ESBD_566785_1791574927398_Exhibit_D_Bidder_Reference_Qualif_Form_HHS0018063.pdf
PDF 104 KB Posted
- Attached to
- San Angelo SSLC seeks dental services
- Solicitation number
- HHS0018063
- Issued by
- Texas
About this file
This is a Bidder Reference and Contract Qualifications Form (Exhibit D) for a dental services contract opportunity in San Angelo, Texas. Bidders are required to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last five years. For each reference, bidders must provide the business name, point-of-contact information, address, phone number, email address, clarification of whether services were performed as a prime contractor or subcontractor, and a description of services with dates of performance. The form also requests 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.
Additional submission requirements include documentation of industry certifications, qualifications, and formal training programs for staff servicing the account, as well as applicable licenses held by service personnel. Bidders must provide a narrative description (maximum one page) detailing their experience and qualifications as they apply to Section 7.1.5 of the solicitation. A written description of operational size and scope is required, including the number of employees available for customer service, order fulfillment, and product shipping and handling, along with supervisor counts for each location. The form mandates a minimum of two 24-hour emergency contacts with name, phone number, and email address for each contact.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .