ESBD_401286_1741632017803_HHS0015672v2 - Exhibit D Bidder Reference Qualifications.pdf
PDF 72 KB Posted
- Attached to
- PM for Bladder Scanners
- Solicitation number
- HHS0015672v2
- Issued by
- Angelina County, Texas
About this file
This document is an Exhibit D Bidder Reference Form and Contract Qualifications Form for solicitation HHS0015672v2, likely associated with a state or local government health and human services procurement. The document requires bidders to provide three verifiable references for contracts of similar size and scope completed within the past three years, with each reference requiring detailed contact information, service descriptions, and contractor status (prime or subcontractor).
The form requests comprehensive company information including years in business, employee count, geographic operational limits, industry certifications, and staff licenses. Bidders must also submit a one-page narrative describing their experience and qualifications, and provide a written description demonstrating their ability to perform, covering operational size, employee availability, customer service capabilities, order fulfillment, and product handling. The document appears designed to thoroughly evaluate potential contractors' experience, operational capacity, and professional qualifications for a specific service contract.
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Text version
Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24
HHS0015672v2 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.
| HHS0015672v2 |
| Exhibit D – Bidder Reference Form & Contractor Qualifications Form |
File details come from the government source that posted it. Updated .