24._Contractor_Contact_Information_(CCHCS-MC-332).pdf
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- Solicitation number
- 0000031431
- Issued by
- California
About this file
This document is a Contractor Contact Information form related to a contract opportunity for Portable Diagnostic Sleep Testing Services issued by the California Department of Corrections and Rehabilitation (CDCR) and the California Correctional Health Care Services (CCHCS). The contract opportunity, Bid Number SD23-00080, is seeking contractors to provide these services. Contractors awarded a contract must submit this form to CCHCS with their company information, including the authorized representative's name and title, telephone and fax numbers. The contract term and any renewal options are not specified in this document.
The contract opportunity description indicates that all questions or concerns should be directed to the contract analyst Amanda Saragoza. No other details are provided regarding pricing, set asides, incumbents, funding, or other salient information about the contract opportunity.
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Bid Number: SD23-00080
CCHCS-MC-332 – Contractor Contact Information Rev. 11/01/2017
CONTRACTOR CONTACT INFORMATION
The information provided below is included on the award matrix posted on the California Department of Corrections and Rehabilitation Internet website. This information is used by institutions/facilities to contact your company to request services. It is the contractor’s responsibility to submit a new form to California Correctional Health Care Services (CCHCS) if there are any changes to the telephone number and/or fax number provided below. If your company was awarded a contract for more than one service, then a separate form for each service type is required. Submit the completed form(s) to the CCHCS Direct Care Contracts Section Help Desk at: cchcshealthcarecontractshelpdesk@cdcr.ca.gov.
Type of Service: Portable Diagnostic Sleep Testing Services
Company Name: (Must be identical to the payee’s legal business name listed on the STD 204)
Telephone Number: Fax Number:
Name of Authorized Representative: Title:
Signature of Authorized Representative: Date:
| Company Name Must be identical to the payees legal business name listed on the STD 204: |
| Telephone Number: |
| Fax Number: |
| Name of Authorized Representative: |
| Title: |
| Signature of Authorized Representative: |
| Date: |
File details come from the government source that posted it. Updated .