ESBD_533030_1782933409515_Exhibit_D_Bidder_Reference_Qualifications_Form.docx
DOCX document 32 KB Posted
- Solicitation number
- HHS0017278V2
- Issued by
- Texas
About this file
Summary of Bidder Reference Qualifications Form
This is a Bidder Reference Qualifications Form for a sole source Perkin Elmer maintenance contract opportunity with the Texas Department of State Health Services (DSHS) Lab. The form is designed to gather information about a bidder's qualifications, experience, and references to support their proposal submission. The document establishes the framework for evaluating whether potential contractors possess the necessary expertise and track record to perform maintenance services on Perkin Elmer laboratory equipment. The form requires bidders to demonstrate their qualifications through detailed responses covering their company background, relevant experience with similar equipment or services, technical capabilities, and professional references.
The form requests that bidders provide contact information for previous clients or projects where they have performed comparable work, allowing the contracting agency to verify the bidder's capability and reliability. This qualification assessment is part of the sole source procurement process for DSHS laboratory maintenance services, ensuring that only qualified vendors are considered for award. The completion and submission of this reference qualifications form is a mandatory requirement for bidders seeking to contract with the state of Texas for these specialized laboratory equipment maintenance services.
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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
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
File details come from the government source that posted it. Updated .