ESBD_439178_1753368994067_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf

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Attached to
As needed Oral and Maxillofacial Services, Austin State Supported Living Center
Solicitation number
HHS0016350
Issued by
Travis County, Austin City, Texas

About this file

This document is Exhibit D - Bidder Reference Form and Contract Qualifications Form dated 03/01/24, designed for potential bidders to provide detailed company and service information. The form requires bidders to submit three verifiable references for contracts of similar size and scope within the last three years, including business names, contact information, and descriptions of services performed. Additionally, the form requests comprehensive company details such as years in business, number of employees, geographic operational limits, industry certifications, and staff qualifications.

The form is structured to capture critical information about a bidder's operational capabilities and past performance, requiring a one-page narrative describing the bidder's experience and qualifications, and a written description of the company's operational scope. This includes details about employee availability for customer service, order fulfillment, shipping and handling, and supervisory structure. The document is intended to help the procuring entity assess a bidder's competence, experience, and capacity to successfully execute the contract by providing a standardized method for bidders to demonstrate their professional credentials and organizational capabilities.

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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 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 & Contractor Qualifications Form

File details come from the government source that posted it. Updated .