4_Attachment_4_-_Customer_Reference_Form.docx
DOCX document 38 KB Posted
- Solicitation number
- 0000035292
- Issued by
- California
About this file
This document is a Customer Reference Form attachment for the State of California Department of General Services Temporary Healthcare Staffing Services Request for Proposal (RFP), Event ID 5259947. Bidders are required to submit two customer references demonstrating their ability to provide healthcare staffing services. Each reference must document services provided on or after January 1, 2020, with a contract value exceeding $1.00, and the description of services must align with the scope of work outlined in Exhibit A. The form requires completion of contractor and customer information, including contact details, service dates, and dollar amounts.
The Customer Reference Form includes a five-point performance rating scale that references will complete to evaluate the proposer across five key criteria: ability to manage services and associated staff to meet project goals; turnaround time for customer support and issue resolution; ability to meet delivery timelines; quality of services provided; and overall satisfaction with the proposer. Ratings range from Exceptional (5) to Unsatisfactory (1), with customer references providing narrative comments and signatures to validate their assessments. This evaluation mechanism allows the State to verify bidder performance history and organizational capability to deliver healthcare staffing services effectively.
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Other files
| File | Type | Posted |
|---|---|---|
| 3_Attachment_3_-_Narrative_Response.xlsx | XLSX spreadsheet | |
| 5_Attachment_5_-_Proposing_Regions___Groups.xlsx | XLSX spreadsheet | |
| 1_Attachment_1_-_Key_Action_Dates.docx | DOCX document | |
| 6_Attachment_6_-_Proposed_Agreement.docx | DOCX document | |
| 7_Proposal_Checklist.docx | DOCX document | |
| 0_RFP_5259947.docx | DOCX document | |
| 2_Attachment_2_-_Cost_Workbook.xlsx | XLSX spreadsheet |
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Text version
| State of California | Temporary Healthcare Staffing Services RFP |
| Department of General Services | Event ID: 5259947 |
| Procurement Division | ATTACHMENT 4 |
ATTACHMENT 4 – CUSTOMER REFERENCE FORM
Bidder must submit two (2) customer references as indicated in RFP Section 3.2.1. Customer References may be contacted for verification. Please fill in electronically or print legibly.
CUSTOMER REFERENCE INFORMATION
| Contractor Name (Proposer): |
| Company Name (Proposer’s Customer): |
| Customer Contact Name: |
| Customer Reference Contact Title: |
| Customer Phone Number: |
| Customer E Mail Address: |
| Start date of the services (must be on or after 01/01/2020): |
| Dollar amount of Contract (dollar amount must be greater than $1.00): |
| Enter a brief description of services, provided by the Proposer (description of services must be similar to services described in Exhibit A, Scope of Work): |
(continued on next page)
CUSTOMER REFERENCE RATINGS
Please summarize contractor performance and select the number in the right column which best corresponds to the performance rating for each question|_|. Please follow the rating guidelines below for description of rating scale.
Rating Scale:
· Exceptional (5) - Best-in-class performance. Performance met all contract requirements and exceeded several to the customer’s benefit. No issues were encountered|_|.
· Very Good (4) - Performance met all contract requirements and exceeded some to the customer’s benefit. There were a few minor issues, which were negligible|_|.
· Satisfactory (3) - Performance met contract requirements. There were some minor issues, and corrective actions taken by the contractor were acceptable|_|.
· Marginal (2) - Performance did not meet the contractual requirements. There were issues, some of a serious nature, for which corrective action was only somewhat effective|_|.
· Unsatisfactory (1) - Performance did not meet contractual requirements. There were serious issues and the contractor’s corrective actions were ineffective|_|.
| Customer Reference Questions |
| Comments, if desired |
| Rating |
| 1. How would you rate the Proposer’s ability to manage the services provided and associated staff to meet project goals and objectives? |
| 2. How would you rate the Proposer's turnaround time when contacted to provide customer support or address issues? |
| 3. How would you rate the Proposer's ability to meet all requirements for the delivery of services in a timely manner? |
| 4. How would you rate the quality of the Proposer's services? |
| 5. How would you rate your agency/company's overall satisfaction with the Proposer? |
Rater’s Signature|_|: Date:
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