attachment-2-rfp-2026-nhvh-01-tstaf.docx

New Hampshire Veterans Home Appendix B – Transmittal Letter and Vendor Information

TRANSMITTAL LETTER

Solicitation ID Number

Vendor Name

Vendor Address

Vendor Telephone

State of NH Vendor Code Number (required)

Date of Submission

To whom it may concern:

We hereby submit this response to the Solicitation referenced above, in complete accordance with all conditions and specifications set forth in the Solicitation.

We attest to the fact that:

1. The Vendor has read and fully understands this Solicitation and agrees to be bound by its terms, conditions, and requirements.

2. The Vendor fully understands and agrees to items listed in Section 2 – Special Provisions and Scope of Services and Appendix A - Form P-37 General Provisions and Standard Exhibits.

3. The Vendor’s Solicitation Response is effective for a period of 180 days from the Vendor Solicitation Response Due Date or until the Effective Date of any resulting Contract, whichever is later.

4. The prices, terms and conditions, and services in the Vendor’s Solicitation Response have been established without collusion with other vendors.

5. This document is signed by a person who is authorized to legally obligate the responding Vendor.

Further, in accordance with RSA 21-I:11-c, the undersigned Vendor certifies that neither the Vendor nor any of its subsidiaries, affiliates or principal officers is currently debarred from performing work on any project of the federal government or the government of any state.

Authorized Signature

Authorized Signature (printed)

Title

Telephone

Email

1. Vendor Contact Information

Primary Point of Contact Individual who will serve as the Vendor’s primary contact for all other matters relating to the Solicitation.

Name

Fiscal Contact Individual who will serve as the Vendor’s primary contact for fiscal matters.

Name

Title

Email

Telephone

2. Vendor References Provide the information requested below for three (3) individuals or organizations who have knowledge of your organization’s capability to deliver services applicable to this Solicitation. The Department may contact references at its discretion. A current Department employee will not be considered a valid reference.

Vendor Reference 1

Individual/Organization Name

Email

Telephone

Description of Work Complete

Dates of Performance

Vendor Reference 2

Individual/Organization Name

Email

Telephone

Description of Work Complete

Dates of Performance

3. Affiliations – Conflict of Interest

a. If YES, explain the relationship(s) and how the affiliation(s) would not represent a conflict of interest.

4. Executive Summary

a. Provide a general company overview:

i. Describe the company’s management, organizational structure, and history; ownership and subsidiaries; company background and primary lines of business; headquarters and satellite locations; mission statement; and number of employees.

ii. Summarize the organization’s current project commitments, as well as major government and private sector clients.

iii. Describe any strengths considered to be assets to the organization and notable company accomplishments.

b. Provide an overview of the services the Vendor intends to provide.

i. Describe the organization’s understanding of the services requested in this solicitation and any problems anticipated in accomplishing the work.

ii. Describe the organization’s familiarity with the project elements, its solutions to the problems presented and knowledge of the requested services.

iii. Summarize how the organization is capable of effectively completing the services outlined in the solicitation.

5. Pricing

Bidder hereby offers to provide mobile dental services to the NHVH in accordance with all of the requirements of this bid at the following prices for the entire contract term.

Shift Hours include: 0645-1515, 1500-2330, 2300-0700 (no differential or holiday pay in addition to hourly rates set below)

RN

Travel RN Hourly Rate: $____________

Local RN Hourly Rate: $____________

LPN

Travel RN Hourly Rate: $____________

Local RN Hourly Rate: $____________

LNA

Travel RN Hourly Rate: $____________

Local RN Hourly Rate: $____________

Other Available Services:

Position:_______________________________ Rate $___________

Position:_______________________________ Rate $___________

Position:_______________________________ Rate $___________

Position:_______________________________ Rate $___________