ESBD_531291_1782316983799_HHS0017569 - Exhibit D - Bidder_Reference.pdf
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- Solicitation number
- HHS0017569
- Issued by
- Hockley County, Beaumont City, Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for HHS0017569, a medical equipment preventive maintenance, calibration, and repair services contract for Big Spring State Hospital in Texas. The form requires bidders to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last five years. For each reference, bidders must provide the business name, point-of-contact information, service description, and dates of service, along with documentation supporting whether work was performed as a prime contractor or subcontractor. Additionally, bidders must supply company information including years in business, office address, current staffing levels (permanent full-time, permanent part-time, and total employees), and geographic service areas. The form also requests a list of industry certifications, qualifications, and formal training programs relevant to staff servicing the account, as well as applicable licenses held by personnel.
The qualification section requires bidders to provide a narrative description (maximum one page) of their experience and qualifications as they apply to the contract requirements, along with a detailed written description of operational size and scope, including the number of employees available for customer service, order fulfillment, product shipping and handling, and supervisory personnel at each location. Bidders must also designate a minimum of two 24-hour emergency contacts with name, phone number, and email address. This form serves as a critical evaluation tool to assess contractor capability, experience, and readiness to perform medical equipment maintenance and repair services for the state hospital facility.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017569
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
Contact 2
Name
Phone
| HHS0017461 |
| Exhibit D – Bidder Reference and Contractor Qualifications Form |
File details come from the government source that posted it. Updated .