247134 University Health Master Agreement Application~1.docx

DOCX document 29 KB Posted

Attached to
247134 Support for Health-Related Activities at Massachusetts Public Colleges and Universities
Solicitation number
BD-24-1031-BCHAP-BCH01-95611
Issued by
Massachusetts

About this file

This document is an Application Response Form for RFR #247134 - Support for Health-Related Activities at Massachusetts Colleges and Universities. The opportunity is open to University of Massachusetts campuses, state universities, and community colleges in Massachusetts. Applicants must express interest in being added to a pre-qualified list of approved vendors eligible for potential future funding from the Department of Public Health (DPH). Applicants must agree to comply with reporting and federal requirements outlined in any future engagements awarded.

The application form collects information about the applicant organization, including name, address, vendor code, EIN, and contact details. Applicants must confirm their eligibility and agree to the terms outlined in the RFR. There are no details provided about pricing, set asides, incumbents, funding sources or amounts, or the contract term.

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Text version

RFR #247134 – Support for Health-Related Activities at Massachusetts Colleges and Universities

Application Response

ORGANIZATION NAME:
ADDRESS:
VENDOR CODE:
EIN:
CONTACT PERSON:
TITLE:
TELEPHONE:
FAX:
EMAIL:
CONTACT PERSON ADDRESS (if different):

A COMPLETE RFR RESPONSE MUST INCLUDE:

· An application response form

Application Form

1. Applicant Name

2. Please specify your eligibility type.

☐ University of Massachusetts campus ☐ State university ☐ Community college

3. According to the eligibility requirements (Section C1, Page 4) outlined in RFR #247134 is the applicant eligible for consideration?

☐ Yes ☐ No

4. By selecting yes, the applicant is expressing its interest in being added to a pre-qualified list of approved vendors, namely public colleges and universities, to be eligible for potential future funding from the Department of Public Health (DPH). The applicant understands and acknowledges that prequalification does not entitle the applicant to a specific engagement or funding.

☐ Yes ☐ No

5. By selecting yes, the applicant agrees to comply with reporting and federal requirements outlined in any future engagements awarded to the applicant.

☐ Yes ☐ No

By submitting this application, you have attested that the information included in this application is accurate.

File details come from the government source that posted it. Updated .