2 - Submittal Forms I-J 9-5-25.docx
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- Solicitation number
- 1626-006
- Issued by
- Juneau City and Borough, Anchorage Municipality, Alaska
About this file
This document is a Submittal Form for a state-level procurement opportunity involving a central registry with a behavioral or public health focus. The form outlines three mandatory requirements for offerors, which include: (1) having three years of experience operating a central registry within the last five years, (2) possessing the capability to integrate with other systems via APIs or data exchange standards, and (3) holding all necessary licenses to operate a central registry. Offerors must confirm they meet these requirements and provide detailed explanations for each, with a maximum of 500 words per requirement.
The document also includes a Subcontractors Form, which allows offerors to list subcontractors, their functions, names, addresses, and percentage of work to be performed. The state may require additional documentation during contract negotiation, including signed commitments from subcontractors and verification of valid Alaska business licenses for those performing work within the state. No specific pricing details, funding sources, or contract duration are explicitly stated in this submittal form.
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Text version
SUBMITTAL FORM I – Mandatory Requirements
The following are mandatory requirements. The offeror must confirm they meet each requirement and provide an explanation (up to 500 word maximum for each requirement) in the Explanation section at the end of this document to demonstrate their acknowledgement and how they meet or will comply with each related requirement. A “No” selection or failure to check “Yes” and provide an explanation will cause the proposal to be deemed non-responsive. Make sure to indicate start and end dates for any requirements that have time requirements and provide sufficient detail to ensure the procurement officer can adequately determine the requirements are met.
Mandatory Requirements
| NUMBER |
| CRITERIA |
| RESPONSE |
| 1. |
| The offeror must have three years in the last five years of experience operating a central registry with a behavioral health or public health focus. |
| □ Yes □ No |
| 2. |
| The offeror must have the capability to integrate with other systems via APIs or data exchange standards. |
| □ Yes □ No |
| 3. |
| The offeror must have all necessary licenses to operate a central registry. |
| □ Yes □ No |
Explanation
| NUMBER |
| Explanation |
1.
2.
3.
SUBMITTAL FORM J – Subcontractors
Please complete the below form if using subcontractors. During contract negotiation, the state may require a signed written statement from each subcontractor that clearly verifies the subcontractor is committed to performing the services required by the contract. Prior to contract award, the state will also require evidence that a subcontractor possesses a valid Alaska business license if they will be performing work within Alaska.
| Subcontractor Function |
| Subcontractor Name |
| Address |
| % of Work Performing |
File details come from the government source that posted it. Updated .