BUSINESS REFERENCE FORMS~10.docx

DOCX document 38 KB Posted

Attached to
Employee Occupational Health Services
Solicitation number
BD-26-1053-1053C-CSR-129753
Issued by
Hampden County, Massachusetts

About this file

This is a Business Reference Form template for the Massachusetts Veterans Home at Holyoke's Request for Response (RFR) for Employee Occupational Health Services. The form establishes guidelines for bidders to submit business references that will be contacted to verify the bidder's abilities and qualifications. Bidders must provide a specified number of references, and the department reserves the right to deem a response unresponsive if a reference cannot be obtained after reasonable attempts. The RFR seeks qualified occupational health providers to perform comprehensive off-site employee occupational health and physical examinations, along with related laboratory and testing services.

The Business Reference Form requires bidders to submit contact information for each reference, including the reference name, primary contact person, address, email address, phone number, and alternative contact numbers. For each reference, bidders must describe the commodities or services provided and specify the dates during which those services were delivered. The template accommodates up to three references and is designed to support the evaluation of bidders' qualifications and past performance in providing occupational health services.

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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.

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 .