ESBD_369872_1722373468645_HHS0014780 - Exhibit D -Bidder_Reference.pdf
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- Attached to
- RENTAL, REPAIR, AND PM SERVICES OF RESPIRATORY AND OTHER MEDICAL EQUIPMENT FOR Denton SSLC
- Solicitation number
- HHS0014780
- Issued by
- Denton County, Denton City, Texas
About this file
This document is the Exhibit D - Bidder Reference Form and Contract Qualifications Form for an Invitation for Bids (IFB) issued by the Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) for the rental, repair, and preventative maintenance services of respiratory and other medical equipment for the Denton State Supported Living Center (SSLC). The successful vendor will be required to provide full-service coverage, including equipment tracking, electrical safety inspections, preventative maintenance, and repair services, on an annual or semi-annual basis. The contract term will be from September 1, 2024 to August 31, 2025, with two optional one-year renewal periods. Responses are due by August 21, 2024 at 10:30 AM Central Time.
Bidders must meet minimum experience and qualification requirements, provide required insurances and bonds, and develop and submit a HUB (Historically Underutilized Business) Subcontracting Plan prior to contract execution. The historical spend for these services was $20,000 for the prior year, and the IFB does not specify any set-asides or the incumbent contractor. Funding will be provided through the State of Texas.
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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
HHS0014780
Bidders must provide a minimum of three (3) verifiable references for contracts of similar size and scope of services within the last five (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 .