ESBD_484613_1770221082065_HHS0016283v2 - Exhibit D - Bidder Reference Form.pdf
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- Attached to
- As Needed Electrical Services for HHSC Region 4
- Solicitation number
- HHS0016283v2
- Issued by
- Texas
About this file
This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for HHS0016283v2, a state and local health and human services contract opportunity. The form requires bidders to demonstrate their qualifications and experience to perform services related to customer service, order fulfillment, safe shipping and handling of products, and general operations management. Bidders must submit 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, service description, and dates of performance. Additionally, bidders must provide details on their years in business, current staffing levels (permanent full-time and part-time employees), geographic operating limits, and organizational structure including the number of supervisors available at each location.
The form requires bidders to document all industry certifications, qualifications, formal training programs, and applicable licenses held by staff who will service the account. Bidders must also submit a narrative of no more than one page describing their experience and qualifications relevant to the contract requirements, along with a written description demonstrating their operational capacity and ability to perform. Finally, bidders are required to provide a minimum of two 24-hour emergency contacts with name, phone, and email information to ensure continuity of service and rapid response capabilities throughout the contract term.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0016283v2 Exhibit D – Bidder Reference and 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
Contact 2
Name
Phone
| HHS0016283v2 |
| Exhibit D – Bidder Reference and Contractor Qualifications Form |
File details come from the government source that posted it. Updated .