ATTACHMENT E Reference Questionnaire 4-5-19~3.doc

244 KB Posted

Attached to
Actuarial Services
Solicitation number
40DHHS-S697
Issued by
Churchill County, Nevada

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This document is a Reference Questionnaire for a Request for Proposal (RFP) issued by the State of Nevada for Actuarial Services. The purpose of this questionnaire is to document the experience of prospective vendors relevant to the scope of work outlined in the RFP and provide assistance in the evaluation process. The questionnaire requires proposing vendors or their subcontractors to complete Part A and/or Part B, while the business references are requested to submit the completed questionnaire directly to the State of Nevada Purchasing Division by the due date of July 16, 2019. The State may also contact the business references by phone for further clarification, if necessary.

The Reference Questionnaire covers various aspects of the vendor's services, including knowledge and expertise, flexibility, quality of deliverables, customer service, staff capabilities, billing accuracy, and problem resolution. Business references are asked to rate the vendor's performance on a scale of 0 to 10 and provide comments. The questionnaire also requests information on the time period during which the vendor provided services and the likelihood of the reference recommending the vendor to others.

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ATTACHMENT E – REFERENCE QUESTIONNAIRE

The State of Nevada requires proposing vendors to submit business references. The purpose of these references is to document the experience relevant to the scope of work identified within the RFP and provide assistance in the evaluation process.

INSTRUCTIONS TO PROPOSING VENDOR

1.
Proposing vendor or vendor’s proposed subcontractor shall complete Part A and/or Part B of the Reference Questionnaire.
2.
Proposing vendor shall send the Reference Questionnaire to each business reference listed for completion of Part D, Part E and Part F.
3.
Business reference is requested to submit the completed Reference Questionnaire via email or facsimile to:

State of Nevada, Purchasing Division

Subject:

RFP 40DHHS-S697

Attention:

Purchasing Division

Email:

rlmiller@admin.nv.gov

Fax:

775-684-0188

Please reference the RFP number in the subject line of the email or on the fax.

4.
The completed Reference Questionnaire shall be received no later than 4:30 PM PT 7/16/19
5.
Business references are not to return the Reference Questionnaire to the Proposer (Vendor).
6.
In addition to the Reference Questionnaire, the State may contact any and all business references by phone for further clarification, if necessary.
7.
Questions regarding the Reference Questionnaire or process shall be directed to the individual identified on the RFP cover page.
8.
Reference Questionnaires not received, or not complete, may adversely affect the vendor’s score in the evaluation process.

State of Nevada

Steve Sisolak

Department of Administration

Governor

Purchasing Division

Deonne E. Contine

Director

515 E. Musser Street, Suite 300

Carson City, NV 89701

Kevin D. Doty

Acting Administrator

BUSINESS REFERENCE’S RESPONSE TO REFERENCE QUESTIONNAIRE FOR

STATE OF NEVADA REQUEST FOR PROPOSAL (RFP) 40DHHS-S697

ACTUARIAL SERVICES

PART A – TO BE COMPLETED BY PROPOSING VENDOR – Please type or print

Name of Company Submitting Proposal:

PART B – IF APPLICABLE, NAME OF COMPANY ACTING AS SUBCONTRACTOR

FOR VENDOR IDENTIFIED IN PART A – Please type or print

Name of Subcontractor:

PART C – BUSINESS REFERENCE INSTRUCTIONS

1.
This Reference Questionnaire is being submitted to your organization for completion as a business reference for the company listed in Part A or Part B, above.
2.
Business reference is requested to submit the completed Reference Questionnaire via email or facsimile to:

State of Nevada, Purchasing Division

Subject:

RFP 40DHHS-S697

Attention:

Purchasing Division

Email:

rlmiller@admin.nv.gov

Fax:

775-684-0188

Please reference the RFP number in the subject line of the email or on the fax.

3.
The completed Reference Questionnaire MUST be received no later than 4:30 PM PT 7/16/19
4.
Do NOT return the Reference Questionnaire to the Proposer (Vendor).
5.
In addition to the Reference Questionnaire, the State may contact references by phone for further clarification, if necessary.
6.
Questions regarding the Reference Questionnaire or process should be directed to the individual identified on the RFP cover page.
7.
When contacting the State, please be sure to include the RFP number listed at the top of this page.
8.
We request all questions be answered. If an answer is not known please answer as “U/K”. If the question is not applicable please answer as “N/A”.
9.
If you need additional space to answer a question or provide a comment, please attach additional pages. If attaching additional pages, please place your company/organization name on each page and reference the RFP # noted at the top of this page.

PART D – COMPANY PROVIDING REFERENCE – Please type or print

CONFIDENTIAL INFORMATION WHEN COMPLETED

Company Providing Reference:

Contact Name:

Title:

Contact Telephone:

Contact Email Address:

RATING SCALE:

Where a rating is requested and using the Rating Scale provided below, rate the following questions by noting the appropriate number for each item. Please provide any additional comments you feel would be helpful to the State regarding this contractor.

Category
Rating
Poor or Inadequate Performance
0
Below Average Performance
1 – 3
Average Performance
4 – 6
Above Average Performance
7 – 9
Excellent Performance
10

PART E – QUESTIONS:

1. In what capacity have you worked with this vendor in the past?

2. Rate the firm’s knowledge and expertise.
RATING:

Comments:

3. Rate the vendor’s flexibility relative to changes in the project scope and timelines.
RATING:

Comments:

4. Rate your level of satisfaction with hard copy materials produced by the vendor.
RATING:

Comments:

5. Rate the dynamics/interaction between the vendor and your staff.
RATING:

Comments:

6. Rate your satisfaction with the products developed by the vendor.
RATING:

Comments:

7. Rate how well the agreed upon, planned schedule was consistently met and deliverables provided on time. (This pertains to delays under the control of the vendor.)
RATING:

Comments:

8. Rate the overall customer service and timeliness in responding to customer service inquiries, issues and resolutions.
RATING:

Comments:

9. Rate the knowledge of the vendor’s assigned staff and their ability to accomplish duties as contracted.
RATING:

Comments:

10. Rate the accuracy and timeliness of the vendor’s billing and/or invoices.
RATING:

Comments:

11. Rate the vendor’s ability to quickly and thoroughly resolve a problem related to the services provided.
RATING:

Comments:

12. Rate the vendor’s flexibility in meeting business requirements.
RATING:

Comments:

13. Rate the likelihood of your company/organization recommending this vendor to others in the future.
RATING:

Comments:

14. With which aspect(s) of this vendor’s services are you most satisfied?

Comments:

15. With which aspect(s) of this vendor’s services are you least satisfied?

Comments:

16. Would you recommend this vendor to your organization again?

Comments:

PART F – GENERAL INFORMATION:

1. During what time period did the vendor provide these services for your organization?

Month/Year:

TO:
Month/Year:

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