ESBD_461616_1761589085054_HHS0016339v2 - Exhibit D Reference Form _Qualifications.docx
DOCX document 34 KB Posted
- Solicitation number
- HHS0016339v2
- Issued by
- Schleicher County, Texas
About this file
This document is an Exhibit D Bidder Reference Form and Contractor Qualifications Form for a state or local government contract (potentially with HHS, based on the file naming convention). The form requires bidders to provide a minimum of three verifiable references for contracts of similar size and scope within the last three years, with detailed contact information, service descriptions, and performance details for each reference.
The form also requests comprehensive company information, including years in business, employee count, geographic operational limits, industry certifications, and staff licensing. Bidders must submit a one-page narrative describing their experience and qualifications, demonstrate their ability to perform by detailing operational capabilities, customer service resources, order fulfillment processes, and product handling. Additionally, the document requires listing at least two 24-hour contacts for the bidding organization. The form appears to be part of a solicitation process dated 03/01/24, with a structured approach to evaluating potential contractors' qualifications and past performance.
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Text version
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.
24-Hour Contacts – Must list a minimum of 2:
Contact 1 Name Phone Email Contact 2 Name Phone Email
Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24
File details come from the government source that posted it. Updated .