ESBD_539316_1785243466860_Exhibit_D_Bidder_Reference_Qualifications_Form.docx
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- Solicitation number
- HHS0017383
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a preventative maintenance contract with the Texas Department of State Health Services (DSHS) for BD Max Clinical Instrument services. The form requires bidders to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last three years, with each reference including the business name, point-of-contact information, service description, dates of performance, and designation as either prime contractor or subcontractor. Bidders must also provide comprehensive company 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 qualification form additionally requires bidders to submit a one-page narrative describing their experience and qualifications relevant to the contract requirements, a detailed written description of operational size and scope including available customer service and order fulfillment personnel and supervisory staff by location, and a minimum of two 24-hour emergency contacts. The form does not specify pricing terms, set-asides, incumbent information, or contract duration; however, it establishes baseline qualification requirements to evaluate bidder capability to perform preventative maintenance services for BD Max Clinical Instruments on behalf of the state health services agency.
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Text version
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 three (3) 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 .