2d.Customer Cert Form for Category 4 - SFGOV-11976.pdf
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- Solicitation number
- SFGOV-0000011976
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Customer Certification Form for a Request for Quotation (RFQ) issued by the City and County of San Francisco for the Department of Public Health, solicitation number SFGOV-00000119796. The RFQ seeks to establish a prequalified list of vendors to provide as-needed technical assistance and consulting services. Category 4 specifically focuses on public health and health care program and operations implementation and project management services, including planning, organizing, and overseeing programs or projects to achieve goals within established time and budget parameters for public health and health care organizations. Respondents must demonstrate successful prior experience in providing these services to public health or health care organizations through customer references.
The form requires respondents to provide customer certification documentation signed by representatives of organizations for which they have previously performed qualifying services. Each respondent must submit valid customer contact information, including the customer name, location, and contact details for a representative who can verify the services provided. The City reserves the right to contact listed customer references up to three times to confirm experience claims and will deem non-responsive any proposal that includes invalid or unreachable customer contacts. This verification process ensures that only qualified vendors with demonstrated experience in public health program implementation and project management are added to the prequalified vendor list for future as-needed consulting engagements.
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Text version
SOURCING EVENT ID: SFGOV-00000119796
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 4: Public Health and/or Health Care Program and Operations Implementation and Project Management Services
(To be Signed by Responder’s Customer)
SFGOV-0000011976 As-Needed Technical Assistance and Consulting Services
Responder has successfully provided public health or health care program and operations implementation or project management, including planning, organizing, and overseeing programs or projects to achieve goals within a set time and budget for a public health and/or health care organization.
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 .