ESBD_467236_1762453677881_Exhibit D Bidder Reference & Contractor Qualifications.pdf
PDF 121 KB Posted
- Solicitation number
- HHS0016791
- Issued by
- Johnson County, Texas
About this file
Exhibit D – Bidder Reference and Contractor Qualifications Form for Solicitation HHS0016791
This document is a bidder qualification and reference form issued by the Texas Health and Human Services Commission (HHS) for Solicitation HHS0016791. The form requires bidders to submit comprehensive information regarding their business qualifications, operational capacity, and relevant experience. Bidders must provide a minimum of three verifiable references for contracts of similar size and scope completed within the last three years, with each reference including the business name, point-of-contact information, address, phone number, email address, and a detailed description of services performed as either a prime contractor or subcontractor. Additionally, bidders must disclose their Texas Vendor ID number or Federal ID number and document supporting information for current or prior contracts.
The form requires bidders to provide extensive additional company information including years in business, office address, current staffing levels (permanent full-time and part-time employees, and total employee count), and any geographic limitations on operations. Bidders must list industry certifications, qualifications, formal training programs, and applicable licenses held by staff servicing the account, along with names and license numbers. The form mandates that bidders provide a detailed description of their experience and qualifications as applied to the Scope of Work and demonstrate their ability to perform by describing the size and scope of operations, the number of employees available to provide services, and the number of supervisors for each location. Additional pages may be submitted as needed for both qualification and capability demonstration sections.
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Solicitation HHS0016791
Exhibit D – Bidder Reference and Contractor Qualifications Form
Name of Business:____________________________________________________
Texas Vendor ID No. or Federal ID No:____________________________________
References:
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:
3. Business Name:
Point-of-Contact Name and Title:
Address (City, State, Zip):
Phone:
Email address:
Solicitation HHS0016791
Exhibit D – Bidder Reference and Contractor Qualifications Form
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:
List any 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: Provide a description of the bidder’s experience and qualifications as it applies to the Scope of Work. Additional pages may be added as needed.
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 the services in the Scope of Work, and the number of supervisors for each location, as applicable. Additional pages may be added as needed.
| Solicitation HHS0016791 |
| Exhibit D – Bidder Reference and Contractor Qualifications Form |
File details come from the government source that posted it. Updated .