ESBD_544012_1785267223288_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
PDF 76 KB Posted
- Solicitation number
- HHS0017565
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a contract opportunity with the El Paso State Psychiatric Center in Texas, identified as HHS0017565. The form establishes the qualifications and experience requirements that bidders must demonstrate to be considered for the Music Therapist position. Bidders are required to submit a minimum of three verifiable references for contracts of similar size and scope completed within the past year, with each reference requiring detailed documentation including the contracting entity's business name, point of contact information, service description, and dates of performance. Additionally, bidders must provide comprehensive company information including years in business, office locations, current staffing levels (permanent full-time and part-time employees), geographic operational limits, and relevant industry certifications and licenses held by staff assigned to the account.
The form requires bidders to submit a one-page narrative describing their experience and qualifications specific to the position, along with a detailed written description of operational capabilities, including staffing available for customer service, order fulfillment, and any applicable supervisory structure. Bidders must also designate a minimum of two 24-hour emergency contacts with name, phone, and email information. The form does not specify pricing terms, contract duration, renewal options, or funding sources within the provided document, as these details are contained in other sections of the solicitation package.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017565
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 one (1) year.
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
File details come from the government source that posted it. Updated .