AppendixBRequiredFormsExhibits1-9revised.pdf

This document is Appendix B containing required forms and exhibits for the County of Los Angeles, Department of Public Health's Request for Statement of Qualifications (RFSQ) for As-Needed Substance Use Disorder Treatment Services at County Behavioral Health Facilities. The appendix comprises nine exhibits that establish the formal application and compliance requirements for providers seeking to enter into master agreements with the County. The RFSQ operates on a continuous basis with SOQs accepted and reviewed at the County's convenience, allowing qualified providers to submit applications throughout the solicitation period rather than within a single deadline window. The exhibits within this appendix provide standardized forms and documentation templates that prospective bidders must complete and submit as part of their Statement of Qualifications package.

The required exhibits establish baseline qualifications, insurance requirements, compliance certifications, and organizational documentation necessary for providers to demonstrate capability and eligibility for the master agreement awards. These forms include attestations regarding organizational status, financial capacity, insurance coverage specifications, and compliance with County and state requirements for substance use disorder treatment service providers. The exhibits serve as screening mechanisms to ensure that only qualified, properly insured, and compliant organizations proceed in the procurement process. By consolidating required forms and exhibits in a single appendix, the County streamlines the application process and ensures consistency in the information and documentation collected from all responding providers.