9-HSS-26-047 - BEHAVIORAL HEALTH NUTRITION SERVICES- Attachment 5 - Business References Form.docx
DOCX document 128 KB Posted
- Attached to
- BEHAVIORAL HEALTH NUTRITION SERVICES
- Solicitation number
- HSS-26-047
- Issued by
- Delaware
About this file
This is a Business References Form for Contract No. HSS-26-047, issued by the Delaware Health and Social Services Division of Substance Abuse and Mental Health (DSAMH). The contract procures Behavioral Health Nutrition Services from a healthcare provider experienced in addressing the interconnected issues of serious mental illness, substance use disorders, and nutritional deficiencies. Applicants must submit a minimum of three business references with complete contact information, including business name and mailing address, contact name and phone number, years of business association, and type of work performed. The form includes separate sections for each reference and requires disclosure of whether the reference is a current vendor, as well as a separate listing of any State contracts held within the last five years.
State of Delaware employees are explicitly prohibited from being listed as business references. The form does not specify response due dates, site visits, bidder conferences, award dates, or contract term information. No pricing terms, set-asides, incumbent information, or funding amounts are detailed in this attachment document.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 8-HSS-26-047 - BEHAVIORAL HEALTH NUTRITION SERVICES - Attachment 6 - Subcontractor Information Form.docx | DOCX document | |
| 6-HSS-26-047- Attachment 2 - Non-Collusion Stmt.docx | DOCX document | |
| 4-Appendix C- Budget Workbook-Nutrition RFP.xlsx | XLSX spreadsheet | |
| 3-Nutrition RFP-Appendix B SOW and Technical Requirements.docx | DOCX document | |
| 1-RFP HSS-26-047 BEHAVIORAL HEALTH NUTRITION SERVICES.docx | DOCX document | |
| 2-Appendix D-workplan-Nutrition.docx | DOCX document | |
| 5-HSS-26-047 - BEHAVIORAL HEALTH NUTRITION SERVICES Attachment 4 - Confidential Information Form.docx | DOCX document | |
| 7-HSS-26-047 - BEHAVIORAL HEALTH NUTRITION SERVICES- Exceptions Form.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Delaware Health and Social Services
Division of Substance Abuse and Mental Health d
Delaware Health and Social Services
Division of Substance Abuse and Mental Health d
Attachment 5
Contract No. HSS-26-047 Contract Title: BEHAVIORAL HEALTH NUTRITION SERVICES
BUSINESS REFERENCES
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: |
Business Name:
Address:
Email:
Phone # / Fax #:
Current Vendor (YES or NO):
Years Associated & Type of Work Performed:
| 3. |
| Contact Name & Title: |
Business Name:
Address:
Email:
Phone # / Fax #:
Current Vendor (YES or NO):
Years Associated & Type of Work Performed:
STATE OF DELAWARE PERSONNEL MAY NOT BE USED AS REFERENCES.
image1.png image2.png
File details come from the government source that posted it. Updated .