attachment_2,_minimum_qualifications_certification.docx
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- Solicitation number
- 0000030365
- Issued by
- Sacramento County, Sacramento City, California
About this file
This document is a Minimum Qualifications Certification for RFP 24-3004 issued by the California Department of Social Services. The RFP is for a California Food Assistance Program Application Assistance Outreach Campaign, which requires the successful proposer to have at least three years of experience within the last five years in researching, designing, developing, and implementing statewide application assistance services; establishing strategies to address barriers to program participation and increase rates of submitted and approved applications; developing and maintaining effective working relationships with stakeholders; and performing data collection, evaluation, and research to build program awareness. The proposer must also have at least three years of experience within the last five years working with low-income individuals and/or immigrants and undocumented individuals in community-based settings. The proposer must have at least one California office and be a legal business entity authorized to do business in California.
The pricing terms, set asides, incumbents, funding requirements and sources, and other salient information are not provided in this document. The jurisdictions involved are Sacramento County and Sacramento City.
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Minimum Qualifications Certification As required in the RFP 24-3004, section C, Minimum Qualifications for Proposers, Proposer must complete and return this Certification, along with written evidence of how each qualification is met. All required fields must be completed to satisfy this requirement. Additional rows may be added, if necessary.
Evidence of Minimum Qualifications:
A. Provide evidence of satisfaction of Minimum Qualification C.1. by completing the table below. All requested fields must be completed in order to satisfy this Minimum Qualification.
1. As of the final date for proposal submission, Proposer must have at least three (3) consecutive years of experience within the last five (5) years:
| Type of Experience |
| Name(s) of Entity to Whom Services Were Provided |
| Brief Description of Service |
| Years of Experience |
(MM/YY – MM/YY)
| a. Researching, designing, developing, and implementing statewide application assistance services. |
| MM/YY - MM/YY |
| b. Establishing strategies to address barriers to program participation. |
| MM/YY - MM/YY |
| c. Establishing strategies to increase rates of applications that are submitted and approved. |
| MM/YY - MM/YY |
| d. Developing and maintaining effective working relationships with various stakeholders. |
| MM/YY - MM/YY |
| e. Performing data collection, evaluation of activities, and research and development of materials to build program awareness. |
| MM/YY - MM/YY |
B. Provide evidence of satisfaction of Minimum Qualification C.2. by completing the table below. All requested fields must be completed in order to satisfy this Minimum Qualification. Additional rows may be added, if necessary.
1. As of the final date for proposal submission, the Proposer must have at least three (3) years of experience within the last five (5) years of working with low-income individuals and/or the Focused Population of the CFAP Expansion, including immigrants and undocumented individuals, in community-based settings similar to the size and scope of the services required in Exhibit 2, Sample Agreement, Exhibit A, Scope of Work.
| Name of Public Entity Served |
| Brief Description of Services |
| Years of Experience |
(MM/YY – MM/YY)
| MM/YY - MM/YY |
| MM/YY - MM/YY |
C. Provide evidence of satisfaction of Minimum Qualification C.3. by completing the appropriate check box below. All requested fields must be completed in order to satisfy this Minimum Qualification.
1. Proposer must provide evidence that it has at least one (1) California office, or prior to execution of the awarded agreement, will establish and maintain at least one California office, and will provide services through this location. All travel expensed must be charged on the premise that travel commences from the California office location.
|_| Proposer certifies that it has at least one (1) California office, and will provide services through this location.
California Office Address
|_| Or, prior to execution of the awarded agreement, Proposer certifies that it will establish and maintain at least one (1) California office, and will provide services through this location.
D. Provide evidence of satisfaction of Minimum Qualification C.4. by completing the appropriate check box below and completing the table below as applicable. All applicable fields must be completed in order to satisfy this Minimum Qualification. Additional rows may be added, if necessary.
1. Proposer must be a legal business entity authorized to do business in the State of California. A business license from the city/county in which the Proposer’s California-based office(s) are located shall be submitted with the proposal. All business based in unincorporated areas are required to submit signed proof of “exempted” business license status from the city or county, if applicable.
|_| Proposer certifies that it is a legal business entity authorized to do business in the State of California and has submitted the business license from the city/county in which the Proposer’s California based office(s) are located.
| State of California Business License Number |
| Issue Date |
| Date of Expiration |
| MM/YY |
|_| Proposer certifies that it is a legal business entity authorized to do business in the State of California, is based in an unincorporated area, and has submitted signed proof of “exempted” business license status from the city or county, if applicable.
E. Provide evidence of satisfaction of Minimum Qualification C.5. by completing the table below OR selecting the appropriate check box as applicable. All requested fields must be completed in order to satisfy this Minimum Qualification.
1. All non-public organizations must be registered with the California Secretary of State as verified by the Secretary of State’s website: http://www.sos.ca.gov/business/, or registered and in good standing in another State and qualified to conduct business in the State of California in compliance with the California Corporations Code Section 2105.
| SOS Entity File Number |
| SOS Status |
|_| Not applicable; Proposer is a governmental entity.
F. Provide evidence of satisfaction of Minimum Qualification C.6. by completing the appropriate check box below. All applicable fields must be completed in order to satisfy this Minimum Qualification.
1. All non-public organizations must submit a copy of their latest audit report from an independent certified public accountant. Any noted audit exception must be explained. This report cannot be more than 12 months old at the time of submission.
|_| Proposer certifies that it has submitted a copy of their latest audit report from an independent certified public accountant which is not more than 12 months old as of the final date for bid submission.
|_| Not applicable; Proposer is a governmental entity.
Proposer certifies this response fulfills the Minimum Qualifications outlined by signing below.
California Public Employee’s Retirement System PBM Solicitation No. 2015-7755 Attachment B, Exhibit 1
Request for Proposal No. 2014-7233 Attachment A, Exhibit 1
| RFP 24-3004 | Attachment 2 |
| California Department of Social Services | Page 2 of 4 |
Authorized Signature
Name of Firm
Name and Title (Please Print)
Date image1.png image2.png image3.png image4.png
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