ESBD_368158_1721051492697_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Solicitation number
- HHS0015062
- Issued by
- Texas
About this file
This document is Exhibit D - Bidder Reference Form and Contract Qualifications Form related to a state and local contract opportunity from the Health and Human Services Commission (HHSC) in the state of Texas. The contract opportunity is for the rental of 150# chlorine gas cylinders for the Mexia State Supported Living Center (SSLC) wastewater treatment plant. The solicitation requires a minimum of three verifiable references for similar contracts within the last five years, as well as details on the bidder's company, experience, qualifications, and ability to perform the required services. The procurement schedule includes an IFB posting date of July 15, 2024, a question/clarification deadline of July 22, 2024, with responses posted by July 24, 2024, and a response deadline of July 31, 2024 at 10:30 AM Central Time. The anticipated contract start date is September 1, 2024.
The document also includes a section for the bidder to provide a narrative of their experience and qualifications, as well as a description of the size and scope of their operations, including the number of employees and supervisors available to service the account. Pricing terms, set-asides, funding sources, and other financial details are not provided in this exhibit.
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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 (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.
Exhibit D – Bidder Reference Form & Contractor Qualifications Form
File details come from the government source that posted it. Updated .