5826 Att D - Reference Check Form~2.docx

DOCX document 36 KB Posted

Attached to
RFP 5826 - LEARNING COLLABORATIVE FACILITATION SERVICES
Solicitation number
S-44300-00009162
Issued by
Marion County, Oregon

About this file

This document is a Reference Check Form for a Request for Proposals (RFP) issued by the Oregon Health Authority (OHA) for Learning Collaborative Model Facilitation Services. The RFP, designated as OHA RFP #5826, is seeking a contractor to provide these services. The reference check form is to be completed by three professional references of the proposer and submitted as part of the application packet. The form requests information on the type of services provided by the proposer, their customer service, satisfaction with the business relationship, problem resolution methods, likelihood of future use, strengths and weaknesses of the proposer's services, adherence to timelines, and comparison of final project cost to initial proposed cost.

The related state and local contract opportunity is for the State of Oregon, acting through the OHA Behavioral Health Equity and Community Partnerships unit. The services are to be provided within the jurisdictions of Marion County and the City of Salem. No specific pricing terms, set asides, incumbents, or funding information is provided in the document.

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Text version

RFP [###-####-##] – [RFP title]

ATTACHMENT F - REFERENCE CHECK FORM

OregonBuys Bid Number S-44300-00009162

OHA RFP #5826

ATTACHMENT D - REFERENCE CHECK FORM

(Proposer: Send this form to three professional references for them to complete and return to you. Once you receive the completed forms back, submit them with your Application Packet.)

Proposer Name:__________________________________________
Reference Business Name:__________________________________________
Reference Contact Name:__________________________________________
Reference Contact Phone #:__________________________________________
Reference Contact Email Address:__________________________________________

Please respond to the following questions:

1. For what type of services did you engage Proposer?

Describe the services listed in response to question 1.

Describe Proposer’s customer service.

Describe your satisfaction with the business relationship with Proposer.

Describe Proposer’s methods for problem resolution.

How likely would you be to use Proposer’s services again?

With which aspect(s) of Proposer’s services are you the most satisfied?

With which aspect(s) of Proposer’s services are you the least satisfied?

How well did Proposer stay within the proposed timeline?

How did the final project cost compare to the initial proposed cost?

Version 1.0 - November 19, 2014 Page 1 of 2

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