4-RFP 04 Request for Preference Form.pdf
PDF 164 KB Posted
- Attached to
- Health Commons Services
- Solicitation number
- RFP27-33
- Issued by
- Los Alamos County, New Mexico
About this file
This is a Request for Preference Form issued by the Incorporated County of Los Alamos Procurement Division in New Mexico for the Health Commons Services solicitation. The form establishes the process for offerors to request applicable preference factors in accordance with Los Alamos County Code Section 31-261(b) and NMSA 1978 Section 13-1-21 et al. The Health Commons Services contract seeks a healthcare provider to deliver family planning services (particularly to vulnerable populations including Los Alamos Public Schools students, UNM LA students, and community members), STI screening and treatment, primary care services (including immunizations, vaccinations, annual physicals, acute and chronic condition management, health promotion, and screenings), and behavioral health services encompassing mental health and substance use services. All programs must incorporate participant feedback into program design and implementation, and the successful offeror may be required to secure and supervise physical properties or facility space assigned for exclusive use.
Offerors must submit a valid preference request form with their proposal by the solicitation closing date, accompanied by applicable documentation to qualify for preferences. Preference options available include no preference, Local (Los Alamos) Business preference (requiring New Mexico incorporation and principal office location in Los Alamos County), Resident (New Mexico) Business preference, Native American Resident Business preference (with annual gross revenues up to $6,000,000), Native American Resident Veteran Business preference (with annual gross revenues up to $6,000,000), and Resident Veteran Business preference (with annual gross revenues up to $6,000,000). Local Business preference applicants must also provide a current valid Los Alamos County Business License and maintain their principal office and place of business in Los Alamos County. The County reserves the right to verify all submitted information and deny preference requests if offerors do not meet applicable requirements.
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Text version
REQUEST FOR PREFERENCE
Incorporated County of Los Alamos Procurement Division
101 Camino Entrada, Building 3 Los Alamos, NM 87544
Version:20250501
Offeror Company Name:
Solicitation No.:
Solicitation Title:
Name and Title of the Person Completing this Form
In accordance with Incorporated County of Los Alamos (“County”) Code Section. 31-261(b) and NMSA 1978 Section 13-1-21 et al., if the chief purchasing officer determines preference is applicable to the solicitation, Offeror(s) must submit a written request for preference, with a valid copy of the applicable New Mexico state-issued preference certificate with its Proposal to qualify for the requested preference. If requesting local preference, Offeror(s) must also submit with its Proposal a current valid Los Alamos County Business License and must maintain its principal office and place of business in Los Alamos County to qualify for Local Business preference. County reserves the right, for any reason, to (1) verify the accuracy and validity of any information and documents submitted by Offerors prior to applying any preference factors; and (2) deny any request for preference if Offeror(s) have not met applicable requirements to qualify for any requested preference.
By checking the box(s) below and submitting this form with my Proposal, I certify the following statements are true and correct:
1) By requesting a preference type below, my company meets the definition for that preference type as defined in the regulations stated above;
2) I understand that a request for preference or preference-related documents or information cannot be submitted or modified after the solicitation closing date;
3) Preference factors will be applied as applicable in accordance with the most current County Code Section 31-261(b) and NMSA 1978 Section 13-1-21 et al., as may be modified from time to time.
Preference Requested Check all being requested
Preference Type As defined in Los Alamos Code Section 31-261(b) and NMSA 1978 Section 13-1-21
□ No Preference. I certify that I am not requesting any preference for this solicitation.
Local (Los Alamos) Business. I certify that my company is incorporated in New Mexico and my company’s principal office and place of business is in Los Alamos County.
□ Resident (New Mexico) Business
Version:20250501
□ Native American Resident Business with annual gross revenues of up to six million dollars ($6,000,000) in the preceding tax year
□ Native American Resident (New Mexico) Business
Resident Veteran Business with annual gross revenues of up to six million dollars ($6,000,000) in the preceding tax year
Native American Resident Veteran Business with annual gross revenues of up to six million dollars ($6,000,000) in the preceding tax year
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File details come from the government source that posted it. Updated .