ESBD_369551_1721843677777_Exhibit D Bidder_Reference_Qualifications_Form_(03-01-24) (1).docx
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- Solicitation number
- HHS0014963
- Issued by
- Texas
About this file
This document is an Exhibit D - Bidder Reference Form & Contractor Qualifications Form related to a state and local contract opportunity issued by the Texas Health and Human Services Commission (HHSC) for the manufacturing of an entrance sign and installation of two monument brick walls at the Texas Center for Infectious Disease. The form requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope within the last three years, including details on the business name, point-of-contact, services performed, and dates of services provided. Additionally, the form requests information about the bidder's company, including the number of years in business, office address, number of employees, geographic limits of operations, industry certifications, licenses, and a narrative describing the bidder's experience and qualifications as they apply to the minimum requirements for the contract.
The related state and local contract opportunity is for the manufacturing of an entrance sign and installation of two monument brick walls at the Texas Center for Infectious Disease. The contract is being issued by the Texas Health and Human Services Commission, and the services are to be performed 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 three (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 .