ESBD_537806_1784042138130_Exhibit D - Bidder Reference and Quals Form.pdf
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- Solicitation number
- HHS0017698
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a Certified Orientation Mobility Specialist contract opportunity with the State of Texas, specifically for the Brenham 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 five years, with each reference including business name, point-of-contact information, address, phone, email, and a detailed description of services provided as either a prime contractor or subcontractor. Additionally, bidders must provide company background information including years in business, office address, current staffing levels (permanent full-time and part-time employees), geographic operational limits, and relevant industry certifications and licenses held by staff who will service the account.
The form also requires bidders to demonstrate their qualifications and ability to perform through a one-page narrative addressing relevant experience and a written description of operations size and scope, including available customer service personnel, order fulfillment capacity, product shipping and handling procedures, and supervisory structure by location. Bidders must provide a minimum of two 24-hour emergency contacts with name, phone number, and email address. The form serves as a mechanism to evaluate contractor qualifications, operational capacity, and references prior to contract award, with all supporting documentation attached to the response submission.
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Text version
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
Contact 2
Name
Phone
Exhibit D – Bidder Reference and Contractor Qualifications Form
File details come from the government source that posted it. Updated .