Att D - Reference Check Form.docx
DOCX document 36 KB Posted
- Solicitation number
- 004970000085638
- Issued by
- Indiana
About this file
This document is a Reference Check Form from the Indiana Family and Social Services Administration (FSSA) for a Business Enterprise Program Request for Qualifications (RFQ). The form requires vendors to submit three professional references as part of their bid proposal, with a submission deadline of November 13, 2025 at 4:00 PM EST. Vendors must email the completed reference form to Amber.Schwipps@fssa.IN.gov, using an email subject line that clearly identifies the submitting company.
The reference form provides a structured template for vendors to document three separate reference contacts, including details such as reference company name, contact name, title, mailing address, website, telephone number, fax number, email address, and industry. The form emphasizes that during the competitive procurement process, state representatives may directly contact the provided references to obtain additional information about the vendor's professional capabilities and performance history.
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Other files
| File | Type | Posted |
|---|---|---|
| SolicitationPackage 0049700000854638.docx | DOCX document | |
| Att B - Business Proposal.docx | DOCX document | |
| Att C- Q&A.xlsx | XLSX spreadsheet | |
| 497_Vending_Machine_Delivery_and_Repair.pdf | ||
| 2025 RFQ Machine delivery and maintenance.docx | DOCX document | |
| Att A - Cost Proposal.xlsx | XLSX spreadsheet | |
| Att F BEP Site List as of 10.8.25.xlsx | XLSX spreadsheet |
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Text version
Attachment DState of Indiana Contact:
Amber.Schwipps@fssa.IN.gov Family and Social Services Administration
Reference Check Form Business Enterprise Program RFQ
Reference Check Form Due Date:
November 13, 2025 by 4:00pm EST
INSTRUCTIONS: You have been asked by State of Indiana to provide 3 professional references to accompany your bid proposal. During this competitive process, a representative from the State of Indiana, may contact references provided directly for more detail. If you have any questions, please contact the State of Indiana contact listed in the box in the top left side of the form.
Please provide the information requested below and submit this reference check form to:
Amber.Schwipps@fssa.IN.gov
The subject line of the email submissions must clearly state the following:
Reference for [INSERT COMPANY NAME]
VENDOR NAME
REFERENCE CONTACT INFORMATION
Reference Company Name
Contact Name
Contact Title
Company Mailing Address
Company City, State, Zip
Company Website Address
Contact Telephone Number
Contact Fax Number
Contact Email
Industry of Company
Reference Company Name
Contact Name
Contact Title
Company Mailing Address
Company City, State, Zip
Company Website Address
Contact Telephone Number
Contact Fax Number
Contact Email
Industry of Company
Reference Company Name
Contact Name
Contact Title
Company Mailing Address
Company City, State, Zip
Company Website Address
Contact Telephone Number
Contact Fax Number
Contact Email
Industry of Company
File details come from the government source that posted it. Updated .