ESBD_370240_1722374645771_HHS0015218_Exhibit_D_Bidder_Reference_Qualifications.pdf
PDF 71 KB Posted
- Attached to
- Neurology Services for Richmond SSLC
- Solicitation number
- HHS0015218
- Issued by
- Fort Bend County, Rhome City, Texas
About this file
This document is an Exhibit D - Bidder Reference Form and Contract Qualifications Form related to a state and local contract opportunity for Neurology Services for Richmond State Supported Living Center (SSLC) in Texas. The form requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope within the last five years, as well as information about the bidder's company, including years in business, number of employees, geographic limits of operations, and staff certifications and licenses. Bidders must also provide a narrative describing their experience and qualifications as they apply to the minimum requirements in Section 7.1.5 of the solicitation, and a written description of the size and scope of their operations, including the number of employees and supervisors available to provide the requested services.
The related state and local contract opportunity is for Neurology Services for the Richmond SSLC located in Fort Bend County, Texas. No additional details about pricing, set asides, incumbents, funding, or other salient information are provided in the document.
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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 (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 .