Attachment C Reference Form_1.docx

DOCX document 38 KB Posted

Attached to
DPH | Institutional Master Plan Consulting Service
Solicitation number
SFGOV-0000011940
Issued by
California

About this file

This is a Reference Form attachment for a Request for Proposals issued by the San Francisco Department of Public Health (SFGOV-0000011940) for Institutional Master Plan Consulting Services. The form requires bidders to provide three completed references documenting prior work experience as either prime contractors or subcontractors. For each reference, bidders must supply the name of the firm that provided products or services, the organization that received those services, a contact name and title with email and phone number, the contract effective and end dates, the contract value, and a description of the products or services provided. The RFP timeline includes a pre-proposal conference on September 18, 2026, a deadline for questions on September 25, 2026, an estimated Q&A addendum posting on October 2, 2026, and a proposal submission deadline of October 13, 2026 at 2:00 PM PT. The estimated award announcement is scheduled for November 2026, with an estimated contract start date of June 1, 2027.

The reference form does not address pricing, set-asides, or funding details, as it is a supporting document designed solely to collect evidence of bidder qualifications and past performance. All fields on the form are mandatory, and the completed reference form must be submitted as part of Electronic File #2 with the proposal response. This document serves as a qualification and evaluation tool to assess bidder experience in providing similar consulting services related to hospital Institutional Master Plan reviews.

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Other files

File Type Posted
Attachment B Non-Collusion Affidavit Form.docx DOCX document
Attachment I Cost Proposal Form.xlsx XLSX spreadsheet
Attachment F MCO Declaration Form.pdf PDF
Attachment A Contact Information Cover Sheet_1.docx DOCX document
Attachment G HCAO Declaration Form.pdf PDF
Attachment G HCAO Declaration Form_1.pdf PDF
Attachment M City's Contract Terms.pdf PDF
Attachment M City's Contract Terms_1.pdf PDF
Attachment N COI Acknowledgement Form.docx DOCX document
Attachment E CMD LBE Form 2A.pdf PDF
RFP_11940_Institutional_Master_Plan_Consulting_Services_v2.pdf PDF
Attachment F MCO Declaration Form_1.pdf PDF
Attachment N COI Acknowledgement Form_1.docx DOCX document
DPH___Institutional_Master_Plan_Consulting_Service.pdf PDF
Attachment D 12L Compliance.docx DOCX document
Attachment H First Source.pdf PDF
Attachment H First Source_1.pdf PDF
Attachment E CMD LBE Form 2A_1.pdf PDF
DPH___Institutional_Master_Plan_Consulting_Service.xml XML file
Attachment B Non-Collusion Affidavit Form_1.docx DOCX document
Attachment C Reference Form.docx DOCX document
Attachment A Contact Information Cover Sheet.docx DOCX document
RFP_11940_IMP_Consulting_Services_Addendum.pdf PDF
Attachment D 12L Compliance_1.docx DOCX document
Attachment I Cost Proposal Form_1.xlsx XLSX spreadsheet
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Text version

Attachment C Reference Form Request for Proposals SFGOV-0000011940 Institutional Master Plan Consulting Services All fields are required. This form must be completed and included with Electronic File #2.

Reference 1 Name of Firm that Provided Products/Services to Reference (Prime or Subcontractor's Name): Click or tap here to enter text.

Organization Name: Click or tap here to enter text.

Contact Name and Title: Click or tap here to enter text.

Email: Click or tap here to enter text.

Phone Number: Click or tap here to enter text.

Effective Date of Contract: Click or tap here to enter text.

End Date of Contract: Click or tap here to enter text.

Value of Contract: Click or tap here to enter text.

Description of Products/Services Provided: Click or tap here to enter text.

Reference 2 Name of Firm that Provided Products/Services to Reference (Prime or Subcontractor's Name): Click or tap here to enter text.

Organization Name: Click or tap here to enter text.

Contact Name and Title: Click or tap here to enter text.

Email: Click or tap here to enter text.

Phone Number: Click or tap here to enter text.

Effective Date of Contract: Click or tap here to enter text.

End Date of Contract: Click or tap here to enter text.

Value of Contract: Click or tap here to enter text.

Description of Products/Services Provided: Click or tap here to enter text.

Reference 3 Name of Firm that Provided Products/Services to Reference (Prime or Subcontractor's Name): Click or tap here to enter text.

Organization Name: Click or tap here to enter text.

Contact Name and Title: Click or tap here to enter text.

Email: Click or tap here to enter text.

Phone Number: Click or tap here to enter text.

Effective Date of Contract: Click or tap here to enter text.

End Date of Contract: Click or tap here to enter text.

Value of Contract: Click or tap here to enter text.

Description of Products/Services Provided: Click or tap here to enter text.

File details come from the government source that posted it. Updated .