7-Attachment F - Score Sheet (DHHS26085).xls

XLS spreadsheet 56 KB Posted

Attached to
Stabilization and Mobile Response
Solicitation number
DHHS26085
Issued by
Utah

About this file

This RFP Evaluation Scoresheet for DHHS26085 is used by the Utah Department of Health and Human Services to assess proposals for Stabilization and Mobile Response services in the Western Region, which includes Utah, Wasatch, Millard, Juab, Sanpete, Sevier, Wayne, and Piute counties. The procurement seeks a single qualified vendor to provide these services beginning September 13, 2026, under a five-year contract term. The evaluation process accommodates up to seven offerors and requires all evaluators to assess proposals against four mandatory requirements: vendor registration with the Utah Department of Commerce, enrollment as a Utah Medicaid Provider, ability to commence services by the specified start date, and capacity to serve all designated Western Region counties.

The scoresheet establishes a technical evaluation framework worth 500 total points, distributed across three primary scoreable criteria: ISS projection (10% weight, 50 points), Plan and Timeline (75% weight, 375 points), and Anticipated Annual Targets (15% weight, 75 points). Evaluators score each criterion on a 0-5 scale, with 5 representing proposals that address and exceed all RFP requirements. The evaluation process involves up to five evaluators who must calculate average scores and total points for each criterion and offeror, followed by combined technical and cost scoring to determine final rankings. The scoresheet template includes sections for cost evaluation and grand total point calculations, though specific cost weighting, funding amounts, and pricing terms are not detailed in this evaluation instrument.

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Score Sheet

SOLICITATION # DHHS26085
RFP EVALUATION SCORESHEET
Vendor:
Evaluator:Date:
Minimum Mandatory RequirementsEvaluation (Pass/Fail)
1Is the Offeror registered, or will the Offeror register, with the Utah Department of Commerce, Division of Corporations and Commercial Code?
2Is the Offeror enrolled as a Utah Medicaid Provider?
3Can the Offeror begin providing services on September 13, 2026?
3Can the Offeror provide services to the all counties in the Western Region. (Utah, Wasatch, Millard, Juab, Sanpete, Sevier, Wayne, Piute)
0
Score will be assigned as follows:
0 = The proposal fails to address the requirements or crieteria described in the RFP or cannot be assessed due to missing information.
1 = Poor, the proposal inadequately addresses the requirements or criteria described in the RFP or cannot be assessed due to incomplete information.
2 = Unsatisfactory, the proposal addresses the requirements or criteria in the RFP in an unsatisfactory manner.
3 = Satisfactory, the proposal addresses all of the requriements or criteria described in the RFP in a minimum satisfactory manner.
4 = Good, the proposal addresses all requirements or criteria described in the RFP and, in some respects, exceeds them.
5 = Excellent, the proposal addresses and exceeds all of the requirements or criteria described in the RFP.
Scoreable Technical CriteriaEvaluator Score (0-5)Criteria Weight% of Tech CriteriaPoints PossiblePoints
EarnedMinimum Required
1ISS projection1010.0%50.00.0
2Plan & timeline7575.0%375.00.0
4Anticipated annual targets1515.0%75.00.0
Totals:100.0%500.00.00.0

Scoresheet Summary

XX##### Solicitation Name Scoresheet Summary
Signatures:Date:
Evaluator 1__________________
Evaluator 2__________________
Evaluator 3__________________
Evaluator 4__________________
Evaluator 5__________________
Minimum Mandatory RequirementsOfferor AOfferor BOfferor COfferor DOfferor EOfferor FOfferor G
1
2
3
WeightTechnical ScoresOfferor AOfferor BOfferor COfferor DOfferor EOfferor FOfferor G
Criteria #1
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #1 - Total Points (Total Possible Points = XX)0.00.00.00.00.00.00.0
Criteria #2
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #2 - Total Points (Total Possible Points = XX)0.00.00.00.00.00.00.0
Criteria #3
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #3 - Total Points (Total Possible Points = XX)0.00.00.00.00.00.00.0
Criteria #4
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #4 - Total Points (Total Possible Points = XX)0.00.00.00.00.00.00.0
Criteria #5
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #5 - Total Points (Total Possible Points = XX)0.00.00.00.00.00.00.0
Criteria #6
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #6 - Total Points (Total Possible XX)0.00.00.00.00.00.00.0
Criteria #7
Evaluator 1
Evaluator 2
Evaluator 3
Evaluator 4
Evaluator 5
Total Average Score0.00.00.00.00.00.00.0
Criteria #7 - Total Points (Total Possible Points = XX)0.00.00.00.00.00.00.0
Total Technical Points (Total Possible Points = XX) Minimum Threshold = XX0.00.00.00.00.00.00.0
Total Cost PointsCost ScoresOfferor AOfferor BOfferor COfferor DOfferor EOfferor FOfferor G
Cost
Cost Points0.00.00.00.00.00.00.0
Score SummaryOfferor AOfferor BOfferor COfferor DOfferor EOfferor FOfferor G
Total Technical Points (Total Possible = XX)0.00.00.00.00.00.00.0
Total Cost Points (Total Possible = XX)0.00.00.00.00.00.00.0
Grand Total Points (Total Possible = XX)0.00.00.00.00.00.00.0

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