ESBD_369597_1722116413442_Exhibit D_Bidder Reference Form.pdf
PDF 160 KB Posted
- Attached to
- Lufkin SSLC Medical Equipment Maintenance
- Solicitation number
- HHS0014850
- Issued by
- Angelina County, Texas
About this file
The document provided is an Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity related to annual preventive maintenance services for medical equipment at the Lufkin State Supported Living Center (SSLC) in Pollok, Texas. The form requires bidders to provide a minimum of three verifiable references for similar contracts performed within the last three years, as well as information about the bidder's company, including number of years in business, office address, number of employees, and any relevant certifications, qualifications, or licenses held by staff. Bidders must also provide a narrative description of their experience and qualifications as they apply to the scope of work outlined in the contract requirements. The related state and local contract opportunity is for Lufkin SSLC Medical Equipment Maintenance, located in Pollok, Texas, within Angelina County.
The contract requires preventive maintenance services for Bolero bath trolleys, Concerto shower trolleys, Freedom baths, MaxiMove lifts, and Rhapsody baths at the Lufkin SSLC facility. No specific pricing details, set-asides, or funding sources are provided in the document.
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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 <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.
File details come from the government source that posted it. Updated .