ESBD_366876_1720457740275_Exhibit D_Bidder Reference_Qualifications.pdf
PDF 160 KB Posted
- Attached to
- Rental_Durable Medical Equipment_AbSSLC
- Solicitation number
- HHS0014788
- Issued by
- Taylor County, Texas
About this file
This document is an Exhibit D - Bidder Reference Form and Contract Qualifications Form related to a state and local contract opportunity for the rental of durable medical equipment (DME) for the Abilene State Supported Living Center (AbSSLC) in Texas. The form requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope of services within the last three years, as well as additional company information including number of years in business, office address, number of employees, and any relevant industry certifications, qualifications, or licenses held by staff. Bidders must also provide a narrative describing their experience and qualifications as they apply to the minimum experience and qualifications outlined in the solicitation. Additionally, bidders are required to provide a written description of the size and scope of their operations, including the number of employees available for customer service, order fulfillment, and shipping, as well as the number of supervisors.
The state and local contract opportunity is being solicited by the Texas Health and Human Services Commission (HHSC) PCS and is seeking competitive bids to establish contract(s) for the provision of as-needed DME rental services for AbSSLC residents. The contract will be awarded to the successful bidder(s) and will cover the jurisdictions of Taylor County and the city of Abilene.
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Text version
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 three (3) 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.
File details come from the government source that posted it. Updated .