4. DCF Parenting Capacity Evaluation Attach C Cover Sheet 7.30.21.xlsx

XLSX spreadsheet 25 KB Posted

Attached to
DCF Parenting Capacity Evaluation
Solicitation number
BD-22-1034-0009-DSS09-65235
Issued by
Massachusetts

About this file

This document is a cover sheet and checklist for a Request for Response (RFR) issued by the Massachusetts Department of Children and Families (DCF) for a DCF Parenting Capacity Evaluation contract. The RFR seeks proposals from qualified bidders to provide culturally and linguistically competent, impartial parenting capacity evaluations across the Commonwealth of Massachusetts. Approved bidders will form a pool of provider resources available to conduct evaluations in response to referrals from DCF's 29 Area Offices. The cover sheet outlines the required bidder information, documents, and proposed regions/areas to serve. Regions include Western, Southern, Central, Boston, and Northern.

The document does not provide information on pricing terms, set asides, incumbents, funding requirements and sources, or other salient commercial details. It focuses solely on the administrative requirements for submitting a responsive proposal to the DCF Parenting Capacity Evaluation RFR.

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Text version

RFR Response Summary Form

Department of Children and Families
RFR Title: DCF Parenting Capacity Evaluation
RFR Number: DCF PCE22
RFR Cover Sheet and Checklist
Please Include this Response Summary Form as the First Page of your Response Materials
Bidder Information (All fields are required)
Bidder Organization Name
Vendor Code Number **
FEIN
Agency Address
Agency Main Phone NumberFax Number
Contact Person Name and Title
Cell Phone Number
Email Address
** Vendor Code Number is not required only if bidder does not have a Vendor Code Number. All other fields are required.
Required Documents (Click on appropriate box to use the drop down to select an "X" to indicate completion of document)
Bidder Check offDocument NameDCF Check off
RFR Cover Sheet and Checklist
RFR Response Form
Supplier Diversity Program (SDP) Plan Form
SOMBWA Certificate (if applicable)
Vendor Type
Click on the appropriate box in Column C or F to indicate whether vendor is an organization or individual.

Organization Individual

Proposed Regions
REQUIRED: Click on appropriate box(es) in Column(s) B and G to use the drop down to select "X" for each Region your organization is proposing to serve.

OPTIONAL: Click in the Appropriate box(es) in Column(s) E and J for each Area your organization is proposing to not serve within any Region you are otherwise proposing to serve.

Required Opt In (X)DCF RegionDCF Area OfficeOptional Opt Out (X)Required Opt In (X)DCF RegionDCF Area OfficeOptional Opt Out (X)
Western RegionBerkshireSouthern RegionArlington
GreenfieldCoastal
HolyokeTaunton
Van WartBrockton
SpringfieldFall River
New Bedford
Central RegionNorth CentralBarnstable
South CentralPlymouth
Worcester East
Worcester WestBoston RegionHyde Park
Jackson Square
Northern RegionGreater LowellPark Street
LawrenceHarbor
Haverhill
Salem
Lynn
Metro North
Framingham
Cambridge-Burlington
The following documents are NOT Submitted with the Initial Proposal Bid, but must be completed upon contract award and negotiations:
Commonwealth Standard Contract Form
Request for Taxpayer Identification Number and Certification Form (W-9)
Authorization for Electronic Funds Payment Form (mandatory if not already on EFT)
Contract Authorized Signatory Listing Form
Scope of Work
Clarifications/Negotiated Adjustments/Modifications Form (when applicable)
Subcontract Information Form (when applicable)

Authorized Signature Title Date

Sheet1 X

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