ESBD_546835_1786036602878_Exhibit_D_Bidder_Ref and Qualif_HHS0017597v2.pdf

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Attached to
Dental Anesthesia services needed for El Paso SSLC
Solicitation number
HHS0017597v2
Issued by
El Paso County, Texas

About this file

This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a state and local contract opportunity in Texas related to dental anesthesia services needed for El Paso SSLC. 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, whether services were provided as a prime contractor or subcontractor, and a description and dates of services provided. Additionally, bidders must provide company information including years in business, office address, current staffing levels (permanent full-time, permanent part-time, and total employees), geographic limits of operations, and a list of industry certifications, qualifications, and formal training programs applicable to staff servicing the account. Bidders must also document applicable licenses held by staff members who will service the account.

The form further requires bidders to submit a narrative of no more than one page describing their experience and qualifications as it applies to the relevant contract section, along with a written description of their operational size and scope, including the number of employees available for customer service, order fulfillment, safe shipping and handling of products, and the number of supervisors per location as applicable. Bidders must also provide a minimum of two 24-hour emergency contacts with names, phone numbers, and email addresses. The form does not specify pricing terms, set-asides, incumbent information, funding amounts, or contract term details, as these elements are not included in this qualifications and references document.

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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 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 Contractor Qualifications Form

File details come from the government source that posted it. Updated .