Attachment C Reference Form_1.pdf
PDF 107 KB Posted
- Attached to
- DPH | As-Needed Radiation Safety Consulting Svc
- Solicitation number
- SFGOV-0000011986
- Issued by
- California
About this file
Attachment C is a reference form supporting the Department of Public Health's Request for Proposals for as-needed radiation safety consulting services in California. The solicitation seeks experienced firms to provide qualified staff to serve as a Radiation Safety Officer, supporting regulatory compliance activities, nuclear medicine program development, audits, personnel dosimetry oversight, training, documentation management, and consultation during regulatory inspections. The RFP was published on September 11, 2026, with a deadline for questions at 5:00 PM PT on September 29, 2026, and an estimated Q&A addendum posting on October 6, 2026. The proposal submission deadline is 2:00 PM PT on October 14, 2026, with an estimated award announcement on November 13, 2026 and an estimated contract start date of March 1, 2027. A pre-proposal conference is scheduled for 11:00 AM PT on September 22, 2026, to be held via Microsoft Teams.
The reference form functions as a submission requirement for proposers bidding on this contract opportunity. Specific pricing terms, set-asides, incumbent contractor information, and detailed funding amounts are not addressed in this attachment. The contract is essential to enable DPH's continued compliance with applicable radiation safety regulations and to support the development of future radiation-producing services within the department.
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Text version
Attachment C
Reference Form
Request for Proposals SFGOV-0000011986
As-Needed Radiation Safety Consulting Services
All fields are required. This form must be completed and included with Electronic File #2.
A. Reference 1
Name of Firm that Provided Products/Services to Reference (Prime or
Subcontractor's Name):
Organization Name:
Contact Name and Title:
Email:
Phone Number:
Effective Date of Contract:
End Date of Contract:
Value of Contract:
Description of Products/Services Provided:
B. Reference 2
Name of Firm that Provided Products/Services to Reference (Prime or
Subcontractor's Name):
Organization Name:
Contact Name and Title:
Email:
Phone Number:
Effective Date of Contract:
End Date of Contract:
Value of Contract:
Description of Products/Services Provided:
C. Reference 3
Name of Firm that Provided Products/Services to Reference (Prime or
Subcontractor's Name):
Organization Name:
Contact Name and Title:
Email:
Phone Number:
Effective Date of Contract:
End Date of Contract:
Value of Contract:
Description of Products/Services Provided:
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