ESBD_370780_1722952304711_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Attached to
- Biomedical services needed for North Texas SH
- Solicitation number
- HHS0015081
- Issued by
- Sterling County, Texas
About this file
This document is an Exhibit D - Bidder Reference Form and Contract Qualifications Form for a state and local contract opportunity in Texas. The contract opportunity involves providing biomedical services for the North Texas State Hospital's General Medical Services Department, specifically in the jurisdictions of Wichita County, Wilbarger County, and the City of Wichita Falls. The form requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope within the last two years, as well as information about the bidder's company, including number of years in business, number of employees, geographical limits, certifications, and licenses. Bidders must also provide a narrative describing their experience and qualifications, as well as a written description of their operations, customer service, order fulfillment, and shipping capabilities.
The document does not provide specific details on pricing terms, set-asides, incumbents, funding requirements, or other financial information. It focuses on the bidder's qualifications, references, and ability to perform the required services.
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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 two 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 .