ESBD_381064_1730829029607_Exhibit D - Bidder Reference.pdf
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- Solicitation number
- HHS0014976
- Issued by
- Travis County, Texas
About this file
This is a Bidder Reference Form and Contract Qualifications Form (Exhibit D) from the Texas Health and Human Services Commission (HHSC) and Department of State Health Services (DSHS) for a biomedical repair services contract. The form requires bidders to provide a minimum of three verifiable references for similar contracts completed within the past five years, including detailed contact information and descriptions of services provided for each reference. The form also requests comprehensive company information including years in business, employee counts (full-time and part-time), geographic scope of operations, and staff certifications and licenses.
The document includes sections for bidders to demonstrate their qualifications and ability to perform the required services through a one-page narrative describing their experience (Section 7.1.6) and a written description of their operational capabilities, including details on customer service staff, order fulfillment processes, shipping and handling procedures, and supervisory structure across all locations. The form appears to be part of the evaluation documentation for the larger biomedical equipment maintenance contract, though specific pricing information and terms are not included in this exhibit.
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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 five (5) 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 7.1.6
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 .