2c.Customer Cert Form for Category 3 - SFGOV-11976_1.pdf

This is a Customer Certification Form for Category 3 of RFQ SFGOV-0000011976, issued by the City and County of San Francisco's Department of Public Health. The sourcing event seeks to establish a prequalified list of vendors for as-needed technical assistance and consulting services. Category 3 specifically focuses on Public Health Program Evaluation and Community Needs Assessment Services. Respondents must demonstrate that they have successfully designed and implemented process and outcome evaluations for public health programs and/or community needs assessments at the project, program, and/or organizational levels for a public health organization. The form requires customers to provide certification of the responder's relevant experience and qualifications in this service category.

The certification form requires responders to provide customer references who can validate their experience in public health program evaluation and community needs assessment services. Each customer reference must include the customer name, location, and contact information for a representative who can verify the work performed. The form permits responders to list multiple customers. If a customer is unable to sign the certification form, the responder must provide valid contact information for the City to use for verification purposes. The City reserves the right to contact listed customer references up to three times and may deem a proposer non-responsive if contact information is invalid or if the customer contact is unreachable.