40DHHS-S3214-Reference-Questionnaire.pdf
PDF 176 KB Posted
- Attached to
- Pharmacy Benefits Manager
- Solicitation number
- 40DHHS-S3214
- Issued by
- Churchill County, Nevada
About this file
The document is a Nevada State Purchasing Division Reference Questionnaire from the Department of Administration, located in Carson City, NV, designed to collect vendor performance feedback for a state procurement process. The form provides a structured template for previous clients to evaluate a vendor's performance across 13 different dimensions, including knowledge and expertise, flexibility, customer service, problem resolution, and overall satisfaction, using a 1-10 rating scale. The questionnaire is confidential and designated as business information under Nevada Revised Statutes.
The reference questionnaire is part of a formal solicitation process where vendors must provide client references for projects of similar size and scope. Respondents are instructed to answer all questions comprehensively, using 'U/K' for unknown answers and 'N/A' for non-applicable questions. The form allows for additional comments and attachments, and emphasizes that completed questionnaires should be submitted directly to the state's single point of contact via email by the specified due date, with the solicitation number included in the subject line.
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Other files
| File | Type | Posted |
|---|---|---|
| 40DHHS-S3214-Cost-Schedule-Final.xlsx | XLSX spreadsheet | |
| 40DHHS-S3214-Insurance-Schedule.pdf | ||
| Standard-form-contract~5.docx | DOCX document | |
| 40DHHS-S3214 Pharmacy Benefits Manager Bid Q and A Answers.pdf | ||
| Quote Instructions.pdf | ||
| Terms-and-conditions-for-services~6.pdf | ||
| 40DHHS-S3214-NMAP-MAC BI-LAWS.pdf | ||
| 40DHHS-S3214-Scope-of-Work.docx | DOCX document | |
| Certification-regarding-lobbying~5.pdf | ||
| 40DHHS-S3214-RFP-Pharmacy-Benefit-Manager.docx | DOCX document |
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Text version
Nevada State Purchasing Division Department of Administration 515 E Musser St Ste 300 Carson City, NV 89701 purchasing.nv.gov nevadaepro.com
Revised 2024-10 Page 1 of 2
Reference questionnaire
Due Date
Solicitation number
Single point of contact name
Single point of contact email
Proposing vendor or subcontractor
Client providing the reference
Client contact name and title
Client telephone and email
Period of performance
1. CLIENT REFERENCE INSTRUCTIONS
1.1. As part of a formal solicitation the State of Nevada has requested vendors provide references from current and/or former clients for projects of similar size and scope. This reference questionnaire is to provide a client reference for the proposing vendor or subcontractor above. Once you have completed the reference questionnaire, please submit to the single point of contact via email, with the solicitation number in the subject line, no later than the due date above.
1.2. The State requests all questions be answered. If an answer is not known, please answer as ‘U/K’. If the question is not applicable, please answer as ‘N/A’. If additional space is needed to answer a question or provide a comment, please attach additional pages. If attaching additional pages, please place your company/organization name on each page and reference the appropriate RFP number.
1.3. Do not return the completed reference questionnaire to the proposing vendor. To allow for candid responses, completed reference questionnaires are designated as confidential business information by the Administrator pursuant to NRS 333.020(5(b) and not public information pursuant to NRS 333.333. In addition to the reference questionnaire, the State may contact references for further clarification.
1.1. Where a rating is requested, please provide a rating between 1-10. For all items, please provide any comments you feel would be helpful to the State in evaluation below each item. Poor or inadequate performance: 0; Below average performance: 1-3; Average performance: 4-6; Above average performance: 7-9; Exceptional performance: 10.
2. EVALUATION ITEMS
2.1. In what capacity have you worked with this vendor in the past? (no rating) https://purchasing.nv.gov/ https://nevadaepro.com/ https://www.leg.state.nv.us/nrs/nrs-333.html#NRS333Sec020 https://www.leg.state.nv.us/nrs/nrs-333.html#NRS333Sec020 https://www.leg.state.nv.us/nrs/nrs-333.html#NRS333Sec333
Page 2 of 2 Reference questionnaire
2.2. Vendor’s knowledge and expertise, rating:
2.3. Vendor’s flexibility relative to changes in scope and timelines, rating:
2.4. Your satisfaction with delivered materials, rating:
2.5. Dynamics and interaction between the vendor and your staff, rating:
2.6. Your satisfaction with products developed by the vendor, rating:
2.7. Was the schedule met and deliverables timely? Rating:
2.8. Overall customer service and timeliness in response and issue resolution, rating:
2.9. Accuracy and timeliness of billing, rating:
2.10. Vendor’s ability to quickly and thoroughly resolve a service-related problem, rating:
2.11. Vendor’s flexibility in meeting business requirements, rating:
2.12. Response time and customer service of local office, if applicable, rating:
2.13. Likelihood of recommending this vendor to others in the future, rating:
2.14. Which aspects of this vendor’s services are you most satisfied with? (no rating)
2.15. Would you recommend this vendor to your organization again? (no rating)
| 1. Client reference instructions |
| 1.1. As part of a formal solicitation the State of Nevada has requested vendors provide references from current and/or former clients for projects of similar size and scope. This reference questionnaire is to provide a client reference for the proposi... |
| 1.2. The State requests all questions be answered. If an answer is not known, please answer as ‘U/K’. If the question is not applicable, please answer as ‘N/A’. If additional space is needed to answer a question or provide a comment, please attach add... |
| 1.3. Do not return the completed reference questionnaire to the proposing vendor. To allow for candid responses, completed reference questionnaires are designated as confidential business information by the Administrator pursuant to NRS 333.020(5(b) a... |
| 1.1. Where a rating is requested, please provide a rating between 1-10. For all items, please provide any comments you feel would be helpful to the State in evaluation below each item. Poor or inadequate performance: 0; Below average performance: 1-3;... |
| 2. Evaluation items |
| 2.1. In what capacity have you worked with this vendor in the past? (no rating) |
| 2.2. Vendor’s knowledge and expertise, rating: |
| 2.3. Vendor’s flexibility relative to changes in scope and timelines, rating: |
| 2.4. Your satisfaction with delivered materials, rating: |
| 2.5. Dynamics and interaction between the vendor and your staff, rating: |
| 2.6. Your satisfaction with products developed by the vendor, rating: |
| 2.7. Was the schedule met and deliverables timely? Rating: |
| 2.8. Overall customer service and timeliness in response and issue resolution, rating: |
| 2.9. Accuracy and timeliness of billing, rating: |
| 2.10. Vendor’s ability to quickly and thoroughly resolve a service-related problem, rating: |
| 2.11. Vendor’s flexibility in meeting business requirements, rating: |
| 2.12. Response time and customer service of local office, if applicable, rating: |
| 2.13. Likelihood of recommending this vendor to others in the future, rating: |
| 2.14. Which aspects of this vendor’s services are you most satisfied with? (no rating) |
| 2.15. Would you recommend this vendor to your organization again? (no rating) |
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