ESBD_517848_1779202286501_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
PDF 75 KB Posted
- Solicitation number
- HHS0017293
- Issued by
- Texas
About this file
This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a Texas Health and Human Services (HHS) contract opportunity (HHS0017293). The form requires bidders to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last three years. For each reference, bidders must provide the business name, point-of-contact information, service description, dates of service, and clarification of whether services were provided as a prime contractor or subcontractor. Additionally, bidders must complete sections documenting their years in business, office address, current employee count (full-time, part-time, and total), geographic operational limits, and relevant industry certifications, qualifications, and formal training programs applicable to staff servicing the account.
The form further requires bidders to provide a maximum one-page narrative describing their experience and qualifications as it applies to Section 7.1.5 of the solicitation, along with a written description of operational size and scope, including available customer service personnel, order fulfillment capacity, safe shipping and handling procedures, and supervisory structure by location. Bidders must also list a minimum of two 24-hour emergency contacts with name, phone, and email information. The form emphasizes the need to demonstrate the ability to perform and requires supporting documentation to validate all provided information regarding current or prior contracts.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017293
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 (3) three 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
File details come from the government source that posted it. Updated .