6-RFQ 542299 - Attachment A - Respondent Questionnaire (RFQ).docx
DOCX document 63 KB Posted
- Attached to
- Detroit Health Department (DHD) - IT Equipment
- Solicitation number
- 542299
- Issued by
- Wayne County, Detroit City, Michigan
About this file
This is a Request for Quote (RFQ) respondent questionnaire issued by the City of Detroit Office of Contracting and Procurement (OCP) on behalf of the Detroit Health Department (DHD) for IT Equipment to support participants in the Birthing Futures Workforce Institute. The questionnaire serves as the evaluation instrument for assessing respondent qualifications and experience. Respondents must provide detailed contact information for a single point of contact and project manager, complete background information about their firm including legal business name, business entity designation, tax status, FEIN, years in business, and employee count, and disclose any prior experience with the City of Detroit. Additionally, respondents must identify any claims, lawsuits, or contract terminations within the past ten years and describe at least three relevant projects completed within the last five years that demonstrate comparable size and scope to the RFQ requirements, including detailed reference information and key personnel assignments.
The questionnaire requires respondents to provide comprehensive subcontractor information if applicable, including verification that proposed subcontractors are not on the City of Detroit's debarred and suspended suppliers list. Respondents must identify each subcontractor's legal business name, address, description of goods or services to be provided, percentage of work allocation, and number of similar projects completed together. For each subcontractor, respondents must submit at least one reference from the past five years documenting relevant experience, including contact details, dates of service, and description of services provided. This is a grant-funded project, though no specific funding amounts, response deadlines, or contract award dates are specified within this questionnaire document.
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Text version
City of Detroit Office of Contracting and Procurement (OCP) Request for Quote – #542299 DHD IT Equipment
Attachment A – Respondent Questionnaire
PART 1 – RESPONDENT EXPERIENCE / ORGANIZATION
1. Respondent’s Contact Information
Complete the following table for your Sole Point of Contact During RFQ Process.
| Single Point of Contact for RFQ |
| Respondent Response |
a. Name
b. Title
c. Address
d. E-mail
e. Phone Number
Complete the following table for your firm’s Partner and or Manager(s) that will be in charge of this project if awarded.
| Partner and or Manager Contact Details |
| Respondent Response |
a. Name
b. Title
c. Address
d. E-mail
e. Phone Number
2. Respondent Background Information
Complete this table with your background information. Quotes by a partnership or joint venture shall list the full names and addresses of all parties to the joint venture by completing this table for all parties.
Respondent Response
a. Full legal business name.
b. Full legal business address of the firm’s principal place of business and, if different, the location of the place of performance of the contract.
c. Business entity designation, e.g., sole proprietor, Inc., LLC, or LLP.
d. Current tax status and Federal Employer Identification Number (FEIN) (if applicable).
e. State company formed in.
f. Company phone number.
g. Website address (if applicable).
h. Number of years in business.
i. Average number of employees during each of the last three (3) years.
j. Does your company have experience working with the City of Detroit? If so, please list the contracts you hold or have held with the City of Detroit for the last 5 years.
k. Identify any claims or lawsuits that have been brought against your organization as a result of any services provided within the last ten (10) years.
l. Identify any projects in which your contract was terminated for any reason.
3. Prior Experience (Respondent) Describe at least three (3) relevant experiences from the last five (5) years supporting your ability to successfully manage a contract of similar size and scope for the work described in this RFQ, by completing the table(s) below.
| Reference Form #1 |
| Respondent Response |
a. Name of Reference (Company Name)
b. Project Name/Title
c. Client Location
d. Contact Person Name
e. Contact Person Title
f. Contact Person Phone Number
g. Contact Person E-mail Address
h. Dates of Service (mm/yy – mm/yy)
i. Description of Services Provided, including how the services are similar in size and scope to the RFQ requirements j.
k. Identify respondent’s key personnel working on this project (if applicable)
| Reference Form #2 |
| Respondent Response |
a. Name of Reference (Company Name)
b. Project Name/Title
c. Client Location
d. Contact Person Name
e. Contact Person Title
f. Contact Person Phone Number
g. Contact Person E-mail Address
h. Dates of Service (mm/yy – mm/yy)
i. Description of Services Provided, including how the services are similar in size and scope to the RFQ requirements
j. Identify respondent’s key personnel working on this project (if applicable)
| Reference Form #3 |
| Respondent Response |
a. Name of Reference (Company Name)
b. Project Name/Title
c. Client Location
d. Contact Person Name
e. Contact Person Title
f. Contact Person Phone Number
g. Contact Person E-mail Address
h. Dates of Service (mm/yy – mm/yy)
i. Description of Services Provided, including how the services are similar in size and scope to the RFQ requirements
j. Identify respondent’s key personnel working on this project (if applicable)
4. Respondent’s Subcontractor(s) Prior Experience (if applicable)
| Question |
| Respondent Response |
a. Do you intend to utilize any subcontractors?
If yes, provide their legal business name and address, and a description of the goods/services they will supply. Also complete the Subcontractor Reference Form provided below for each subcontractor.
Has Respondent ensured proposed subcontractor(s) are not on the City of Detroit’s list of debarred and suspended suppliers?
No debarred contractor is eligible to serve as a subcontractor or as a goods, services or materials supplier for any contract. https://detroitmi.gov/government/office-inspector-general/debarment-information
Subcontractor’s Legal Business Name
Subcontractor’s Business Address
Description of goods/services to be provided by the Subcontractor
Percentage of work to be completed by Subcontractor
Number of Similar Projects the Respondent and Subcontractor have completed together
Description of Similar Projects the Respondent and Subcontractor have completed together
If applicable, describe below at least one (1) relevant experience from the last five (5) years supporting your subcontractor’s ability to successfully perform similar work as set forth in your company’s Quote.
| Subcontractor Reference Form |
| Respondent Response |
a. Name of Reference (Company Name)
b. Project Name/Title
c. Client Location
d. Contact Person Name
e. Contact Person Title
f. Contact Person Phone Number
g. Contact Person E-mail Address
h. Dates of Service (mm/yy – mm/yy)
i. Description of Services Provided
Revised 8/22/23.
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