Attachment C Reference Form.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 Reference Form is a submission requirement for the City and County of San Francisco Department of Public Health's Request for Proposals for As-Needed Radiation Safety Consulting Services (SFGOV-0000011986). The RFP seeks qualified firms to provide a Radiation Safety Officer to support regulatory compliance, nuclear medicine program development, audits, personnel dosimetry oversight, training, and consultation during regulatory inspections. The RFP was published on September 11, 2026, with a pre-proposal conference scheduled for September 22, 2026, at 11:00 AM PT via Microsoft Teams. Questions must be submitted by 5:00 PM PT on September 29, 2026, with a Q&A addendum posted by October 6, 2026. Proposals are due by 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.
The Reference Form requires proposers to provide three completed reference sections, each documenting a prior contract where the firm provided comparable products or services. For each reference, proposers must include the name of the firm that provided services, the client organization name, contact person and title, email and phone number, contract effective and end dates, contract value, and a description of products or services provided. This documentation is required as part of Electronic File #2 submission and serves to demonstrate the proposer's relevant experience and track record in radiation safety consulting or related services.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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:
| Text1: |
| Text2: |
| Text3: |
| Text4: |
| Text5: |
| Text6: |
| Text7: |
| Text8: |
| Text9: |
| Text10: |
| Text11: |
| Text12: |
| Text13: |
| Text14: |
| Text15: |
| Text16: |
| Text17: |
| Text18: |
| Text19: |
| Text20: |
| Text21: |
| Text22: |
| Text23: |
| Text24: |
| Text25: |
| Text26: |
| Text27: |
File details come from the government source that posted it. Updated .