ATTACHMENT 16.9- ORGANIZATIONAL CHANGE MANAGEMENT LEAD QUALIFICATIONS FORM.pdf

ATTACHMENT 16.9: ORGANIZATIONAL CHANGE MANAGEMENT

LEAD QUALIFICATIONS FORM

ORGANIZATIONAL CHANGE MANAGEMENT LEAD QUALIFICATIONS FORM

The Bidder may cite no more than five (5) projects to meet the total experience required for each mandatory qualification and, if applicable, desirable qualifications. The Bidder may use multiple projects to meet the total experience required for each mandatory experience. A separate form must be completed for each project cited. Experience must have occurred within twelve (12) years of the solicitation release date for all projects. The reference contact on this form must be the same as the reference on the corresponding key staff qualification form.

ORGANIZATIONAL CHANGE MANAGEMENT LEAD QUALIFICATIONS FORM

1 Bidder:

2 Key Staff Name:

3 Staff’s Referenced Project Name:

4 Company Name (of staff’s reference):

5 Contact Name, Email Address and Telephone Number (of Staff’s Reference):

6 Staff Start Date (MM/DD/

YYYY):

7 Staff End Date (MM/DD/

YYYY):

8 Staff Work Schedule: ☐ Full-time

☐ Part-time

9 Project Description:

State of California Department of Technology

RFP 26-014-280

ORGANIZATIONAL CHANGE

MANAGEMENT LEAD

QUALIFICATIONS FORM

October 2, 2026

10 Contract Amount: $

11 Documenting instructions when a minimum number of years of experience is required. For each mandatory or desirable experience listed below,

• Check “Yes” if the total years of experience was met on this referenced project; or

• Check “Partial” if fewer than the total years of experience was met on this referenced project; or

• Check “No” if none of the experience was met on this referenced project.

Enter the corresponding amount of time including a description of Key Staff's roles and responsibilities on the project being used as reference.

Classificatio n

Qualification Total Experience Required

Experience gained on this cited Project

Mandatory

(MQ#1)

The Organizational Change Management Lead shall have five (5) years of experience implementing organizational change management practices in a lead capacity using an industry-standard change management framework.

5 Years ☐ Yes

Yr. ___ Mo.___

☐ Partial

Yr. ___ Mo.___

☐ No

Provide a description of the work performed on the cited project and how it meets this requirement:

State of California Department of Technology

RFP 26-014-280

ORGANIZATIONAL CHANGE

MANAGEMENT LEAD

QUALIFICATIONS FORM

Mandatory

(MQ#2)

The Organizational Change Management Lead shall have five (5) years of experience creating, managing, and delivering organizational change management products such as roadmaps, risk logs, staff transition plans, training plans, communication plans, execution plans, and readiness assessments.

5 Years ☐ Yes

Yr. ___ Mo.___

☐ Partial

Yr. ___ Mo.___

☐ No

Mandatory

(MQ#3)

The Organizational Change Management Lead shall possess an Organizational Change Management (OCM) certification from a recognized certification body or accredited educational institution.

Attached Copy of Certification

N/A

Provide a copy of the Certification:

Desired

(DQ#1)

One (1) or more years of experience implementing organizational change management for a city, county, state, or federal government entity.

One (1) year = 35 points up to a maximum of 175 points.

1+ Years

Up to five (5) additional years.

☐ Yes

Yr. ___ Mo.___

☐ Partial

Yr. ___ Mo.___

☐ No

State of California Department of Technology

RFP 26-014-280

ORGANIZATIONAL CHANGE

MANAGEMENT LEAD

QUALIFICATIONS FORM

Desired

(DQ#2)

One (1) or more years of experience delivering organizational change management for IT implementation projects.

One (1) year = 35 points up to a maximum of 175 points.

1+ Years

Up to five (5) additional years

☐ Yes

Yr. ___ Mo.___

☐ Partial

Yr. ___ Mo.___

☐ No

State of California Department of Technology

RFP 26-014-280

ORGANIZATIONAL CHANGE

MANAGEMENT LEAD

QUALIFICATIONS FORM