ESBD_553277_1787664703547_Exhibit_D_Bidder_Reference_Qualifications_Formv2.pdf
PDF 94 KB Posted
- Solicitation number
- HHS0017696v2
- Issued by
- Texas
About this file
This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a state and local contract opportunity issued by HHS under contract number HHS0017696v2. The form establishes qualification and experience requirements that bidders must satisfy to be considered for the contract award. Bidders are required to provide a minimum of three verifiable references for contracts of similar size and scope performed within the last five years, including detailed information such as business name, point of contact, address, phone, email, and a description of services provided as either a prime contractor or subcontractor. Additionally, bidders must provide company background information including years in business, office address, current number of permanent full-time and part-time employees, total employee count, and geographic limits of operations. The form also requires documentation of industry certifications, qualifications, formal training programs, and applicable licenses held by staff who will service the account.
The form mandates that bidders submit a narrative statement (maximum one page) describing their experience and qualifications relevant to Section 7.1.5, as well as a written description demonstrating their ability to perform the contract by detailing the size and scope of all 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 for each applicable location. Bidders must also provide a minimum of two 24-hour emergency contacts with name, phone number, and email address. The form serves as the primary qualification evaluation tool and requires supporting documentation to verify all submitted information regarding current or prior contract experience.
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Text version
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
HHS0017696v2 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
File details come from the government source that posted it. Updated .