ESBD_368420_1721159934204_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Attached to
- Counseling services needed for Brenham SSLC
- Solicitation number
- HHS0015000
- Issued by
- Washington County, Brownsville City, Texas
About this file
This document is Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity in Texas. The purpose is for bidders to provide a minimum of three verifiable references for contracts of similar size and scope within the last five years, and to demonstrate their experience, qualifications, and ability to perform the required services. Bidders must provide details on the business name, point-of-contact, services performed as prime contractor or subcontractor, and a description and dates of services provided for each reference. Additionally, bidders must provide information on their company, including number of years in business, office address, number of employees, geographic limits of operations, industry certifications, licenses, and a narrative describing their experience and qualifications as they apply to the minimum requirements.
The related state and local contract opportunity is for Counseling services needed for the Brenham State Supported Living Center in Texas. The Texas Health and Human Services Commission is soliciting these client services under Texas Government Code 2155.144(b) (b-1).
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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 five 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 .