Att L - Intent to Respond Form.docx

This is an Intent to Respond Form for RFP 27-88864 issued by the Indiana Department of Administration (IDOA) for Pharmacy Benefit Administrator (PBA) Services. The form is an optional submission that allows prospective bidders to indicate their intention to respond to the RFP or decline participation. Respondents must complete the form with company name, contact information (name, title, address, telephone, email, and fax), and return it via email to Robert Cohen at Rcohen@idoa.in.gov according to the timeline specified in Section 1.24 of the RFP. The form requires respondents to mark whether they plan to submit a proposal or decline to participate; if declining, respondents are requested to provide their reasoning.

No specific pricing terms, contract duration, award dates, site visits, or bidder conferences are detailed in this form. The document serves solely as an administrative tool to gauge bidder interest and collect preliminary contact information prior to formal proposal submission. Additional contract details, including scope of services, evaluation criteria, pricing requirements, and response deadlines, are contained in the complete RFP documentation.