Exhibit_D_Bidder_Reference_Qualifications_Form.docx
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- Solicitation number
- HHS0017251
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form (Exhibit D) for a state and local contract opportunity in Texas involving bottle exchange services for a Reverse Osmosis Deionization (RO/DI) water system at the DSHS Lab in Austin, Texas. The form requires bidders to submit a minimum of three verifiable references for contracts of similar size and scope completed within the last five years. For each reference, bidders must provide the business name, point of contact information, service address, phone and email, designation as either prime contractor or subcontractor, and a detailed description with dates of services rendered. Additionally, bidders must provide comprehensive company information including years in business, office address, current staffing levels (permanent full-time, permanent part-time, and total employees), geographic operational limits, and relevant industry certifications and licenses held by staff assigned to service the account.
The form also requires bidders to submit a narrative statement (maximum one page) describing their experience and qualifications as they apply to the specific contract requirements outlined in Section 7.1.5, along with a written description demonstrating their ability to perform the work, including details on operational size and scope, available customer service personnel, order fulfillment capabilities, product shipping and handling procedures, and supervisory structure by location. Bidders must additionally provide a minimum of two 24-hour emergency contacts with names, phone numbers, and email addresses to ensure availability for urgent matters related to the contract services.
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Text version
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 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 .