Appendix I.doc
DOC document 64 KB Posted
- Attached to
- Behavioral Health Training Services
- Solicitation number
- RFSQ-BHS-FY25-0176
- Issued by
- California
About this file
This is a Designation of Subcontractors form from the County of Santa Clara Behavioral Health Services Department (BHSD) for Request for Statements of Qualifications (RFSQ-BHS-FY25-0176): Behavioral Health Training Services. The County seeks qualified firms to provide health and professional training services supporting County clinical staff and County-contracted Provider staff. Offerors must complete the subcontractor designation form for any subcontract exceeding 0.5% of the total proposal value, identifying each subcontractor's name, complete address, telephone number, and specialty. Subcontractors are defined as entities that perform work or labor, provide services to the vendor, or specially fabricate and install portions of work according to plans and specifications. All work must comply with California Public Contract Code sections 4100-4114 and any amendments thereof.
Offerors assume full responsibility for the actions, omissions, and errors of all listed subcontractors. No changes to subcontractor assignments are permitted after contract award without prior written approval from the Director of the Behavioral Health Services Department or their designee. Unauthorized changes to subcontractors may result in cancellation of the purchase order or contract. The form requires the authorized representative's signature under penalty of perjury, confirming that all statements and representations are true and accurate.
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Other files
| File | Type | Posted |
|---|---|---|
| Appendix H.docx | DOCX document | |
| Attachment B.pdf | ||
| Attachment D.pdf | ||
| Appendix C.docx | DOCX document | |
| RFSQ-BHS-FY25-0176.pdf | ||
| Appendix E.docx | DOCX document | |
| Appendix B.docx | DOCX document | |
| Appendix F.docx | DOCX document | |
| Attachment E.pdf | ||
| Solicitation_Document_1.pdf | ||
| Solicitation_Document.pdf | ||
| Appendix J.docx | DOCX document | |
| Addendum 1.pdf | ||
| Attachment C.pdf | ||
| Appendix G.docx | DOCX document | |
| Addendum 2.pdf | ||
| Attachment A.pdf | ||
| Appendix K.docx | DOCX document | |
| Appendix A.docx | DOCX document | |
| Appendix D.docx | DOCX document |
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Text version
APPENDIX I
County of Santa Clara – Behavioral Health Services Department
RFSQ-BHS-FY25-0176: Behavioral Health Training Services
DESIGNATION OF SUBCONTRACTORS
Offeror shall completely fill in the form below for each subcontract that exceeds one-half percent (0.5%) of Offeror’s total proposal. A subcontractor is defined as one whom:
1) Performs work or labor
2) Provides a service to the vendor 3) Specially fabricates and installs a portion of the work according to the plans and specifications.
Work shall be done in compliance with California Public Contract Code sections 4100-4114 and any amendment thereof.
Offeror shall assume full responsibilities for the actions, omissions and errors of subcontractors listed below. No change in subcontractor shall be permitted, after award, without prior written approval from the Director of the Behavioral Health Services Department or their designee. Changes in subcontractors without prior written consent from the Director of the Behavioral Health Services Department or their designee may result in the cancellation of the purchase order or contract.
NAME OF
SUBCONTRACTOR
COMPLETE ADDRESS
AND TELEPHONE NUMBER
SPECIALTY
The undersigned hereby declares under penalty of perjury that all statements, answers and representations made in this questionnaire are true and accurate, including all supplementary statements hereto attached. In the case of a corporate Offeror, the signature of one duly authorized representative is sufficient.
Signature
(Please print or type name)
Title
Signature
(Please print or type name)
Title
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