Attachment-L.-Reference-Checks.pdf
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- Attached to
- R00B7600029 - Vehicle Equipment Adaptation Prescription Agreement (VEAPA) for DORS Client (CS #26-04)
- Solicitation number
- BPM058318
- Issued by
- Maryland
About this file
Attachment L: Reference Checks - Maryland DORS Vehicle Equipment Adaptation Contract
This is a reference check form for the Division of Rehabilitation Services (DORS) in Maryland for solicitation R00B7600029, which seeks a qualified contractor to provide vehicle adaptation services for a DORS client with functional limitations due to disabilities. The form requires bidders/offerors to submit one or more references from customers for whom they have provided comparable goods or services within the timeframe specified in Section 3, Table A of the solicitation. References may overlap with those submitted to meet minimum qualifications. Each reference must include detailed company information, contact person details (name, title, phone, and email), project title, contract value, performance dates, and a comprehensive description of goods or services provided that are comparable to the solicitation requirements, including facility size and type where applicable. The form accommodates multiple references (at minimum three are requested, with space for additional references on separate pages), and all references must be reachable and willing to provide information via email or telephone.
The Procurement Officer reserves discretion to request additional references beyond those submitted or to utilize references not provided by the bidder/offeror, and may deem bidders/offerors as "Not Responsible" and reject bids/proposals if references are deemed insufficient. References serve as a basis for determining contractor responsibility and capability to perform the specified vehicle adaptation services. The effective date of this attachment is April 2024, and all reference information must be printed clearly to facilitate verification by the Procurement Officer.
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Attachment L. Reference Checks effective date: April, 2024
ATTACHMENT L. REFERENCE CHECKS.
One or more references are requested from customers who are capable of documenting the Bidder/Offeror’s ability to provide the goods or services specified in this solicitation.
References used to meet any Minimum Qualifications (see Section 1 of the IFB/RFP) may also be used to meet this reference check request.
Each reference shall be from a customer for whom the Bidder/Offeror has provided goods or services within the timeframe specified in the solicitation Section 3, Table A and shall include the information requested in the boxes below.
Information furnished in response to this Attachment and any verification made by the Procurement Officer shall provide a basis for determining the responsibility of Bidders/Offerors. The Procurement Officer reserves the right to request additional references or utilize references not provided by the Bidder/Offeror. Points of contact must be accessible and knowledgeable regarding the Bidder’s/Offeror’s performance.
In the event that references are deemed insufficient by the Procurement Officer, the Procurement Officer may determine the Bidder/Offeror to be Not Responsible, which would cause the Bid/Proposal to be rejected.
If more space is needed for the type of service provided, please list on an additional sheet. All references must be reachable and willing to furnish information by email or telephone conversation.
Please PRINT clearly.
Reference #1
Company Name:
Address:
City: State: Zip Code:
Contact Person - Name and Title:
Solicitation Title:
Solicitation Number:
Name of Company/Firm (Bidder/Offeror):
VEHICLE EQUIPMENT ADAPTATION PRESCRIPTION
AND AGREEMENT (VEAPA) FOR DORS CLIENT CS #26-04
R00B7600029
Phone No. for Contact Person:
Email Address for Contact Person:
Project Title/Type of Project:
Contract Value: $
Date(s) contract was performed:
Please describe in detail the goods or services that were provided that are comparable to the requirements in the solicitation. If requested, include the size and type of facility where goods or services were provided here.
Reference #2
Company Name:
Address:
City:
State: Zip Code:
Contact Person - Name and Title:
requirements in the solicitation. If requested, include the size and type of facility where goods or
Reference #3 requirements in the solicitation. If requested, include the size and type of facility where goods or
Reference #___ requirements in the solicitation. If requested, include the size and type of facility where goods or
Add more pages as necessary for additional references.
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