40DHHS-S3757 - reference-questionnaire.docx

DOCX document 41 KB Posted

Attached to
Medical Staff Credentialing
Solicitation number
40DHHS-S3757
Issued by
Churchill County, Nevada

About this file

This is a reference questionnaire form issued by the Nevada State Purchasing Division, Department of Administration, for solicitation number 40DHHS-S3757 related to Medical Staff Credentialing Services. The questionnaire is designed to gather client references for vendors and subcontractors bidding on this state contract opportunity. Completed reference questionnaires must be submitted to the single point of contact, Annette Morfin at amorfin@admin.nv.gov, with the solicitation number in the subject line by the established due date. The State of Nevada requires vendors to provide references from current and/or former clients for projects of similar size and scope as part of the formal solicitation process.

The reference questionnaire requires clients to evaluate vendor performance across thirteen rating categories using a scale of 0-10, with detailed performance descriptors ranging from poor or inadequate performance (0) to exceptional performance (10). Evaluation items include vendor knowledge and expertise, flexibility relative to changes in scope and timelines, satisfaction with delivered materials and products, schedule adherence and timeliness of deliverables, customer service and issue resolution, billing accuracy and timeliness, and likelihood of future recommendations. Additionally, clients must provide written responses regarding their working relationship capacity with the vendor, aspects of services most satisfying, and whether they would recommend the vendor again. All questions must be answered, with "U/K" (unknown) or "N/A" (not applicable) used when appropriate. Completed reference questionnaires are designated as confidential business information under Nevada Revised Statutes and are not subject to public disclosure.

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Other files

File Type Posted
Standard-form-contract~20.docx DOCX document
40DHHS-S3757 - Questions and Answers.docx DOCX document
Terms-and-conditions-for-services~27.pdf PDF
40DHHS-S3757 - Vendor-Information-Response.pdf PDF
40DHHS-S3757 - request-for-proposals.docx DOCX document
Certification-regarding-lobbying~22.pdf PDF
Quote Instructions.pdf PDF
40DHHS-S3757 - Insurance Schedule.docx DOCX document
Cost Schedule~13.xlsx XLSX spreadsheet

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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

Reference questionnaire

Due Date

Solicitation number 40DHHS-S3757

Single point of contact name Annette Morfin

Single point of contact email amorfin@admin.nv.gov

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.

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.

Evaluation items

In what capacity have you worked with this vendor in the past? (no rating)

Vendor’s knowledge and expertise, rating:

Vendor’s flexibility relative to changes in scope and timelines, rating:

Your satisfaction with delivered materials, rating:

Dynamics and interaction between the vendor and your staff, rating:

Your satisfaction with products developed by the vendor, rating:

Was the schedule met and deliverables timely? Rating:

Overall customer service and timeliness in response and issue resolution, rating:

Accuracy and timeliness of billing, rating:

Vendor’s ability to quickly and thoroughly resolve a service-related problem, rating:

Vendor’s flexibility in meeting business requirements, rating:

Response time and customer service of local office, if applicable, rating:

Likelihood of recommending this vendor to others in the future, rating:

Which aspects of this vendor’s services are you most satisfied with? (no rating)

Would you recommend this vendor to your organization again? (no rating)

Revised 2024-10 Page 2 of 2

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File details come from the government source that posted it. Updated .