Attachment_4_-_Customer_References.xlsx
XLSX spreadsheet 32 KB Posted
- Solicitation number
- 5249923
- Issued by
- California
About this file
This document is an attachment for a solicitation issued by the California Department of General Services, Procurement Division (DGS-PD) Master Agreements Unit 1 (MAU1) for Temporary Healthcare Staffing Services. The solicitation requests customer references from proposers for the various temporary healthcare provider personnel (THPP) classifications they are proposing, including Audiologist, Clinical Social Worker, Dental Assistant, Registered Dental Assistant, Registered Dietician, Clinical Laboratory Technologist, Medical Assistant, Registered Nurse, Optometrist, Pharmacist, Podiatrist, Nurse Practitioner, Physician, Psychologist, Psychiatric Technician, Radiologic Technologist, Occupational Therapist, Physical Therapist, Recreation Therapist, Rehabilitation Therapist, Respiratory Care Practitioner, and Speech Pathologist. Proposers must submit a minimum of two customer references for each proposed Healthcare Group. The customer references may be contacted for verification.
The document provides detailed instructions for proposers to complete the customer reference spreadsheet, including entering their legal entity name, the customer contact information, and the THPP classifications for which each reference is being provided. Proposers are required to email the customer reference Microsoft Form link to each referenced customer and copy the MSA Solicitations email address. The document also includes an email template for proposers to use when contacting customer references.
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Instructions
| Department of General Services, Procurement Division (DGS-PD) | |
| Master Agreements Unit 1 (MAU1) | |
| Temporary Healthcare Staffing Services Solicitation | Event ID: 5249923 | |
| Attachment 4 - Customer References | |
| PROPOSER NAME: | |
| CUSTOMER REFERENCE - INSTRUCTIONS | |
| Workbook Information: | - Proposers must not alter this workbook. |
| - Some cells have been locked to maintain the integrity of the workbook. | |
| - Review all instructions prior to filling out any worksheets within this workbook. | |
| Requirement: | - Per RFP Section 3.6.2, Proposers must submit a customer reference for each Temporary Healthcare Provider Personnel (THPP) Classification they are prosing. |
| - Proposers must submit a minimum of two customer references for each proposed Healthcare Group. | |
| - Per RFP Section 3.6.3, customer references may be contacted for verification. | |
| Instructions: | - Enter the Proposer's legal entity name in cell "B5" and complete the Customer References spreadsheet. |
| - Additional instructions are identified within the Customer References tab. | |
| - Refer to Request for Proposal (RFP) for more information. |
Customer References
| Department of General Services, Procurement Division (DGS-PD) | |||||
| Master Agreements Unit 1 (MAU1) | |||||
| Temporary Healthcare Staffing Services Solicitation | |||||
| Attachment 4 - Customer References | |||||
| PROPOSER: | |||||
| PROPOSER TO COMPLETE SPREADSHEET BELOW | |||||
| Additional Instructions - PART 1: | - Using the spreadsheet below, enter the contact information for each customer reference that will be included in the submitted proposal. | ||||
| - All customer references listed must meet the minimum requirements as stated in RFP Section 3.6.2. | |||||
| - If proposing on a Healthcare Group, a customer reference must be provided for EACH Classification within the Healthcare Group. | |||||
| - Column D contains cells with a drop-down menu of all the possible Classifications. (Click each cell to view the drop-down options.) | |||||
| - Ensure the emails entered below are accurate. | |||||
| - A single customer may provide a reference for multiple Classifications. | |||||
| Additional Instructions - PART 2: | - Once the customer reference list is completed, the Proposer must complete the steps listed below to ensure customer references are collected and verified correctly: | ||||
| - NOTE: Proposers are recommended to use the Email Template (tab) provided, but may add additional information to their correspondence. | |||||
| 1. For every customer providing a reference, the Proposer must email the solicitation Microsoft Customer Reference Form link to each customer. | Customer Reference MS Form Link: | https://forms.office.com/g/PhYmjd219z | |||
| 2. The MSA Solcitations email MUST be cc'd in the email to the customer reference to be validated. | MSA Solicitations Email Address: | MSASolicitations@dgs.ca.gov | |||
| 3. In the email to the customer, clearly identify the list of classifications the customer is providing a reference for, as identified in the Email Template (tab). | |||||
| 4. Once all email addresses are entered in Column B, use the "SEND CUSTOMER REFERENCE EMAIL" hyperlink(s) in Column E to create the email to the customer. | |||||
| Subject: | |||||
| Temporary Healthcare Staffing Services Solicitation, Event ID: 5249923 | Customer Reference (Action Required) | |||||
| Email Instructions: | |||||
| Paste email body template here | |||||
| CUSTOMER FULL NAME | CUSTOMER EMAIL | CUSTOMER AGENCY / COMPANY NAME | THPP CLASSIFICATION REFERENCE IS FOR | LINK TO SEND EMAIL TO REFERENCE | DETAILS (OPTIONAL) |
Berrios, Kayla@DGS: Details (Optional): Proposers may use this column to provide any additional information or details regarding their reference.
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
| Enter Customer Full Name | Enter Customer Email | Enter Customer Agency / Company Name | Select Classification | SEND CUSTOMER REFERENCE EMAIL | Enter details / notes. |
mailto:MSASolicitations@dgs.ca.govhttps://forms.office.com/g/PhYmjd219z Email Template
| Subject: | Temporary Healthcare Staffing Services Solicitation, Event ID: 5249923 | Customer Reference (Action Required) |
| Body: | Hello- |
My entity is proposing on a solicitation for Temporary Healthcare Staffing Services (THSS). I have identified you as a customer reference for similar services that have been previously provided by our entity. Please use the following link to complete the Customer Reference Form (CRF) and provide a customer reference for the services mentioned in this email by (PROPOSER TO ENTER A DUE DATE FOR THEIR REFERENCE HERE.): https://forms.office.com/g/PhYmjd219z
Identified Classifications (Select the classifications listed in this email for CRF Question 9): PROPOSER: ENTER THE LIST OF ALL RELEVANT CLASSIFICATIONS THAT THE CUSTOMER IS PROVIDING A REFERENCE FOR HERE. (RECOMMENDED TO COPY-PASTE FROM ATTACHMENT 4 - CUSTOMER REFERENCE TABLE).
Proposer Name (Enter in CRF Question 5): PROPOSER: ENTER THE PROPOSING ENTITY NAME HERE. (ENSURE THIS IS THE SAME NAME USED FOR ALL REFERENCES.)
Proposer Email (Enter in CRF Question 6): PROPOSER: ENTER THE EMAIL ADDRESS THAT WILL RECEIVE A COPY OF THE CUSTOMER REFERENCE SUBMISSION CONFIRMATION FILE.
Thank you!
Healthcare Groups - KEY
| Healthcare Group | Service Type | THPP Classification | Data Validation Option |
| Select Classification | |||
| 1 | Audiologist Services | Audiologist | 1 - Audiologist |
| 2 | Clinical / Social Services | Clinical Social Worker | 2 - Clinical Social Worker |
| 3 | Dental Services | Dental Assistant | 3 - Dental Assistant |
| 3 | Dental Services | Dental Laboratory Technician | 3 - Dental Laboratory Technician |
| 3 | Dental Services | Dentist | 3 - Dentist |
| 4 | Registered Dental Services | Registered Dental Assistant | 4 - Registered Dental Assistant |
| 4 | Registered Dental Services | Registered Dental Hygienist | 4 - Registered Dental Hygienist |
| 5 | Dietetic Services | Dietetic Technician | 5 - Dietetic Technician |
| 5 | Dietetic Services | Dietetics Assistant Director | 5 - Dietetics Assistant Director |
| 5 | Dietetic Services | Dietetics Director | 5 - Dietetics Director |
| 5 | Dietetic Services | Registered Dietician | 5 - Registered Dietician |
| 6 | Laboratory Services | Clinical Laboratory Technologist | 6 - Clinical Laboratory Technologist |
| 6 | Laboratory Services | Laboratory Assistant | 6 - Laboratory Assistant |
| 6 | Laboratory Services | Laboratory Assistant (Phlebotomist) | 6 - Laboratory Assistant (Phlebotomist) |
| 7 | Medical Support Services | Medical Assistant | 7 - Medical Assistant |
| 8 | Nursing Services | Certified Nursing Assistant (CNA) | 8 - Certified Nursing Assistant (CNA) |
| 8 | Nursing Services | Licensed Vocational Nurse (LVN) | 8 - Licensed Vocational Nurse (LVN) |
| 8 | Nursing Services | Registered Nurse (RN) | 8 - Registered Nurse (RN) |
| 9 | Optometry Services | Optometrist | 9 - Optometrist |
| 10 | Pharmacy Services | Pharmacist I | 10 - Pharmacist I |
| 10 | Pharmacy Services | Pharmacist II | 10 - Pharmacist II |
| 10 | Pharmacy Services | Pharmacy Technician | 10 - Pharmacy Technician |
| 11 | Podiatry Services | Podiatrist | 11 - Podiatrist |
| 12 | Primary Care Services | Nurse Practitioner (NP) | 12 - Nurse Practitioner (NP) |
| 12 | Primary Care Services | Physician | 12 - Physician |
| 12 | Primary Care Services | Physician Assistant | 12 - Physician Assistant |
| 13 | Psychology Services | Psychologist | 13 - Psychologist |
| 14 | Psychology Services - Clinical | Psychologist (Clinical) | 14 - Psychologist (Clinical) |
| 15 | Psychiatry Services | Psychiatric Technician | 15 - Psychiatric Technician |
| 15 | Psychiatry Services | Psychiatrist | 15 - Psychiatrist |
| 16 | Psychiatry Services - Correctional | Psychiatrist (Correctional) | 16 - Psychiatrist (Correctional) |
| 17 | Psychiatry Services - Nursing | Nurse Practitioner (Psychiatric) | 17 - Nurse Practitioner (Psychiatric) |
| 18 | Radiology Services | Radiologic Technologist | 18 - Radiologic Technologist |
| 19 | Social Services - Behavioral | Behavior Specialist I | 19 - Behavior Specialist I |
| 19 | Social Services - Behavioral | Behavior Specialist II | 19 - Behavior Specialist II |
| 20 | Therapy Services - Occupational | Occupational Therapist | 20 - Occupational Therapist |
| 20 | Therapy Services - Occupational | Occupational Therapy Assistant | 20 - Occupational Therapy Assistant |
| 21 | Therapy Services - Physical | Physical Therapist I | 21 - Physical Therapist I |
| 21 | Therapy Services - Physical | Physical Therapist II | 21 - Physical Therapist II |
| 21 | Therapy Services - Physical | Physical Therapy Assistant | 21 - Physical Therapy Assistant |
| 22 | Therapy Services - Recreational | Recreation Therapist | 22 - Recreation Therapist |
| 23 | Therapy Services - Rehabilitation | Rehabilitation Therapist | 23 - Rehabilitation Therapist |
| 24 | Therapy Services - Respiratory | Respiratory Care Practitioner | 24 - Respiratory Care Practitioner |
| 25 | Therapy Services - Speech | Speech Pathologist I | 25 - Speech Pathologist I |
| 25 | Therapy Services - Speech | Speech Pathologist II | 25 - Speech Pathologist II |
File details come from the government source that posted it. Updated .