6-Business References -Attachment 5.pdf

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Attached to
SCHOOL-BASED CENTERS for ADOLESCENTS in NINETEEN SCHOOL DISTRICTS
Solicitation number
HSS-26-014
Issued by
Delaware

About this file

This is a Business References attachment form for the Delaware Department of Health and Social Services, Division of Public Health, related to Contract No. HSS-26-014 for School-Based Health Centers for Adolescents in Nineteen School Districts. The form requires vendors to provide a minimum of three business references with specified information including business name and mailing address, contact name and phone number, years of business association, and type of work performed. Vendors must also identify whether each reference is a current vendor and provide a separate list of any state contracts held within the past five years. The form explicitly prohibits the use of state employees as business references and requires completion in its entirety.

The attachment serves as a component of the vendor qualification and evaluation process for this contract opportunity. Bidders are required to submit the completed form as part of their proposal package to demonstrate their experience and capability in delivering school-based health center services. The form provides standardized fields for three separate business references to allow the contracting agency to verify the vendor's track record, professional reputation, and relevant experience in performing similar work.

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Text version

Delaware Health and Social Services Division of Public Health

Attachment 5

CONTRACT NO: HSS-26-014

CONTRACT TITLE: School-Based Health Centers for Adolescents in Nineteen School Districts

BUSINESS REFERENCES (COMPLETE THIS FORM IN ITS ENTIRELY)

List a minimum of three business references, including the following information:

Business Name and Mailing address Contact Name and phone number Number of years doing business with Type of work performed Please do not list any State Employee as a business reference. If you have held a State contract within the last 5 years, please provide a separate list of the contract(s).

1. Contact Name & Title:

Business Name:

Address:

Email:

Phone # / Fax #:

Current Vendor (YES or NO):

Years Associated & Type of Work Performed:

2. Contact Name & Title:

3. Contact Name & Title:

STATE OF DELAWARE PERSONNEL MAY NOT BE USED AS REFERENCES.

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