ESBD_573386_1793745670247_Exhibit_D_Bidder_Reference_Qualifications_Form_(01-21-26).pdf
PDF 104 KB Posted
- Attached to
- FY27 Dental Services for RGSC
- Solicitation number
- HHS0018095
- Issued by
- Texas
About this file
This is a Bidder Reference Qualifications Form for the FY27 Dental Services for RGSC contract opportunity in Texas. The form serves as a submission document for bidders to demonstrate their qualifications and relevant experience for providing dental services. Bidders are required to complete this form as part of their proposal package, providing references and details about their past performance on similar projects to establish their capability to deliver the requested services. The form functions as a qualification assessment tool to evaluate bidder experience, track record, and suitability for the dental services contract.
The form does not contain specific information regarding pricing terms, set-asides, incumbent contractors, funding sources, or contract duration in the materials provided. Completion and submission of this qualifications form is a mandatory requirement for bidder consideration, and responses should include relevant project references and performance history that directly correlate to the dental services scope of work for the RGSC engagement.
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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 .