ESBD_522305_1780600834257_Exhibit_D_Bidder_Reference_Qualifications_Form_(01-21-26).pdf

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Attached to
Biomedical Services for Durable Medical Equipment
Solicitation number
HHS0017184
Issued by
Texas

About this file

This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a Texas state and local contract opportunity, dated January 21, 2026. The form establishes the minimum qualifications and documentation requirements that bidders must submit to demonstrate their capability to perform the requested services. Bidders are required to provide a minimum of three verifiable references for contracts of similar size and scope completed within the last five years, with each reference including the business name, point of contact information, service description, dates of performance, and clarification of whether services were provided as a prime contractor or subcontractor. Additionally, bidders must submit information regarding their years in business, office address, current staffing levels (permanent full-time and part-time employees), geographic operational limits, and any relevant industry certifications, qualifications, and formal training programs applicable to staff assigned to the account.

The form requires bidders to provide comprehensive operational and staffing details, including a narrative description of experience and qualifications relevant to the contract scope, a written description of operational size and scope with details on customer service capacity, order fulfillment capabilities, product shipping and handling procedures, and supervisory structure by location. Bidders must also list a minimum of two 24-hour emergency contacts with corresponding phone numbers and email addresses. The form serves as the primary qualification documentation vehicle for evaluating bidder suitability, financial stability, and operational readiness to perform under the contract terms.

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Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26

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 five (5) 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

File details come from the government source that posted it. Updated .