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 an Exhibit E - Bidder Reference Form for a state and local contract opportunity in Texas. The contract is 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). The contract will affect the ongoing validation of practitioner competency for the state of Texas and the jurisdictions of Travis County and the City of Austin. 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. The information required for each reference includes the business name, point-of-contact, address, phone, email, whether the bidder served as the prime contractor or subcontractor, and a description of the services provided along with the dates of service.
The document does not provide details on pricing terms, set asides, incumbents, the current environment, funding requirements and sources, award amounts, or contract term and renewal options.
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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 .