4-RFP 06 Request for Client Information Form.pdf
PDF 175 KB Posted
- Solicitation number
- RFP26-70
- Issued by
- Los Alamos County, New Mexico
About this file
This is a Request for Client Information form issued by the County of Los Alamos Procurement Division in New Mexico in connection with a solicitation for Long-Term Disability Benefits for eligible County employees. The form requires offerors to provide detailed information about a minimum of three previous or current clients for whom they have provided similar services within the last three to five years. Each client entry must include the company name, address, contact name and position, email address, telephone number, the period during which services were provided, a description of the services provided, and the outcome of the engagement. The County reserves the right to contact any or all listed clients to verify the information provided and request additional details.
The form allows offerors to claim confidentiality for previous client information if necessary; however, if client references constitute a scored evaluation criterion, the offeror's evaluation score will reflect any inability to provide complete information in the bid or proposal. The form provides space for up to five client references and must be completed and submitted by the person designated on the offeror's team. This document serves as a critical component of the proposal evaluation process, enabling the County to assess the offeror's relevant experience and track record in delivering similar services to comparable organizations.
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Text version
REQUEST FOR CLIENT
INFORMATION
Incorporated County of Los Alamos Procurement Division
101 Camino Entrada, Building 3 Los Alamos, NM 87544
Version:20250318
Please follow the instructions below to provide information about previous or current clients as requested in this form.
1. The County reserves the right to contact some or all of the clients listed to verify any information provided and to request that they provide additional information.
2. If previous client information is confidential, you may state so; however, if previous or current client information is a scored evaluation criteria, evaluation scores will reflect Offeror’s inability to include some or all of the requested information in the bid or proposal.
3. Provide a minimum of 3 previous or current clients for similar services performed in the last 3-5 years.
4. Information provided should include company name, address, contact name, position, e-mail address, telephone number, the period during which services were provided, a description of the services provided, and outcome of the engagement.
GENERAL INFORMATION
Offeror Company Name:
Solicitation No.:
Solicitation Title:
Name and Title of the Person Completing this Form
PREVIOUS OR CURRENT CLIENT INFORMATION
CLIENT 1
Company Name
Address
Contact Name and Position
E-mail Address
Telephone Number
Period During Which Services Were Provided
MM/DD/YY – MM/DD/YY
Description of Services Provided and Outcome of the Engagement
CLIENT 2
Company Name
Address
Contact Name and Position
E-mail Address
Telephone Number
Period During Which Services Were Provided
MM/DD/YY – MM/DD/YY
CLIENT 3
Address
Contact Name and Position
E-mail Address
Telephone Number
CLIENT 4
Address
Contact Name and Position
E-mail Address
Telephone Number
CLIENT 5
Company Name
Address
Contact Name and Position
E-mail Address
Telephone Number
Period During Which Services Were Provided
MM/DD/YY – MM/DD/YY
| Company Name: |
| Address: |
| Contact Name and Position: |
| Email Address: |
| Telephone Number: |
| Period During Which Services Were Provided MMDDYY MMDDYY: |
| Description of Services Provided and Outcome of the Engagement: |
| Company Name_2: |
| Address_2: |
| Contact Name and Position_2: |
| Email Address_2: |
| Telephone Number_2: |
| Period During Which Services Were Provided MMDDYY MMDDYY_2: |
| Description of Services Provided and Outcome of the Engagement_2: |
| Company Name_3: |
| Address_3: |
| Contact Name and Position_3: |
| Email Address_3: |
| Telephone Number_3: |
| Period During Which Services Were Provided MMDDYY MMDDYY_3: |
| Description of Services Provided and Outcome of the Engagement_3: |
| Company Name_4: |
| Address_4: |
| Contact Name and Position_4: |
| Email Address_4: |
| Telephone Number_4: |
| Period During Which Services Were Provided MMDDYY MMDDYY_4: |
| Description of Services Provided and Outcome of the Engagement_4: |
| Company Name_5: |
| Address_5: |
| Contact Name and Position_5: |
| Email Address_5: |
| Telephone Number_5: |
| Period During Which Services Were Provided MMDDYY MMDDYY_5: |
| Description of Services Provided and Outcome of the Engagement_5: |
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