2b.Customer Cert Form for Category 2 - SFGOV-11976_1.pdf
PDF 302 KB Posted
- Solicitation number
- SFGOV-0000011976
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Customer Certification Form for Category 2 of an RFQ issued by the City and County of San Francisco Department of Public Health (SFGOV-0000011976) for the establishment of a prequalified list of vendors to provide as-needed technical assistance and consulting services. The RFQ seeks vendors capable of delivering at least one of the following services to public health organizations: organizational development, technical assistance, or training services. Respondents must submit customer certification forms completed and signed by representatives of previous clients for whom they have successfully delivered these services.
The form requires respondents to provide customer contact information including the customer name, location, and the name, title, phone number, and email of the customer representative completing the certification. The City reserves the right to contact listed customers up to three times to verify the services indicated and may deem proposers non-responsive if contact information is invalid or unreachable. Respondents unable to obtain a customer signature must provide valid alternative contact information for City verification purposes.
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Text version
SOURCING EVENT ID: SFGOV-0000011976
RFQ FOR THE ESTABLISHMENT OF A PREQUALIFIED LIST
FOR AS-NEEDED TECHNICAL ASSISTANCE AND CONSULTING SERVICES
FOR THE DEPARTMENT OF PUBLIC HEALTH
I f a customer is unable to sign a customer certification form, the respondent must include valid contact information for The City to contact and verify services indicated above. The City w ill only attempt to contact the listed customer contact three (3) t imes. The City reserves the right to deem non-responsive any Proposer who submits invalid customer contact, or if the customer contact is unreachable.
Customer Certification Form for Category 2: Public Health Organizational Development, Technical Assistance and Training Services
(To be Signed by Responder’s Customer)
SFGOV-0000011976 As-Needed Technical Assistance and Consulting Services
Responder has successfully provided at least one of the services listed below for a public health organization.
i. Organizational development
ii. Technical assistance
iii. Training services
Customer #1
1. Customer Name:
2. Customer Location:
3. Name and title of Customer representative completing this form:
Signature (same person identified in #3 above):
Date:
Phone Number (same person identified in #3 above):
Email (same person identified in #3 above):
| 1 Customer Name: |
| 2 Customer Location: |
| Phone Number same person identified in 3 above: |
| Email same person identified in 3 above: |
| Name and Title: |
File details come from the government source that posted it. Updated .