ESBD_394345_1738959135470_HHS0015672 - Exhibit D Bidder Reference Qualifications Form.docx
DOCX document 34 KB Posted
- Attached to
- Repairs Bladder Scanners for Lufkin SSLC
- Solicitation number
- HHS0015672
- Issued by
- Angelina County, Texas
About this file
This document is Exhibit D - Bidder Reference Form & Contractor Qualifications Form for solicitation HHS0015672 from the Texas Health and Human Services Commission. The form requires bidders to provide at least three verifiable references for contracts of similar size and scope performed within the last three years. For each reference, bidders must include business name, point of contact details, whether services were performed as prime contractor or subcontractor, and description of services provided with dates.
The form also requires additional company information including years in business, office address, current employee counts (full-time and part-time), geographic operation limits, and industry certifications/qualifications/formal training programs for staff who will service the account. Bidders must provide a one-page narrative describing their experience and qualifications, along with a written description of their operational capabilities including customer service staff, order fulfillment, shipping/handling, and supervision structure. This exhibit appears to be part of a larger solicitation package for biomedical equipment maintenance services at Lufkin State Supported Living Center.
View the file
Other files
Show all 20
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
HHS0015672
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.
Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24
File details come from the government source that posted it. Updated .