Business Reference Form~13.docx

This is a Business Reference Form template issued by the Massachusetts Executive Office of Health and Human Services (EOHHS) in connection with a Request for Responses (RFR) for Personal Care Attendant (PCA) Identification Card Services. The form serves as a standardized template for bidders to provide business references that will be contacted to verify the bidder's qualifications and capabilities relevant to the procurement. The document includes fields for bidder information, RFR identification details, and multiple reference entries, with each reference section requiring the organization name, contact person, address, email, phone number, facsimile or other contact number, and a description of commodities or services provided along with applicable dates. The form specifies that bidders must provide a designated number of references (to be inserted by the procuring agency), and the department reserves the right to deem a response unresponsive if any listed reference cannot be reached after reasonable attempts at contact.

The Business Reference Form contains no specific pricing information, contract terms, renewal options, set-asides, incumbent information, or funding details, as it functions solely as a reference verification tool within the broader RFR process. This template is marked with a low sensitivity level and represents a standard procurement document used by Massachusetts EOHHS to evaluate bidder experience and past performance in similar service delivery areas prior to contract award.