ESBD_371215_1723167914399_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Solicitation number
- HHS0014910A
- Issued by
- Comal 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) and the Department of State Health Services (DSHS). The contract is for annual preventative maintenance and repair services for 18 specified pieces of medical equipment at the San Angelo State Supported Living Center. The scope of work includes providing labor, parts, equipment, tools, transportation, and communication to perform these services. Bidders must submit a completed Pricing Sheet, Bidder Reference Form, and Solicitation Affirmations. The contract will be awarded to the bidder that provides the best value based on meeting the requirements, ability to perform, and price. The initial contract term is for 3 years with no renewal options.
The historical spend for these services is $14,000 for the prior year, but the actual award value is not specified. The solicitation does not mention any set-aside designations or restrictions on the types of organizations that can respond, and there are no listed incumbent vendors or current contractors. The solicitation does not indicate any existing infrastructure or technology that requires integration.
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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 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.
File details come from the government source that posted it. Updated .