ESBD_555667_1788456471152_Exhibit_D_Bidder_Reference_Qualifications_Form.docx
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- Solicitation number
- HHS0017278V3
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a sole source Perkin Elmer Maintenance Contracts procurement with the Texas Department of State Health Services Lab. The form requires bidders to demonstrate their capability and experience to perform the requested services. Bidders must submit 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, service description, dates of performance, and designation of whether services were provided as a prime contractor or subcontractor. Additionally, bidders must provide documentation supporting their current or prior contract experience.
The form 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), and geographic operational limits. Bidders must list industry certifications, qualifications, formal training programs, and applicable licenses held by staff assigned to the account. The submission must include a narrative description (maximum one page) of the bidder's experience and qualifications, a written description of operational size and scope including available customer service employees, order fulfillment capacity, product shipping and handling capabilities, and supervisor counts by location. Bidders are required to provide a minimum of two 24-hour emergency contacts with names, phone numbers, and email addresses.
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Text version
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 .