Attach C1 Admin Response.docx
DOCX document 37 KB Posted
- Attached to
- Caregiver Supports Area 9-14
- Solicitation number
- 25-DCYF-CW-090
- Issued by
- Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Raft Island CDP, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington
About this file
This document is an Administrative Requirements Response Template for RFA No. 25-DCYF-CW-090 issued by the Washington State Department of Children, Youth & Families (DCYF), specifically for Caregiver Supports in Areas 9-14. The solicitation seeks qualified contractors to provide assistance to caregivers in supporting children or youth by helping them access medical, social, educational, and other necessary services. Bidders must complete this template and submit it electronically, with mandatory requirements including three years of experience providing caregiver support services, having an Executive Director with an office near the service catchment area, and being licensed to do business in Washington State.
The document outlines several optional certifications and disclosures, including OMWBE (Office of Minority and Women's Business Enterprises) certification, Veteran-Owned Business status, and Small Business designation. Bidders must provide key personnel information, confirm no recent contract terminations, disclose any recent state employee connections, and verify insurance coverage capabilities. The response requires several mandatory attachments, including a Bidders Certification and Assurances Form, the Administrative Requirements document, a completed application, letters of support, and documentation of coordination with neighboring organizations. The template is designed to comprehensively evaluate bidder qualifications and compliance with state contracting requirements.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A Sample Contract.docx | DOCX document | |
| Attach B Certs & Assurances.pdf | ||
| Catchment Areas 9 - 14 counties E-2.docx | DOCX document | |
| Attach C2 Bidder Response Form.docx | DOCX document | |
| Copy of Fee Table -Caregiver Supports.xlsx | XLSX spreadsheet | |
| RFA Caregiver Supports Areas 9-14.docx | DOCX document |
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Text version
ATTACHMENT C1 - BIDDER RESPONSE TEMPLATE
ADMINISTRATIVE REQUIREMENTS RESPONSE (Pass/Fail)
RFA NO. 25-DCYF-CW-090
Caregiver Supports Area 9-14
Instructions: Bidders must complete this template and attach the PDF to their emailed RFA Response. Please thoroughly read all instructions in the RFA before completing. All mandatory information must be provided for the Bidder to be responsive. Bidder may provide additional documentation as an additional Attachment; the documentation should be specified in this form. Also, please write your Business Name on the bottom of each page of this Response Template.
ADMINISTRATIVE REQUIREMENTS (Mandatory Pass/Fail)
Bidder Information:
Business Name:
Address:
Telephone:
Email of Legal Entity or Individual:
| Contact Person: |
| Name: |
| Signature: |
| Contact Person submitting the Response is authorized to contractually bid the Bidder’s firm: |
| · Yes |
· No
Federal Tax Identifier Number:
WA State Uniform Business Identifier (UBI) Number:
| Bidder confirms they are either currently licensed to do business in the State of Washington or is committed to becoming licensed within 30 days of being announced as the Apparently Successful Bidder: |
| · Yes |
| Bidder confirms they have three (3) years’ experience providing support services to caregivers and children. |
| · Yes |
· No
| Bidder confirms they have an Executive Director on staff with a physical office located within or adjacent and a reasonable distance to the catchment area being served. |
| · Yes |
· No
| Bidder confirms they have not been debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in transactions by any federal department or agency. |
| · Yes |
Key Personnel
Identify the key personnel you will utilize in performing this Contract, and their experience and qualifications.
Contract History:
Has the Bidder’s performance on any contract unsatisfactory and resulted in a contract termination in the past five (5) years?
· Yes
· No
If yes, provide a list of those contracts terminated, and include the following:
· Other party’s Name
· Address
· Telephone Number
· Description of the Incident
· Bidder’s Position on the matter
State of Washington Employee(s):
| Is or was the Bidder’s officer(s) and/or employee(s) an employee of any agency of the State of Washington during the last 24 months preceding the Response Due Date for this RFA? |
| · Yes |
If yes, provide the following information for each individual:
· Name
· Employing Agency
· Job Title while with the Agency
· Separation Date
Insurance Requirements:
| Bidder verifies the ability to provide copies of required insurance coverage as outlined in the RFA Sample Contract, Attachment A, should they be selected as the Apparently Successful Bidder: |
| · Yes |
Proprietary or Confidential Information:
If applicable, identify the Sections of the Response which the Bidder considers “Proprietary” or “Confidential” information:
(Optional) OMWBE Certification:
Is Bidder or Bidder’s subcontractor OMWBE Certified?
· Yes
If yes, Bidder’s OMWBE Certification #:
If Subcontractor(s) is OMWBE Certified, Subcontractor(s) names:
If yes, subcontractor(s) OMWBE Certification #:
(Optional) Veteran Owned Business:
Is Bidder or Bidder’s subcontractor certified Veteran Owned Business?
· Yes
If yes, Bidder’s DVA Certification #:
If Subcontractor(s) is Certified Veteran Owned Business, Subcontractor(s) names:
If yes, subcontractor(s) DVA Certification #:
(Optional) Small Business:
| Is Bidder or Bidder’s subcontractor a Small Business? |
| · Yes |
· No If yes, please be sure to sign and return Attachment B.1 Small Business Self-Certifications as part of your proposal.
If Subcontractor(s) is a self-certified Washington Small Business, Subcontractor(s) names:
If yes, please be sure return a sign Attachment B.1 Small Business Self-Certifications for each subcontractor as part of your proposal.
Checklist of Mandatory Response Attachments:
· Completed and signed Bidders Certification and Assurances Form (Attachment B)
· Completed and Signed Administrative Requirements (Attachment C1; this document)
· Completed Application (Attachment C2)
· Letters of Support and Collaboration
· Coordination with Neighboring Organizations
Page 3 of 3 RFA # 25-DCYF-CW-090 Administrative Requirements
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