ESBD_526602_1781280398580_HHS0017530 - Exhibit D - Bidder_Reference_Qualifications.pdf
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- Solicitation number
- HHS0017530
- Issued by
- Henderson County, Texas
About this file
This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a state and local contract opportunity with the Texas Health and Human Services Commission for preventive maintenance, calibrations, and as-needed repair services for hospital and durable medical equipment at Lubbock State Supported Living Center. The form requires bidders to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last two years. For each reference, bidders must provide the business name, point-of-contact information, address, phone, email, 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 staffing levels (permanent full-time, permanent part-time, and total employees), and geographic operational limits.
The form also requires bidders to list industry certifications, qualifications, formal training programs, and applicable licenses held by staff servicing the account. Bidders must provide a narrative (not to exceed one page) describing their experience and qualifications as they apply to the contract requirements, along with a written description of operational size and scope, including the number of employees available for customer service, order fulfillment, and safe product handling, and the number of supervisors at each location. Bidders must designate a minimum of two 24-hour emergency contacts with names, phone numbers, and email addresses. The document does not specify pricing terms, award dates, contract duration, or renewal options.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017530
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 two (2)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
| HHS0017461 |
| Exhibit D – Bidder Reference and Contractor Qualifications Form |
File details come from the government source that posted it. Updated .