ESBD_File_343291_Exhibit E Bidder Reference Form.pdf
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- Attached to
- Credentialing Software and Maintenance
- Solicitation number
- HHS0013596
- Issued by
- Travis County, Austin City, Texas
About this file
The document is Exhibit E - Bidder Reference Form for a contract opportunity to procure and implement a cloud-based credentialing system and maintenance that meets the standards of the Centers for Medicare & Medicaid Services (CMS), The Joint Commission (TJC), and the Texas Medical Board (TMB). This contract opportunity is open to the jurisdictions of Travis County and the City of Austin, Texas. Bidders must provide a minimum of three (3) verifiable references for contracts of similar size and scope of services within the last three (3) years, providing details on the business name, point-of-contact, address, phone, email, whether services were performed as a prime contractor or subcontractor, and a description of the services provided.
The contract will directly affect the care that patients receive through the ongoing validation of practitioner competency. No other pricing, set aside, incumbent, funding, or renewal information is provided in the document.
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Text version
Exhibit E – Bidder Reference Form – 09/01/21
HHS0013596
Exhibit E – Bidder Reference Form Bidders must provide a minimum of three (3) verifiable references for contracts of similar size and scope of services within the last three (3) 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:
| HHS0013596 |
| Exhibit E – Bidder Reference Form |
File details come from the government source that posted it. Updated .