ESBD_544728_1785526963374_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
PDF 76 KB Posted
- Attached to
- Water Filtration System Maintenance and Repairs at San Angelo State Supported Living Center
- Solicitation number
- HHS0017602
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for the Texas Health and Human Services Commission's Water Filtration System Maintenance and Repairs solicitation at San Angelo State Supported Living Center (HHS0017602). 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. For each reference, bidders must provide the contracting business name, point-of-contact information including name, title, address, phone and email, specification of whether services were performed as prime contractor or subcontractor, and a detailed description with dates of services provided.
The form additionally requests comprehensive company information including years in business, office address, current staffing levels (permanent full-time, part-time, and total employees), geographic operational limits, and all relevant industry certifications, qualifications, formal training programs, and licenses held by staff assigned to the account. Bidders must provide a narrative of maximum one page describing their experience and qualifications, demonstrate their operational capacity by detailing the size and scope of operations including available customer service and fulfillment personnel and supervisory structure by location, and provide a minimum of two 24-hour emergency contacts with name, phone, and email information.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017602
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
Contact 2
Name
Phone
File details come from the government source that posted it. Updated .