Business Reference Form~21.docx
DOCX document 45 KB Posted
- Attached to
- Community Empowerment and Crisis Response Services Master Agreement Request for Application
- Solicitation number
- BD-24-1022-DMH08-8210C-93112
- Issued by
- Massachusetts
About this file
The document is a Business Reference Form related to a Request for Response (RFR) issued by the Massachusetts Department of Mental Health (DMH). The RFR seeks to establish a pool of qualified vendors from which DMH can purchase community empowerment and crisis response services on an as-needed basis to address the immediate and long-term mental health needs of communities exposed to trauma. The form requires bidders to provide a minimum number of business references, which will be contacted to confirm the bidder's abilities and qualifications as stated in the response. Bidders must not include Massachusetts state agencies as references, but if they have provided services to a Massachusetts agency in the last three years, they must provide additional details about the services and a point of contact.
The document does not provide details about pricing terms, set asides, incumbents, funding requirements and sources, or other salient information. The focus is on the business reference requirements for the RFR.
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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 .