ESBD_File_344670_Exhibit E - Bidder Reference Form.pdf
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- Solicitation number
- HHS0014102
- Issued by
- Travis County, Austin City, Texas
About this file
This document is the Bidder Reference Form for a state and local contract opportunity for annual preventive maintenance and inspection services for water purification systems at the Department of State Health Services (DSHS) Laboratory in Austin, Texas. The contract is being issued by the Health and Human Services Commission (HHSC) Procurement and Contracting Services (PCS) division, and the jurisdictions included are Travis County and the City of Austin. The contract requires a minimum of three verifiable references for previous contracts of similar size and scope within the last five years, including details on the business name, point-of-contact, services performed as a prime contractor or subcontractor, and a description of the services provided.
The contract opportunity is for a one-year term with the possibility of four one-year renewal options. Pricing terms, set asides, incumbents, funding sources, and other salient details were not provided in the reference form.
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Text version
Exhibit E – Bidder Reference Form – 09/01/21
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 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:
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