Attachment B- Experience~1.docx
DOCX document 36 KB Posted
- Attached to
- Veterans Benefit Mngmnt System DVA
- Solicitation number
- 27-448DOIT-APP44-B-53273
- Issued by
- Illinois
About this file
This is an experience qualification form (Attachment B) for a state and local contract opportunity issued by the Illinois Department of Innovation and Technology on behalf of the Department of Veterans Affairs for a Veterans Benefit Management System. The document serves as a template for offerors and subcontractors to document their relevant experience on similar projects. The form requires submission of multiple project references, with sections for both prime contractor experience (Attachment B.1) and subcontractor experience (Attachment B.2), allowing offerors to demonstrate up to two projects per category.
For each project referenced, offerors must provide detailed information including the project name, client name and address, scope of work, role (prime, sub, or other), duration of engagement, annual contract value, and type of system or services provided. The form specifically identifies relevant experience categories such as Laboratory Information Management Systems, solution hosting experience, and state government programs, with narrative response fields requiring offerors to elaborate on their qualifications. Each project reference requires contact information for verification purposes, and the template accommodates multiple project examples to establish the offeror's capability and experience in delivering similar systems and services to state and local government clients.
View the file
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| Vendor Disclosure formerly Forms A~1.docx | DOCX document | |
| Exhibit 3- Reports.pdf | ||
| Attachment D- State of Illinois Standard Security Requirements~1.pdf | ||
| C2D vendor-guidance~1.pdf | ||
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Text version
Attachment B Relevant Offeror and Subcontractor Experience Attachment B.1 Offeror Experience Project Name: Click here to enter text.
Client Name and Address:
Click here to enter text.
Exact Primary Scope of Offeror’s Contract with this Client:
Click here to enter text.
Offeror’s Role (prime, sub, other):
Click here to enter text.
Years Engaged:
Click here to enter text.
Actual or Estimated Annual Contract Value:
Click here to enter text.
Type of System/Services Included in the Contract Scope:
☐ Laboratory Information Management System ☐ Solution Hosting Experience ☐ Other Systems or Services (please describe) Programs Included in the Contract Scope:
☐ Laboratory ☐ State government program ☐ Other Program (please describe)
Contact Name and Title:
Click here to enter text.
Contact Phone and Email:
Click here to enter text.
1.
Offeror Narrative Response: Click here to enter text.
2.
Offeror Narrative Response:
3.
Offeror Narrative Response: Click here to enter text.
4.
Offeror Narrative Response: Click here to enter text.
Project Name: Click here to enter text.
Client Name and Address:
Click here to enter text.
Exact Primary Scope of Offeror’s Contract with this Client:
Click here to enter text.
Offeror’s Role (prime, sub, other):
Click here to enter text.
Years Engaged:
Click here to enter text.
Actual or Estimated Annual Contract Value:
Type of System/Services Included in the Contract Scope:
☐ Solution Hosting Experience ☐ Other Systems or Services (please describe) Programs Included in the Contract Scope:
☐ Laboratory ☐ State government program ☐ Other Program (please describe)
Contact Name and Title:
Click here to enter text.
Contact Phone and Email:
Click here to enter text.
1.
Offeror Narrative Response: Click here to enter text.
2.
Offeror Narrative Response:
3.
Offeror Narrative Response: Click here to enter text.
4.
Attachment B.2- Subcontractor Experience (If applicable) Project Name: Click here to enter text.
Client Name and Address:
Click here to enter text.
Exact Primary Scope of Offeror’s Contract with this Client:
Click here to enter text.
Offeror’s Role (prime, sub, other):
Click here to enter text.
Years Engaged:
Click here to enter text.
Actual or Estimated Annual Contract Value:
Type of System/Services Included in the Contract Scope:
☐ Solution Hosting Experience ☐ Other Systems or Services (please describe) Programs Included in the Contract Scope:
☐ Laboratory ☐ State government program ☐ Other Program (please describe)
Contact Name and Title:
Click here to enter text.
Contact Phone and Email:
Click here to enter text.
5.
Offeror Narrative Response: Click here to enter text.
6.
Offeror Narrative Response:
7.
Offeror Narrative Response: Click here to enter text.
8.
Project Name: Click here to enter text.
Client Name and Address:
Click here to enter text.
Exact Primary Scope of Offeror’s Contract with this Client:
Click here to enter text.
Offeror’s Role (prime, sub, other):
Click here to enter text.
Years Engaged:
Click here to enter text.
Actual or Estimated Annual Contract Value:
Type of System/Services Included in the Contract Scope:
☐ Solution Hosting Experience ☐ Other Systems or Services (please describe) Programs Included in the Contract Scope:
☐ Laboratory ☐ State government program ☐ Other Program (please describe)
Contact Name and Title:
Click here to enter text.
Contact Phone and Email:
Click here to enter text.
5.
Offeror Narrative Response: Click here to enter text.
6.
Offeror Narrative Response:
7.
Offeror Narrative Response: Click here to enter text.
8.
File details come from the government source that posted it. Updated .