ESBD_368524_1721316401568_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Solicitation number
- HHS0015158
- Issued by
- Travis County, Austin City, Texas
About this file
This document is the Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity. The form requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope of services provided within the last 5 years. Bidders must include details such as the business name, point-of-contact information, whether services were performed as a prime contractor or subcontractor, and a description of the services provided. The form also requests additional company information, including the number of years in business, number of employees, geographic limits of operations, and any relevant industry certifications, qualifications, or formal training programs. Bidders must also provide a narrative describing their experience and qualifications as they apply to the contract requirements.
The related state and local contract opportunity is an Invitation for Bids (IFB) for Pastoral Services at the Austin State Hospital in Texas. The IFB has a response deadline of August 01, 2024, and an anticipated contract start date of September 1, 2024. The procurement schedule includes a deadline for submitting questions or clarifications and the posting of responses in the form of an addendum.
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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 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 .