ESBD_375578_1726505525076_HHS0015139_Exhibit D Bidder Reference Form & Contractor Qualifications Form.docx
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- Solicitation number
- HHS0015139
- Issued by
- Travis County, Austin City, Texas
About this file
This document is the Bidder Reference Form & Contractor Qualifications Form for a contract opportunity issued by the Texas Health and Human Services Commission (HHSC) for general construction services at the Austin State Supported Living Center. The contract will be for as-needed services, and bidders must provide a minimum of three verifiable references for similar work performed within the last three years. The document outlines the information required for each reference, including business name, point-of-contact details, services performed, and descriptions and dates of services provided. Bidders must also provide additional company information, including years in business, office address, number of employees, geographic limits of operations, industry certifications, and relevant licenses held by staff.
The related state and local contract opportunity is for general construction services at the Austin State Supported Living Center, located in Travis County and the city of Austin, Texas. The contract is being issued by the Texas HHSC, and the jurisdictions involved are Travis County and the city of Austin. No additional details are provided regarding pricing terms, set-asides, incumbents, funding requirements, or other salient information.
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Text version
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.
24-Hour Contacts – Must list a minimum of 2:
Contact 1 Name Phone Email Contact 2 Name Phone Email
Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24
File details come from the government source that posted it. Updated .