ESBD_551080_1787082159414_Exhibit_D_Bidder_Reference_Qualifications_Form.pdf
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- Attached to
- For Non-Emergency Ambulance Services at the El Paso State Supported Living Center (EPSSLC)
- Solicitation number
- HHS0017827
- Issued by
- Texas
About this file
This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a Non-Emergency Ambulance Services contract at the El Paso State Supported Living Center (EPSSLC) in Texas, referenced under HHS0017827. The form establishes the qualifications and experience requirements that bidders must demonstrate to be considered for this service contract. Bidders are required to provide a minimum of three verifiable references for contracts of similar size and scope completed within the last three years, with each reference including business name, point of contact information, service descriptions, and dates of performance. Additionally, bidders must provide comprehensive company information including 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 as applied to the specific requirements.
The form further requires bidders to demonstrate their operational capacity by providing a written description of their size and scope of operations, including the number of employees dedicated to customer service, order fulfillment, safe shipping and handling of products, and the number of supervisors at each location. Bidders must also list all relevant industry certifications, qualifications, formal training programs, and applicable licenses held by staff who will service the account. The form mandates that bidders provide a minimum of two 24-hour emergency contacts with names, phone numbers, and email addresses to ensure continuous communication availability throughout the contract period.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017827
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 .