Exhibit D_Bidder_Reference_Qualifications_Form.docx
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- Solicitation number
- HHS0016990
- Issued by
- Cameron County, Texas
About this file
This is a Bidder Reference and Contractor Qualifications Form for the Texas Health and Human Services Commission's emergency mold assessment and protocol services contract for Building 802 at Rusk State Hospital. Bidders must provide minimum three verifiable references for contracts of similar size and scope completed within the last three years, with detailed information for each reference including business name, point-of-contact, address, phone, email, and description of services provided. A mandatory on-site visit is scheduled for January 22, 2026, at 10:30 AM at Rusk State Hospital, 805 North Dickinson Drive, Rusk, Texas 75785, with automatic disqualification for failure to attend. Questions or clarifications must be submitted by January 26, 2026, at 5:00 PM, with responses posted January 27, 2026. Bids are due January 30, 2026, at 10:30 AM, and pricing must be submitted as firm, fixed prices on the Pricing Sheet covering all labor, equipment, materials, and supplies. The initial contract term extends from award through August 31, 2026, with a possible one-year extension option at the sole discretion of HHSC.
The qualification form requires bidders to document years in business, office address, employee counts (permanent full-time, permanent part-time, and total), geographic operational limits, industry certifications, and applicable licenses for staff servicing the account. Bidders must demonstrate minimum two years of relevant experience and describe their operational capacity, including available customer service employees, order fulfillment capabilities, safe shipping and handling procedures, and supervisor counts per location. Pricing terms require firm, fixed pricing submitted on Exhibit C with no specified set-asides or organizational restrictions. No incumbent vendors are identified, and both HHSC and the Department of State Health Services are entitled to use the resulting contract. Price adjustments may be permitted solely at HHSC's discretion using the Consumer Price Index formula or federal minimum wage increases, with supporting documentation required for any requests.
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Text version
Exhibit D – Bidder Reference Form & 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 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.
Exhibit D – Bidder Reference Form and Contract Qualifications Form – 03/01/24
File details come from the government source that posted it. Updated .