ESBD_368531_1721321277287_Exhibit_D_Bidder References.pdf

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Attached to
46B Evaluator-Psychology Services
Solicitation number
HHS0014683-2
Issued by
Kaufman County, Texas

About this file

This document is an Exhibit D - Bidder Reference Form and Contractor Qualifications Form related to a contract opportunity from the Texas Health and Human Services Commission (HHSC) to provide psychological services for the evaluation of competency to stand trial of 46B patients at Terrell State Hospital in Terrell, Texas. The contract is seeking bidders with a minimum of 3 verifiable references for similar services provided within the last 5 years, as well as information on the bidder's experience, qualifications, number of employees, and geographic scope of operations. The contract covers services in the jurisdictions of Kaufman County and Texarkana City, Texas.

The document also includes a section for bidders to provide a narrative describing their experience and qualifications as they apply to the minimum requirements outlined in the solicitation. Bidders are required to demonstrate their ability to perform the services, including the number of staff available for customer service, order fulfillment, and shipping, as well as the number of supervisors at each location.

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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 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 .