
- HHS0014861_2
- Issued by
- Texas
About this file
This document is an 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 3 years. Bidders must provide information such as business name, point-of-contact, address, phone, email, services performed as prime contractor or subcontractor, and a description and dates of services provided. The document also requests additional company information including number of years in business, office address, current number of full-time and part-time employees, geographic limits of operations, industry certifications/qualifications/formal training programs, and applicable licenses held by staff.
The related state and local contract opportunity is for Preventative Maintenance and Repair of two X-Ray Machines. The procurement schedule includes an IFB date posted to ESBD on 06/21/2024, a questions or clarifications submission deadline of 06/27/2024, responses to questions or clarifications in an addendum posted on 07/02/2024, and a response deadline of 07/09/2024 at 10:30 AM Central Time. The anticipated contract start date is the date of award. The contract is for the state of Texas.
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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 3years.
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 .