Business Reference Form~19.docx
DOCX document 45 KB Posted
- Solicitation number
- BD-23-1022-DMH08-8210C-81963
- Issued by
- Massachusetts
About this file
The document is a Business Reference Form for a Request for Response (RFR) issued by the Massachusetts Department of Mental Health (DMH) to establish a pool of individuals and non-profit corporations to provide guardianship and/or conservatorship services for individuals receiving services from or paid for by DMH. The form requires bidders to provide a minimum of Insert number here business references, which will be contacted to confirm the bidder's abilities and qualifications. The RFR is titled "Guardianship Services Master Agreement Request for Response" and the bidder must provide information such as the RFR name/title, RFR number, reference name, contact information, and a description of the commodities/services provided and the dates of service.
The RFR does not provide any specific details on pricing terms, set asides, incumbents, funding requirements and sources, or other salient information. The document focuses solely on the business reference requirements for the bidder's response.
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Other files
| File | Type | Posted |
|---|---|---|
| Guardian Services RFR_1-2023 Final~1.docx | DOCX document | |
| Guardianship Services Master Agreement RFR Qualified Vendors.xlsx | XLSX spreadsheet | |
| Guardianship Services RFR Questions and Answers.xlsx | XLSX spreadsheet | |
| OSD Required Specifications for Commodities and Services~8.docx | DOCX document | |
| RFR Cover Sheet for Guardianship MA RFR_.pdf | ||
| DMH SOW template Guardianship RFR final1-23.docx | DOCX document | |
| FY23 Guardianship Service Encounter Form V1.xls | XLS spreadsheet | |
| First Amendment Guardianship Master Agreement RFR.docx | DOCX document | |
| OSD Instructions for Vendors Responding to Bids via Commbuys~49.docx | DOCX document | |
| Commonwealth Standard Contract Instructions_Contractor Certifications_Terms~14.pdf | ||
| Contractor Authorized Signatory Listing Form~18.doc | DOC document | |
| Electronic Funds Transfer Sign Up Form~25.pdf | ||
| MA Form_W-9~28.pdf |
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Text version
Business Reference Form
Reference Guidelines The bidder must provide Insert number here business references.
References will be contacted to confirm the bidder’s abilities and qualifications as stated in the bidder’s response. The department may deem the bidder’s response unresponsive if a reference is not obtainable from a listed reference after reasonable attempts.
Do not include Massachusetts state agencies as references. If the provider has provided services to a Massachusetts agency in the last three (3) years, provide as an attachment to this form the following: the name of the agency; a description of the services provided; the dates the services were provided and a name and telephone number for a person at that agency who may be most familiar with the bidder’s work.
Request for Response (RFR) Information
| Bidder: | Click here to enter text. | |
| RFR Name/Title: | Click here to enter text. | |
| RFR Number: | Click here to enter text. |
Reference Information
| Reference Name: | Click here to enter text. | Contact: | Click here to enter text. | ||
| Address: | Click here to enter text. | Email Address: | Click here to enter text. | ||
| Phone Number: | Click here to enter text. | Fax/Other Number: | Click here to enter text. |
Description and dates(s) of commodities/services provided: Click here to enter text.
| Reference Name: | Click here to enter text. | Contact: | Click here to enter text. | ||
| Address: | Click here to enter text. | Email Address: | Click here to enter text. | ||
| Phone Number: | Click here to enter text. | Fax/Other Number: | Click here to enter text. |
| Reference Name: | Click here to enter text. | Contact: | Click here to enter text. | ||
| Address: | Click here to enter text. | Email Address: | Click here to enter text. | ||
| Phone Number: | Click here to enter text. | Fax/Other Number: | Click here to enter text. |
Sensitivity Level: Low
File details come from the government source that posted it. Updated .