ESBD_563015_1790361798712_Form 2 - References.pdf
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- Solicitation number
- 3202600207
- Issued by
- Texas
About this file
This is a References Form (Form 2) for Request for Qualifications (RFQ) No. 3202600207 issued by the State of Texas for Vocational Rehabilitation Impartial Hearing Officers. Respondents must submit a minimum of three professional references who have direct knowledge of the applicant's experience within the past five years, with preference given to references from state, federal, or local governmental entities. For each reference, respondents must provide project descriptions, contact information for the organization receiving services, contract amounts (original and final), service descriptions, and clarification of whether the respondent served as the primary contractor or subcontractor. The form also requires disclosure of any cancelled contracts during the specified period.
In addition to references, respondents must disclose any sanctions, liquidated damages, or other monetary remedies assessed within the past five years; any disciplinary actions for substandard work or unethical practices; any orders or judgments barring or limiting business activities; any civil or criminal litigation, settlements, or consent decrees related to contract performance or relevant to the work; and any project terminations, contract defaults, or convenience terminations. Respondents may withhold information protected by confidentiality provisions but must disclose all other relevant information. The form explicitly prohibits TWC (Texas Workforce Commission) staff from serving as references.
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Text version
RFQ No. 3202600207 Page 1 of 5 Form 2: References (including Cancelled Contract References) v. Dec 2025
Request for Qualifications (RFQ) Form 2
– References
3202600207 Vocational Rehabilitation Impartial
Hearing Officers Must Be Completed and Returned.
Respondent must provide a minimum of three (3) references who have first-hand knowledge of the Respondent’s professional skills and experience as they relate to the qualifications described in
Section 2.2 Description of Services (which may include dispute resolution, practicing law, or managing complex administrative roles) within the last five (5) years. References from state, federal, and/or local governmental entities are encouraged but not required.
Do not include TWC staff as a reference.
By submitting this document, the Respondent releases the below-named companies providing a reference, its agents, employees, and all persons, natural or corporate, in privity with above-named company providing a reference from any and all liability, claims or causes of action arising from their disclosure of information pursuant to this request for a business reference.
RFQ No. 3202600207 Page 2 of 5
#1-Project Description:
Contact Name:
Name of the organization to which the service was provided:
Reason for contract termination/expiration, if contract is no longer in effect:
Contact Number: Contact E-Mail Address:
Original Contract Amount: Final Contract Amount:
Types of services directly provided by the Respondent and whether the Respondent was the contractor or Subcontractor:
#2-Project Description:
Contact Name:
Name of the organization to which the service was provided:
Reason for contract termination/expiration, if contract is no longer in effect:
Original Contract Amount: Final Contract Amount:
RFQ No. 3202600207 Page 3 of 5
#3-Project Description:
Contact Name:
Name of the organization to which the service was provided:
Reason for contract termination/expiration, if contract is no longer in effect:
Contact Number: Contact E-Mail Address:
Original Contract Amount: Final Contract Amount:
RFQ No. 3202600207 Page 4 of 5
Canceled Contracts:
[Add additional projects to the table as needed].
#1-Project 1:
Start Date: Projected Completion Date: Actual Completion Date:
Has the Respondent been assessed any Sanctions, including liquidated damages or other such monetary remedies, under any existing or past contracts during the last five (5) years? If so, note the reason for and the amount assessed or paid for each incident.
Was the Respondent the subject of (i) any threatened, pending, or resolved disciplinary action for substandard work and/or unethical practices; or (ii) any order, judgment or decree of any federal or state authority barring, suspending or otherwise limiting the right of the Respondent to engage in any business, practice, or activity, during the last five (5) years? If so, explain.
RFQ No. 3202600207 Page 5 of 5
#1-Project 1:
Has the Respondent been involved in any civil or criminal litigation and/or entered into any compromise agreement, settlement agreement, or resulting consent decree or judgements, if applicable, related to contract performance, the goods and/or services sought by this Solicitation, or that a reasonable person knowledgeable of the applicable industry would consider relevant to the work under the Contract? If so, explain. Respondents are not required to violate any confidentiality provision but must provide information not prohibited from disclosure.
Has the Respondent had a project terminated, stopped in the middle, or contract terminated for default or convenience within the past five (5) years? Yes or No. If yes, provide an explanation with details including the others party’s name, address, and telephone number.
Request for Qualifications (RFQ) Form 2 – References
File details come from the government source that posted it. Updated .