ESBD_368151_1720823106536_Exhibit_D_Bidder_Reference_Qualifications_Form.docx
DOCX document 32 KB Posted
- Solicitation number
- HHS0014716V2
- Issued by
- Tom Green County, San Marcos City, Texas
About this file
This document is the Bidder Reference Form and Contractor Qualifications Form for an Invitation for Bids (IFB) issued by the Health and Human Services Commission (HHSC) of the state of Texas. The IFB is seeking competitive bids to establish a contract(s) for natural gas inspections and piping testing services as needed for the San Angelo State Supported Living Center. Bidders must provide a minimum of three verifiable references for contracts of similar size and scope within the last 3 years, and include details such as business name, point-of-contact, address, phone, email, whether the services were performed as a prime contractor or subcontractor, and a description of the services provided. The form also requires the bidder to provide additional company information, including number of years in business, office address, number of full-time and part-time employees, geographic limits of operations, industry certifications, and applicable licenses held by staff.
The related state and local contract opportunity is for the Maintenance, Inspection, and Repair of Natural Gas Systems at the San Angelo State Supported Living Center, located in Tom Green County and San Marcos City, Texas. The contract is being issued by the HHSC in the state of Texas.
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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 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.
24-Hour Contacts – Must list a minimum of 2:
Contact 1 Name Phone Email Contact 2 Name Phone Email
File details come from the government source that posted it. Updated .