ESBD_549449_1786980853775_Exhibit_D_Bidder_Reference_Qualifications_Formv2.pdf
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- Attached to
- Audiology services needed for residents of RSSLC
- Solicitation number
- HHS0017735v2
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a state and local contract opportunity in Texas related to audiology services for residents of RSSLC. The form establishes the minimum qualifications and documentation requirements that bidders must submit as part of their proposal response. Bidders are required to provide a minimum of three verifiable references for contracts of similar size and scope completed within the last five years, with each reference including the business name, point-of-contact information, address, phone, email, whether services were performed as prime or subcontractor, and a description of services with dates. Additionally, bidders must provide information regarding their years in business, office address, current staffing levels (permanent full-time and part-time employees), geographic limits of operations, and a narrative description of their experience and qualifications.
The form requires bidders to document all industry certifications, qualifications, and formal training programs that staff will hold, as well as applicable licenses for personnel servicing the account. Bidders must demonstrate their ability to perform by providing a written description of their operations size and scope, including the number of employees available for customer service, order fulfillment, and product handling, along with supervisory personnel at each location. The form mandates that bidders supply a minimum of two 24-hour emergency contacts with names, phone numbers, and email addresses to ensure service continuity and responsiveness to the contracting entity's needs.
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Text version
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 (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
Contact 2
Name
Phone
Exhibit D – Bidder Reference and Contractor Qualifications Form
File details come from the government source that posted it. Updated .