2-[Registry Staffing for the Arizona State Hospital] BPM006391 Attac_638767710997784921_3.pdf
PDF 142 KB Posted
- Attached to
- Registry Staffing for the Arizona State Hospital
- Solicitation number
- BPM006391
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Subcontractors Attachment Form (Attachment G) for Request for Proposal No. BPM006391 issued by the Arizona Department of Health Services for Registry Staffing Services at the Arizona State Hospital. The procurement seeks contract(s) for the provision of Behavioral Health Technicians (BHTs) and Registered Nurses (RNs) to supplement the hospital's existing staffing resources on an as-needed, if-needed basis. The hospital's primary staffing requirement is approximately twenty (20) Registry BHTs per shift across all operational shifts. The solicitation was posted on February 24, 2025, with proposal responses due by March 10, 2025. The Arizona Department of Health Services does not guarantee a specific volume of service utilization; however, the agency anticipates engaging multiple contractors to ensure an adequate candidate pool to meet facility needs. Services are required to support residents and patients at the hospital across Maricopa County, specifically within Phoenix City jurisdiction.
The Subcontractors Attachment Form requires offerors to declare whether they will perform all work with their own personnel or utilize subcontractors. If subcontractors will be used, offerors must provide detailed information for each significant subcontractor, including the name and contact information, identification of whether the subcontractor qualifies as a small business, a description of work to be performed, the approximate percentage of total contract work, relevant certifications, and quality assurance and quality control (QA/QC) measures to ensure compliance with contract requirements. The form provides space for up to five subcontractors and requires offerors to attach supporting documentation. The State reserves the right to demand additional information about proposed subcontractors as a precondition of contract award. No specific pricing terms, set-asides, incumbent vendors, or contract award values are detailed within this attachment.
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Text version
ATTACHMENT G
Subcontractors
ARIZONA DEPARTMENT OF
HEALTH SERVICES
REQUEST FOR PROPOSAL
No.: BPM006391
150 North 18th Avenue, Suite 530 Phoenix, AZ 85007
REGISTRY STAFFING FOR THE ARIZONA
STATE HOSPITAL
Solicitation Attachment – Proposed Subcontractors | Revision No. 1 | Revised 11-22
Contractor Name: [Name]
Check “NO” if you WILL NOT subcontract any portion of the Work and will therefore be performing all of the Work with your own personnel.
☐ NO, the Offeror will not subcontract any portion of the Work.
If you WILL subcontract any portion of the Work, check “YES” below and list the name(s) of persons or companies you propose to use as Subcontractors.
1. Fill in the information for each significant Subcontractor – indicate the type of work the Subcontractor will perform under the
Contract and their approximate percentage of the total Contract work;
2. Provide copies of relevant certifications each person or firm possesses attached to this form; AND
3. Provide a description of quality assurance (QA) and quality control (QC) measures that you will use to ensure that
Subcontractor’s work meets the Contract requirements.
State may demand additional information about proposed Subcontractors as a precondition of Award.
☐ YES, the Offeror will use the Subcontractors listed below:
No. Name and contact information Small business Work to be performed and QA/QC measures %
1. [Name]
[Contact information]
Yes or
No
[Work to be performed]
[QA/QC measures]
X
2. [Name] or
3. [Name] or
4. [Name] or
5. [Name] or
Dell Typewritten text Kupplin Worldwide LLC
Dell Typewritten text
File details come from the government source that posted it. Updated .