ESBD_365478_1719601125552_HHS0014790_Exhibit D Bidder Reference Form and Contractor Qualifications Form.docx
DOCX document 39 KB Posted
- Attached to
- Preventative Maintenance Services for HVAC, Electrical and Plumbing Austin State Hospital
- Solicitation number
- HHS0014790
- Issued by
- Travis County, Texas
About this file
This document is an Exhibit D - Bidder Reference Form and Contractor Qualifications Form for a state and local contract opportunity in Texas. The contract is for preventative maintenance services for HVAC, electrical, and plumbing at the Austin State Hospital, issued by the Health and Human Services Commission Procurement and Contracting Services (HHSC PCS). Bidders must provide a minimum of three verifiable references for similar contracts within the last five years, including details on the services performed, the business name, point-of-contact, and dates of service. The bidder must also provide company information such as number of years in business, office address, number of employees, geographic limits of operations, industry certifications, and licenses held by staff.
The contract requires bidders to demonstrate their ability to perform the work, including the size and scope of operations, number of employees available for customer service and order fulfillment, and number of supervisors. Bidders must also provide 24-hour contact information for at least two individuals.
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Text version
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 (5) 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.
24-Hour Contacts – Must list a minimum of 2:
Contact 1 Name Phone Email Contact 2 Name Phone Email
Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24
File details come from the government source that posted it. Updated .