40DHHS-S3318-Reference-Questionnaire.pdf

PDF 182 KB Posted

Attached to
Psychiatrist Services - NYTC
Solicitation number
40DHHS-S3318
Issued by
Elko County, Nevada

About this file

The document is a Reference Questionnaire issued by the Nevada State Purchasing Division, Department of Administration, for solicitation number 40DHHS-S3318. The form is designed for clients to provide detailed feedback about a vendor's performance, with the single point of contact being Jennifer Thomas from the state administration. The questionnaire requires comprehensive evaluation across 13 different performance metrics, including knowledge and expertise, flexibility, customer service, problem resolution, and overall satisfaction, with ratings requested on a 1-10 scale.

The reference questionnaire is intended to be confidential and is part of a formal solicitation process where vendors must provide references from current or former clients for projects of similar size and scope. The document emphasizes the confidential nature of the responses, citing Nevada Revised Statutes NRS 333.020(5(b)) and NRS 333.333, which protect the information from public disclosure. Respondents are instructed to provide ratings and comments for each evaluation item, with performance levels ranging from poor (0) to exceptional (10), and are asked to submit the completed form to the state's single point of contact via email by the specified due date.

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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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Solicitation-number: 40DHHS-S3318
POC-name: Jennifer Thomas
POC-email: jennthomas@admin.nv.gov
Proposing-vendor-or-subcontractor:
Client-providing-the-reference:
Client-contact-name-and-title:
Client-telephone-and-email:
Period-of-performance:
Due-date:

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