ESBD_391771_1737143571171_Exhibit_D_Bidder_Reference_Qualifications_Form_(03-01-24).pdf
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- Solicitation number
- HHS0015580Version2
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Bidder Reference Form and Contract Qualifications Form (Exhibit D) for a Texas Health and Human Services Commission (HHSC) contract opportunity for NextSeq 2000 instrument service at the Texas Department of State Health Services Laboratory. The form requires bidders to provide a minimum of three verifiable references for similar contracts performed within the last five years, with each reference needing to include business name, point of contact details, and description of services provided. Bidders must indicate whether they served as prime contractor or subcontractor for each reference.
The form includes sections for additional company information such as years in business, employee counts (full-time and part-time), geographic operation limits, and staff certifications/qualifications. Bidders must provide a narrative describing their experience and qualifications (limited to one page) and demonstrate their ability to perform by detailing their operational capacity, including customer service staff, order fulfillment capabilities, shipping procedures, and supervisory structure. The form requires detailed documentation of staff certifications, licenses, and qualifications that will be relevant to servicing the account.
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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 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 7.1.5
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 .