016036 RFPAttD - Reference Check Form.docx

This is a Reference Check Form attachment (Attachment D) for RFP S-44300-00016036 issued by the Oregon Health Authority (OHA) for the Oregon Alliance to Prevent Suicide Staffing and Culturally Specific Programming contract. The form is designed to be completed by reference entities to evaluate proposers' qualifications and performance history. Proposers must provide information about reference entities willing to discuss their experience, including contact details such as name, telephone number, and email address. The evaluation process requires references to rate proposers on a scale of 0 to 10 across three key performance dimensions: overall quality of services provided and relationship with the proposer, delivery of service, and responsiveness to customer service issues and special requests.

The form does not specify pricing terms, set-asides, funding amounts, or contract duration within its content. As a reference check tool rather than a substantive contract document, it functions as a due diligence mechanism to validate proposer capabilities prior to award. The form was originally established November 19, 2014, with updates through December 9, 2016, and represents standard procurement practices used by the Oregon Department of Administrative Services Procurement Services division.