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 Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity in Texas. The contract is for Neurology Services for the Richmond State Supported Living Center (SSLC) located in Richmond, Texas. Bidders must provide a minimum of three verifiable references for similar contracts within the last five years, including details on the services performed, points of contact, and company information. Bidders must also demonstrate their experience and qualifications, the size and scope of their operations, and the number of employees available to provide the required services.
The contract opportunity is for the state of Texas, specifically Fort Bend County. No pricing terms, set asides, incumbents, funding requirements, or other salient information is 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 .