9-Score Sheet - FOR INFORMATION ONLY.xlsx

XLSX spreadsheet 109 KB Posted Oct 8, 2026

Attached to: BB27-104, Oxygen Concentrators for Utah Medicaid
Solicitation number: BB27-104
Issued by: Utah

About this file

Written by GovTribe AI · Oct 13, 2026

This is an RFP evaluation scoresheet template for Solicitation BB27-104, Oxygen Concentrators for Utah Medicaid, issued by the State of Utah Division of Purchasing in conjunction with the Utah Department of Human Services. The RFP seeks a single qualified vendor to provide oxygen concentrators, associated equipment, supplies, and maintenance for all eligible enrolled Medicaid members statewide. The vendor must also provide additional respiratory equipment and supplies ordered by treating practitioners, including ventilators, CPAP units, BiPAP machines, pulse oximeters, and backup and portable oxygen supplies as medically necessary. The contract term is five years, with the vendor required to guarantee pricing for a minimum of one year.

The scoresheet establishes a two-tiered evaluation methodology consisting of seven minimum mandatory requirements and sixteen scoreable technical criteria weighted according to importance. Technical evaluation comprises 70 percent of the total score (614.5 possible points) with a required minimum threshold of 70 percent or 430.2 points, while cost evaluation comprises 30 percent (263.4 possible points). The highest-weighted technical criteria are Quality of Equipment and Supplies and Urgency and Frequency of Services, each carrying a weight of 20. Cost points are calculated using a formula whereby the lowest-priced proposal receives 100 percent of available cost points, with other proposals receiving proportional points based on their price relationship to the lowest bid. The scoresheet template accommodates evaluation of multiple offerors and includes provisions for multiple evaluators to score proposals independently before calculating average scores and final award recommendations.

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Other files

File	Type	Posted
8-Attachment F - Oxygen Concentrator Reporting Measures Worksheet 1.docx	DOCX document	Oct 8, 2026
2-Vendor Prerequisites - RFP Agency.pdf	PDF	Oct 8, 2026
4-Attachment B - Scope of Work - Medicaid Oxygen Concentrator.docx	DOCX document	Oct 8, 2026
5-Attachment C - Intro Background Mandatory Minimum Requirements.docx	DOCX document	Oct 8, 2026
1-Claim of Business Confidentiality Updated.pdf.pdf	PDF	Oct 8, 2026
6-Attachment D - Technical Criteria Questions.docx	DOCX document	Oct 8, 2026
7-Attachment E - Cost Proposal Form.xlsx	XLSX spreadsheet	Oct 8, 2026
3-Attachment A - Terms and Conditions.docx	DOCX document	Oct 8, 2026

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Instructions

Instructions for Interactive Scoresheet

Description: The interactive scoresheet is designed as a tool to help the evaluation committee organize the minimum mandatory requirements and the scoreable technical criteria that will be used in the RFP. The scoresheet will be filled out in phases and upon completion will become the scoresheet that is published with the RFP and eventually used to score the offers. Data should be entered in shaded cells only. This scoresheet may need to be modified, such as adding more rows and adjusting formulas accordingly, to meet the needs of your RFP.

Identify Important Criteria

1. Begin by making a list of all criteria that is important to the eventual solution. The list can be done on the Interactive Scoresheet or any other program you are comfortable with, pen and paper included. The initial list should be a brainstorm. Consider items that would be important later in the life of the solution. For example, compatibility with existing technology, maintenance, service, scaleability, enterprise solutions, emerging technologies, etc.

Prioritize Important Criteria

2. When you feel the list is fairly comprehensive, begin to organize the list. You may choose to organize similar items into subcategories, but most importantly, prioritize the criteria by what is most important.

Identify "Pass - Fail" Criteria

3. Once you have identified all the criteria and their relative importance, consider which items are mandatory and can be scored with either a "Pass", meaning it meets the criteria, or "Fail", meaning it does not meet the criteria. These criteria can be used for Minimum Mandatory Requirements and an initial evaluation.

Insert Minimum Mandatory Requirements

4. Taking the list of criteria, put the Minimum Mandatory requirements in the section labeled "Minimum Mandatory Requirements". You can add lines by clicking on row 20 to highlight the row, right-clicking, and selecting Insert Row. Follow this procedure for any additional lines needed. You will have to fix row numbering and formatting if you insert additional rows.

Insert Technical Criteria

5. Copy Scoreable Technical Criteria items into the apprpriate section. You can add lines by clicking on row 46 to highlight the row, Right-clicking, and selecting Insert Row. Follow this procedure for any additional lines needed. You will have to fix row numbering and formatting if you insert additional rows.

Develop the RFP Scope of Work

6. It is now time to begin writing the "Detailed Scope of Work" and "Proposal Requirements and Company Qualifications" sections of the RFP. The "Detailed Scope of Work" section is designed to describe each task as carefully and with as much detail as possible. If appropriately done, it will produce responsive Proposals and ease the task of managing the project/contract.

Ensure All Scorable Criteria is Included in RFP

7. The "Proposal Requirements and Company Qualifications" section should spell out all of the items on the "Score Sheet". Begin with the "Minimum Mandatory" items and how the offeror will respond and meet the minimums. For example, if the scoresheet says, "Meets minimum wireless technology", this section will state what the minimum wireless technology is, and if necessary, how the offeror will demonstrate compliance. This could be done by stating in the response that the Offeror complies or providing some kind of documentation to establish compliance.

Identify RFP Page Numbers or Section Numbers for all Scoreable Criteria

8. As you address each one of the "Minimum Mandatory" and "Scoreable Technical Criteria", put the section and page number of the criteria explanation on the "Score Sheet" in the cells provided.

Identify Weights for All Scorable Criteria

9. Enter a weight for each "Scoreable Technical Criteria" in column J. The weight is used to identify the importance of the criteria to the project/contract. The weighting should clearly identify the priority of the "Scoreable Technical Criteria". For example, if you have the criteria "The solution should be blue to match our new furniture" and "The solution will sync with our legacy software", and one is more important than the other, you would identify that by the numbers assigned in the "Criteria Weight" column. For example, you could give weight assignments like the following: 1 and 2, 2 and 3, 1 and 4, or 1 and 6. Don't worry about assigning points. Just worry about the relative importance of each of the criteria against each other. This is important because if you weight one criteria of lesser importance the same as the most important criteria, then you could get a substandard solution.

Identify Required Minimum Technical Percentage

10. Enter the technical score minimum threshhold that has to be met to be considered for award.

Identify Cost Percentage

11. The last thing to consider before posting the Score Sheet is the percentage amount that will be used in scoring of the cost portion of the response. Cost has to equal a minimum of 30%. Please fill in the cell labeled "Percent of Total" at this time.

Filling out the RFP Score Sheet

12. When it is time to score the evaluations, first make a copy of the "Score Sheet" tab by right-clicking on the tab and selecting Move or Copy. There is a check box for Make a Copy and you can select where in the workbook you would like the page to be located. Make a sheet for every offer you will be evaluating.

Evaluate Proposals

13. Now is the time to evaluate the offers. First evaluate whether the offer meets each of the Minimum Mandatory Requirements. Use the drop down menu that appears in the cell for "Evaluation" when you click in the cell. If any of the Minimum Mandatory Requirements are not met, you do not need to continue your evaluation.

Proposals Passing Minimum Mandatory Requirements

14. For all offers that pass the Minimum Mandatory Requirements, proceed to the Scoreable Technical Criteria. Using the requirements written in the RFP and identified on the Score Sheet, evaluate each criteria on a scale of 1 - 5. The scale is included on the Score Sheet for your reference. When it is time to make an award recommendation, you will need to put together a Justification Statement. You will have the information you need if you fill these sections out while performing the evaluation.

Scoresheet Summary

15. The "Scoresheet Summary" tab may be used to make the evaluation score sheet that will be used at the Award Determination meeting. All committee members will have an opportunity to review scores before finalizing the technical scores. Some formulas can be used to facilitate this process, but those can only be written after it has been determined how many offers will be evaluated. For help on this please contact your Purchasing Agent.

Bid Sync Posting

16. The "U3P Posting" tab illustrates the format to use for the scoresheet summary posted in U3P when the award is made. The Purchasing Agent will complete this information from the Scoresheet Summary grand totals. Firms that have been disqualified will not be included in the U3P Posting document.

Score Sheet

Oxygen Concentrators for Utah Medicaid
SOLICITATION # BB27-104
RFP EVALUATION SCORESHEET
DRAFT: This document is intended to be a draft and should not be returned to the Division of Purchasing. Please return this document to the evaluation committee chairperson
This document is not subject to GRAMA pursuant to Utah Administrative Code R33-7-702(2).
	Score will be assigned as follows:
	0 = Fail, the proposal fails to address the requirements or criteria described in the RFP or cannot be assessed due to missing information
Firm Name:	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 described in the RFP in an unsatisfactory manner
Evaluator:	3 = Satisfactory, the proposal addresses all requirements 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
Date:	5 = Excellent, the proposal addresses and exceeds all of the requirements or criteria described in the RFP

Minimum Mandatory Requirements		RFP Section	Evaluation (Pass/Fail)
1	Provide Equipment Statewide	MMR 1
2	Specifications for Oxygen Concentrators	MMR 2
3	Urgent Services	MMR 3
4	Certified Respirator Therapy Technician (CRTT) and Registered Respirator Therapist (RRT)	MMR 4
5	Provide Backup Oxygen	MMR 5
6	Qualifications	MMR 6
7	Licensure	MMR 7

		Scoreable Technical Criteria		RFP Section	Evaluator Score (0-5)	Criteria Weight	% of Tech Criteria	Points Possible	Points
Earned	Minimum Required
		1	Transition Plan	TC 1		2.5	2.0%	12.50	0.00
		2	Quality of Equipment and Supplies	TC 2		20	16.3%	100.00	0.00
		3	Supply Chain Planning	TC 3		15	12.2%	75.00	0.00
		4	Claims and Billing	TC 4		2.5	2.0%	12.50	0.00
		5	Education Materials	TC 5		2.5	2.0%	12.50	0.00
		6	Business Qualifications	TC 6		15	12.2%	75.00	0.00
		7	Servicing Equipment	TC 7		5	4.1%	25.00	0.00
		8	Lost, Stolen, or Damaged Beyond Repair Equipment	TC 8		2.5	2.0%	12.50	0.00
		9	Telephone Service	TC 9		5	4.1%	25.00	0.00
		10	Licensure	TC 10		0.2	0.2%	1.00	0.00
		11	Recent Experience	TC 11		0.2	0.2%	1.00	0.00
		12	Reports	TC 12		15	12.2%	75.00	0.00
		13	Member Satisfaction	TC 13		10	8.1%	50.00	0.00
		14	Risk Mitigation Plans	TC 14		2.5	2.0%	12.50	0.00
		15	Urgency and Frequency of Services	TC 15		20	16.3%	100.00	0.00
		16	Staffing Ratios	TC 16		5	4.1%	25.00	0.00
		13					0.0%	0.00	0.00
		14					0.0%	0.00	0.00
		15					0.0%	0.00	0.00
		16					0.0%	0.00	0.00
		17					0.0%	0.00	0.00
		18					0.0%	0.00	0.00
		19					0.0%	0.00	0.00
		20					0.0%	0.00	0.00
		21					0.0%	0.00	0.00
		22					0.0%	0.00	0.00
		23					0.0%	0.00	0.00
							100.0%	614.50	0.00	0.00

Required Technical Point Threshold	RFP Section	Min Percent	Min Points Required	Points Earned	Percent Earned	Evaluation
		70%	430.2	0.0	0.0%

Cost	RFP Section	Low Cost Option	Offered Cost	Percent of Total	Points Possible	Points Earned
				30%	263.4	0.0

* Purchasing will use the following cost formula: The points assigned to each offerors cost proposal will be based on the lowest proposal price. The offeror with the lowest Proposed Price will receive 100% of the price points. All other offerors will receive a portion of the total cost points based on what percentage higher their Proposed Price is than the Lowest Proposed Price. The formula to compute the points is: Cost Points x (Lowest Proposed Price/Proposed Price).

Total Evaluation Points	Percent of Total	Points Possible	Points Earned
Total Technical Evaluation Points	70%	614.5	0.0
Total Cost Evaluation Points	30%	263.4	0.0
Total Evaluation Points	100%	877.9	0.0

Scoresheet Summary

XX##### Solicitation Name Scoresheet Summary

Instructions:

Enter the solicitation number and name.

Enter each Offeror name.

Enter the Criteria name for each category.

Enter the Weight in column B that corresponds to the Criteria Weight on the Score Sheet tab column J for each criterion.

Enter the Total Possible Points for each Criterion, Cost Points, and Score Summary section.

Mandatory Minimum Requirements: Evaluate each offer and enter pass or fail

Ensure that the number of evaluator lines matches the number of evaluators.

Offers not meeting the Minimum Mandatory Requirements will not be evaluated further.

Ensure that the Total Average Score formula includes all of the evaluator line items.

Technical Scores: Enter each evaluator score for each offer.

Signatures:	Date:
Evaluator 1	__________________
Evaluator 2	__________________
Evaluator 3	__________________
Evaluator 4	__________________
Evaluator 5	__________________

Minimum Mandatory Requirements

Offeror A

Offeror B

Offeror C

Offeror D

Offeror E

Offeror F

Offeror G

Offeror H

Offeror I

Offeror J

Offeror K

Offeror L

Offeror M

Offeror N

Offeror O

Offeror P

Offeror Q

Offeror R

Offeror S

Offeror T

Weight	Technical Scores	Offeror A	Offeror B	Offeror C	Offeror D	Offeror E	Offeror F	Offeror G	Offeror H	Offeror I	Offeror J	Offeror K	Offeror L	Offeror M	Offeror N	Offeror O	Offeror P	Offeror Q	Offeror R	Offeror S	Offeror T
	Criteria #1
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #1 - Total Points (Total Possible Points = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #2
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #2 - Total Points (Total Possible Points = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #3
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #3 - Total Points (Total Possible Points = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #4
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #4 - Total Points (Total Possible Points = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #5
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #5 - Total Points (Total Possible Points = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #6
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #6 - Total Points (Total Possible XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #7
	Evaluator 1
	Evaluator 2
	Evaluator 3
	Evaluator 4
	Evaluator 5
	Total Average Score	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Criteria #7 - Total Points (Total Possible Points = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Total Technical Points (Total Possible Points = XX) Minimum Threshold = XX	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
Total Cost Points	Cost Scores	Offeror A	Offeror B	Offeror C	Offeror D	Offeror E	Offeror F	Offeror G	Offeror H	Offeror I	Offeror J	Offeror K	Offeror L	Offeror M	Offeror N	Offeror O	Offeror P	Offeror Q	Offeror R	Offeror S	Offeror T
	Cost
300.0	Cost Points	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Score Summary	Offeror A	Offeror B	Offeror C	Offeror D	Offeror E	Offeror F	Offeror G	Offeror H	Offeror I	Offeror J	Offeror K	Offeror L	Offeror M	Offeror N	Offeror O	Offeror P	Offeror Q	Offeror R	Offeror S	Offeror T
	Total Technical Points (Total Possible = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Total Cost Points (Total Possible = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00
	Grand Total Points (Total Possible = XX)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0.00

File details come from the government source that posted it. Updated Oct 13, 2026.