ESBD_548783_1786634933255_HHS0017769_Exhibit D Bidder Reference Form & Contractor Qualification Form.docx
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- Solicitation number
- HHS0017769
- Issued by
- Texas
About this file
Exhibit D is a Bidder Reference and Contractor Qualifications Form required for the As Needed Plumbing Services contract at Brenham State Supported Living Center in Texas. Bidders must submit a minimum of three verifiable references for contracts of similar size and scope performed within the last five years, with each reference including the 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. The form also requires bidders to provide comprehensive 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 relevant to staff servicing the account.
Additional submission requirements include documentation of applicable licenses held by staff servicing the account, a narrative description not to exceed one page demonstrating the bidder's experience and qualifications relevant to the contract, and a written description of the size and scope of operations including the number of employees available for customer service, order fulfillment, and safe shipping and handling of products, along with the number of supervisors at each location as applicable. Bidders must also provide a minimum of two twenty-four-hour emergency contacts with name, phone number, and email address for each contact listed on the form.
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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 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 .