6-Hss-26-037 -Business References -Attachment 5.pdf

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Attached to
INTERVIEWING SERVICES for THE DELAWARE ADULT TOBACCO SURVEY
Solicitation number
HSS-26-037
Issued by
Delaware

About this file

This is a Business References form attachment for Contract No. HSS-26-037, issued by the Delaware Health and Social Services Division of Public Health. The contract concerns Interviewing Services for the Delaware Adult Tobacco Survey, an annual telephone-based survey of Delaware residents aged 18 and older designed to assess tobacco use prevalence and related factors among adults. The selected vendor will be responsible for administering the survey, which includes both landline and cell phone samples across the non-institutionalized Delaware population, as well as calculating sampling methodology and conducting comprehensive data analysis. The survey has been conducted annually since 2002 and is supported by the U.S. Centers for Disease Control and Prevention's Office of Smoking and Health to evaluate Delaware's tobacco control program and inform future planning and program evaluation initiatives.

Prospective bidders must complete the Business References attachment in its entirety, providing a minimum of three business references with complete contact information, mailing addresses, years of business association, and descriptions of work performed. The form explicitly prohibits the listing of State of Delaware employees as references and requires bidders who have held a State contract within the last five years to provide a separate list of those contracts. Current vendor status must be indicated for each reference provided on the form.

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Text version

Delaware Health and Social Services Division of Public Health

Attachment 5

CONTRACT NO: HSS-26-037

CONTRACT TITLE: Interviewing Services for the Delaware Adult Tobacco Survey

BUSINESS REFERENCES (COMPLETE THIS FORM IN ITS ENTIRETY)

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 .