Exhibit D_Bidder Reference Qualifications_Form.docx

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Attached to
Irrigation System Maintenance & Service at Austin State Hospital (ASH)
Solicitation number
HHS0017509V2
Issued by
Texas

About this file

This is a Bidder Reference and Contractor Qualifications Form for a state and local contract opportunity related to Irrigation System Maintenance & Service at Austin State Hospital in Texas. 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 comprehensive details including the business name, point-of-contact information, address, phone and email, whether services were performed as a prime contractor or subcontractor, and a description with dates of services provided. Additionally, bidders must complete a section on company information that includes the number of years in business, office address, current staffing levels (permanent full-time, permanent part-time, and total employees), geographic limits of operations, and a listing of industry certifications, qualifications, and formal training programs applicable to staff servicing the account.

The form further requires bidders to provide a narrative description of minimum experience and qualifications relevant to Section 7.1.5, not to exceed one page. Bidders must also demonstrate their ability to perform by providing a written description of the size and scope of operations, including the number of employees available for customer service, order fulfillment, safe shipping and handling of products, and the number of supervisors per location as applicable. The form mandates that bidders list a minimum of two 24-hour contacts with names, phone numbers, and email addresses. Additionally, bidders must include any applicable licenses currently held by staff that will service the account, organized by staff member name and license number.

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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 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 .