ESBD_370246_1722428301734_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Solicitation number
- HHS0014858A
- Issued by
- Fort Bend County, Texas
About this file
This document is Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity issued by the Texas Health and Human Services Commission (HHSC) to provide optometry services to individuals served at the Richmond State Supported Living Center. The solicitation requires bidders to provide a minimum of three verifiable references for similar contracts completed within the last three years, as well as details on the bidder's company such as years in business, number of employees, geographic limits, and any relevant certifications or licenses. Bidders must also provide a narrative describing their experience and qualifications, as well as a written description of their operational capabilities to perform the required services.
The related state and local contract opportunity has an Invitation for Bid (IFB) posted on the Electronic State Business Daily (ESBD) on July 31, 2024, with a response deadline of August 22, 2024 at 10:30 AM Central Time. The anticipated contract start date is September 1, 2024. The procurement schedule includes deadlines for submitting questions, a courtesy review of the HUB Subcontracting Plan, and the response deadline.
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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 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.
Exhibit D – Bidder Reference Form & Contractor Qualifications Form
File details come from the government source that posted it. Updated .