Attachment C Reference Form.pdf
PDF 81 KB Posted
- Attached to
- DPH | HIV Prevention CBA Program Admin Services
- Solicitation number
- SFGOV-0000011811
- Issued by
- San Francisco County, San Francisco City, California
About this file
This is a Reference Form attachment for a Request for Proposals issued by the San Francisco Department of Public Health (DPH) for HIV Prevention Capacity Building Assistance Program Administration Services (SFGOV-0000011811). Proposers must complete and submit this reference form with their proposals to demonstrate relevant experience. The form requires bidders to provide up to six references from firms (prime contractors or subcontractors) that have previously provided similar products or services. For each reference, proposers must document the firm name, organization name, contact information (name, title, email, and phone number), effective contract date, contract value, and a description of the products or services provided. The RFP was published on July 10, 2026, with a pre-proposal conference scheduled for July 23, 2026. The deadline for questions is July 30, 2026, with an estimated Q&A addendum posting on August 6, 2026. Proposals are due by 2:00 PM PT on August 13, 2026, with an estimated award announcement in September 2026 and an estimated program start date of April 1, 2027.
The Reference Form does not specify pricing terms, set-asides, or funding amounts within the attachment itself. However, the underlying contract opportunity is funded by the Centers for Disease Control and Prevention (CDC) under Funding Opportunity Announcement PS 24-0020, component D, for program administration and staffing services supporting the getSFcba capacity building assistance program in California. Completion and submission of this reference form with demonstrated relevant experience is a mandatory requirement for proposal consideration.
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Text version
ATTACHMENT “C”
REFERENCE FORM
REQUEST FOR PROPOSALS SFGOV-0000011811
HUMAN IMMUNODEFICIENCY VIRUS (HIV) PREVENTION CAPACITY BUILDING
ASSISTANCE PROGRAM ADMINISTRATION SERVICES
*THIS FORM MUST BE COMPLETED AND SUBMITTED WITH YOUR PROPOSAL*
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: Value of Contract:
Description of Products/Services Provided:
Reference 2 Name of firm that provided products/services
Organization Name: Contact and Title:
Description of products/services provided:
Reference 3 Name of firm that provided products/services
Organization Name: Contact and Title:
Description of products/services provided:
| Name of firm that provided productsservices to reference Prime or Subcontractors Name: |
| Organization Name: |
| Contact Name and Title: |
| Email: |
| Phone Number: |
| Effective Date of Contract: |
| Value of Contract: |
| Description of ProductsServices Provided: |
| Name of firm that provided productsservices to reference Prime or Subcontractors Name_2: |
| Organization Name_2: |
| Contact and Title: |
| Email_2: |
| Phone Number_2: |
| Effective Date of Contract_2: |
| Value of Contract_2: |
| Description of productsservices provided: |
| Name of firm that provided productsservices to reference Prime or Subcontractors Name_3: |
| Organization Name_3: |
| Contact and Title_2: |
| Email_3: |
| Phone Number_3: |
| Effective Date of Contract_3: |
| Value of Contract_3: |
| Description of productsservices provided_2: |
File details come from the government source that posted it. Updated .