Att H - Reference Check Form-rtp.docx
DOCX document 39 KB Posted
- Attached to
- RFP DOC Correctional Health ServicesBid Documents State and local contract opportunity
- Solicitation number
- 27-87787
- Issued by
- Hendricks County, Indiana
About this file
This is a Reference Check Form (Attachment H) issued by the State of Indiana Department of Administration for RFP #27-87787 regarding Correctional Health Services. The form is designed to collect feedback from references provided by vendors responding to the state's solicitation. Reference check forms must be submitted to idoareferences@idoa.in.gov by October 5, 2026, at 3:00 PM Eastern Time, with the email subject line clearly stating "RFP 27-87787 Reference - [Vendor Name]." The form requests that references provide their company information, contact details, and the duration of their working relationship with the vendor, along with information about the types of internal and external stakeholders with whom the vendor communicated.
The reference evaluation comprises thirteen questions designed to assess vendor performance across multiple dimensions, including financial audit history, corrective action requests, quality of services and staff, knowledge of the client's business, stakeholder engagement and communication, resource allocation capabilities, cost and schedule performance, and overall vendor rating. References are asked to rate vendors on a four-point scale (poor, satisfactory, above average, or superior) for most criteria and to provide explanatory comments supporting their assessments. The form also provides space for references to decline participation and to offer additional comments or topics they believe the State of Indiana should consider during its evaluation process. Inquiries regarding the reference check process should be directed to Angie Alexander, Procurement Consultant, at the Indiana Department of Administration.
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Text version
Request for Proposal/Partnership RFP# 27-87787 Correctional Health Services Reference Check Form Attachment H
Reference Check Form Due Date: October 5, 2026 by 3:00pm Eastern Time
Instructions
You have been asked by the vendor listed below to provide a reference as they are responding to the current solicitation with the state of Indiana. This is a standard form created by the State of Indiana and your input is very much appreciated. During this competitive process, a representative from the State of Indiana may contact you directly for more detail. If you have any questions, please direct your inquiries to the State of Indiana representative listed on the bottom right of this form.
Please provide the information requested below and submit this reference check form to:
idoareferences@idoa.in.gov.
The subject line of the email submissions must clearly state the following:
RFP 27-87787 Reference –(Insert Vendor Name being Referenced)
Vendor Name
Reference Contact Information Reference Company Name
Contact Name
Contact Title
Contact Telephone Number
Contact Email
Company Mailing Address
Company City, State, Zip
Company Website Address
Industry of Company
State of Indiana Contact:
Angie Alexander; Procurement Consultant angalexander@idoa.in.gov Indiana Department of Administration Questions
Please provide a response to each of the questions listed below regarding the vendor listed above.
1. If you decline to provide a reference, please indicate that below and provide any comments you would be willing to share regarding the reason.
2. How long did you/have you and/or members of your team worked with the vendor? Please provide specific dates of service.
3. With what type of internal and external stakeholders did the vendor have to communicate with?
4. Has the vendor been cited for any financial audit issues? If you are able, please briefly describe the issue and any corrective actions that were required. Did the vendor ultimately address the issue(s) in a satisfactory manner?
5. Has the vendor been subject to any requests for corrective action to cure performance issues? If you are able, please briefly describe the issue and any corrective actions that were required. Did the vendor ultimately address the issue(s) in a satisfactory manner?
6. Would you rate your experience with the quality of services/work provided by the vendor as poor, satisfactory, above average, or superior? Please provide an explanation supporting the rating you have selected.
7. Would you rate the vendor’s knowledge of your business as poor, satisfactory, above average, or superior? Please provide an explanation supporting the rating you have selected.
8. Would you rate the overall quality of the vendor’s staff as poor, satisfactory, above average, or superior? Please provide an explanation supporting the rating you have selected.
9. Would you describe the quality of the vendor’s engagement and communication with stakeholders (internal and external) throughout the project as poor, satisfactory, above average, or superior? Please provide an explanation supporting the rating you have selected.
10. Would you rate the vendor’s ability to provide the appropriate staff and resources as needed for the project as poor, satisfactory, above average, or superior? Please provide an explanation supporting the rating you have selected.
11. Would you rate the vendor’s performance regarding cost and/or schedule overruns on the project as poor, satisfactory, above average, or superior? Please provide an explanation supporting the rating you have selected.
12. Are there any additional topics you believe Indiana should consider during its reference evaluation, or any further comments you would like to share?
13. Would your overall rating of the vendor be poor, satisfactory, above average, or superior?
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