25520001_-_Bidder_s_Checklist.pdf
PDF 261 KB Posted
- Attached to
- 25520001 - Third Party Adjusting Services
- Solicitation number
- 0000036506
- Issued by
- California
About this file
This document is a Bidder's Checklist from the State of California Department of Veterans Affairs for Third Party Adjusting (TPA) Services, solicitation number 25520001. The checklist outlines the comprehensive documentation required from potential bidders, including various certifications, declarations, and supporting materials necessary for submitting a bid. Key requirements include providing proof of a valid business license, documentation of at least 10 years of TPA service experience, a sample invoice, and several state-specific compliance documents such as Disabled Veteran Business Enterprise (DVBE) declarations and Contractor Certification Clauses.
The bidding process emphasizes strict compliance, requiring that all submitted documents have an identical company name matching the Payee Data Record (STD 204). Potential bidders must complete and submit multiple forms, including a Bidder's Checklist, Bidder Certification, Bid Rate Sheet, and various state-mandated declarations related to civil rights, contracting acts, and business standing. Failure to submit documents precisely as prescribed may result in delays in contract award. The solicitation appears to be focused on selecting a qualified third-party adjusting services provider for the California Department of Veterans Affairs, with a strong emphasis on thorough documentation and regulatory compliance.
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State of California Solicitation Number: 25520001 Department of Veterans Affairs
BIDDER’S CHECKLIST
Third Party Adjusting Services
The checklist below is a summary of documents to be submitted based on requirements in the Invitation for Bid. This checklist should be returned with your bid. Place a check-mark or “X” next to each document being submitted.
Signatures are required on the documents where specified.
The company name listed on all documents submitted (ex. licenses, permits, certifications, and insurance) must be identical to the company name on the Payee Data Record (STD 204). Failure to submit these documents in the manner prescribed may delay award of Agreements.
Bidder’s Checklist
Bidder Certification
Bid Rate Sheet
Signed Payee Data Record - STD 204 (and STD 205 if Applicable)
Bidder Declaration - GSPD-05-105
Commercially Useful Function (CUF) Certification, if applicable
Disabled Veteran Business Enterprise (DVBE) Declarations – DGS PD 843, if applicable
Iran, if applicable
Darfur Contracting Act
California Civil Rights Laws
Contractor Certification Clauses (CCC-4/2017) - The CCC-4/2017 can be found on the Internet at https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language
Valid California city or county business license; or, if a corporation located within the State of California, incorporation documents or letter from the Secretary of State; or, if not a California business, an affidavit that business is in good standing with the State, Province, or Country in which business is headquartered.
Sample Invoice
Documentation of minimum 10 years providing Third Party Adjusting (TPA) services.
File details come from the government source that posted it. Updated .