ESBD_371855_1723479168793_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Attached to
- RSSLC seeks Imaging and Diagnostic services
- Solicitation number
- HHS0014709
- Issued by
- Fort Bend County, Texas
About this file
This document is an Exhibit D - Bidder Reference Form and Contract Qualifications Form for a contract opportunity with the Richmond State Supported Living Center (RSSLC) in the state of Texas. The solicitation is seeking Imaging and Diagnostic services for RSSLC residents under Texas Government Code 2155.144 (b) (b-1), Client Services. Bidders must provide a minimum of three verifiable references for contracts of similar size and scope within the last five years, and include details such as business name, point-of-contact, address, phone, email, services performed, and dates. The form also requires bidders to provide additional company information including years in business, office address, number of employees, geographic limits, industry certifications, and applicable staff licenses.
The solicitation also requires bidders to provide a narrative describing their experience and qualifications, as well as a written description of the size and scope of their operations, including the number of employees available for customer service, order fulfillment, shipping and handling, and supervisors. The contract opportunity does not mention any pricing terms, set asides, incumbents, funding requirements, or other salient commercial details.
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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 five 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 .