5-RFP 06 Request for Client Information Form.pdf

PDF 175 KB Posted

Attached to
Employee Benefits Consulting Services
Solicitation number
RFP26-71
Issued by
Los Alamos County, New Mexico

About this file

This is a Request for Client Information Form issued by the Incorporated County of Los Alamos Procurement Division in New Mexico as part of an Employee Benefits Consulting Services solicitation. The form requires offerors to submit 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. For each client, offerors must provide the company name, address, contact name and position, email address, telephone number, service period, a description of services provided, and the outcome of the engagement. The County reserves the right to contact listed clients to verify information and request additional details. The form accommodates up to five client references and allows offerors to designate previous client information as confidential, though evaluation scores will reflect any inability to provide complete requested information.

Offerors should understand that the provision of client references is a scored evaluation criterion for this solicitation. The absence of or incomplete client information will negatively impact the evaluation score and may reduce the competitiveness of the proposal. All information must be submitted in the prescribed format with accurate contact details to facilitate the County's verification process and due diligence.

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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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