40DHHS-S3965 - Vendor-Information-Response.pdf

This is a Vendor Information Response form for a Record Storage services solicitation issued by the State of Nevada, Department of Health and Human Services (DHHS), for Southern Nevada Adult Mental Health Services. The form requires vendors and any identified subcontractors to provide comprehensive company contact information, including company name, street address, telephone and toll-free numbers, and email address. Additionally, vendors must designate a primary contact person for questions and contract negotiations, including that individual's name, title, address, email, and phone numbers. The form establishes the information collection framework that will be used for contract development if the vendor is awarded the solicitation.

Beyond basic contact information, the form requires vendors to submit an overall company profile and demonstrate compliance with Nevada state requirements, including foreign corporation registration with the Secretary of State's Office pursuant to NRS 80.010 and appropriate state business licensing under NRS 76. Vendors must disclose any prior experience with State of Nevada agencies, identify any current or former state employees who will perform work under the contract, and fully disclose any significant prior or ongoing contractual issues, breaches, litigation, or pending claims occurring within the past six years that could adversely affect performance capability. The form also requires authorization for payment via procurement card and the signature of the individual authorized to bind the vendor organization.