ESBD_509593_1777039347478_Exhibit D – Respondent Reference Form.pdf
PDF 72 KB Posted
- Attached to
- FY27 Claims Processing for DFPS
- Solicitation number
- HHS0016921
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Bidder Reference Form and Contractor Qualifications Form for a Texas state and local contract opportunity, effective as of March 1, 2024. Bidders are required to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last three years. Each reference must include the business name, point-of-contact information, address, phone number, email address, identification of whether services were performed as a prime contractor or subcontractor, and a description with dates of services provided. Additionally, bidders must provide company information including years in business, office address, current number of permanent full-time and part-time employees, total employee count, and geographic limits of operations.
Bidders must also document all industry certifications, qualifications, and formal training programs relevant to staff servicing the account, along with applicable licenses held by such personnel. Respondents are required to provide a narrative statement not exceeding one page describing their experience and qualifications as applicable to Section 7.1.513 of the solicitation. Furthermore, bidders must submit a written description demonstrating their ability to perform, detailing the size and scope of all operations, including the number of employees available for customer service, order fulfillment, and safe shipping and handling of products, as well as the number of supervisors for each applicable location.
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Text version
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 7.1.513.
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 productproducts 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 .