Exhibit_D_Bidder_Reference_Qualifications_Form_(01-21-26) (4).docx
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- Solicitation number
- HHS0017229v2
- Issued by
- Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a state and local contract opportunity with the Texas Department of State Health Services Laboratory in Austin, Texas for an Annual Preventative Maintenance Plan for Qiagen EZ1 Extraction Instruments. The form requires bidders to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last three years. For each reference, bidders must provide the business name, point-of-contact information, address, phone number, email address, whether services were performed as a prime contractor or subcontractor, and a description with dates of services provided. Additionally, bidders must furnish current company information including years in business, office address, number of permanent full-time and part-time employees, total employee count, and geographic limits of operations.
The form also requires bidders to list industry certifications, qualifications, formal training programs, and applicable licenses held by staff who will service the account. Bidders must provide a narrative description (maximum one page) of their experience and qualifications as it applies to Section 7.1.5, along with a written description of their operations' size and scope, including the number of employees available for customer service, order fulfillment, safe shipping and handling of product, and the number of supervisors at each location. The form mandates that bidders provide a minimum of two 24-hour contact names with corresponding phone numbers and email addresses for emergency or urgent communication purposes.
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Text version
Exhibit D – Bidder Reference and Contractor Qualifications Form Comment by Parker,Kelly (HHSC): Update Section letter, as applicable.
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:
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 Email Contact 2 Name Phone Email
Exhibit D – Bidder Reference and Contract Qualifications Form – 1/21/26
File details come from the government source that posted it. Updated .