DCR-889 - Bidder Response Form.pdf

DCR 889

Pool Operator Training & Materials

BIDDER RESPONSE FORM

INSTRUCTIONS: Please complete this form electronically by typing directly into the boxes or clicking on checkboxes.

Submission of a completed Bidder Response Form is MANDATORY. Be sure to read the instructions for each section carefully and thoroughly. Responses found to be incomplete may be disqualified or excluded from evaluation. If additional space is needed to answer any of the questions included on this Bidder Response Form, you may attach additional pages to complete your responses. However, please start answering all questions directly on this Bidder Response Form and only attach additional pages if extra space is needed. Be sure to label any attachments accordingly to correspond to specific questions on this Bidder Response Form.

Bidder/Company Name:

Mailing Address:

(Street Address)

(City/Town) (State) (Zip Code)

Point of Contact Name:

Phone Number:

Email Address:

Please specify the number of years your organization/company has been in business:

Certifications: Please indicate which certifications your organization/company currently possesses. All certifications must be valid and copies of all certifications for all relevant staff must be submitted prior to training:

Check below if Copies of Instructor Certifications are Included/Submitted with Bid Response

Aquatic Facility Operator Certified Pool Operator Practical Pool Management PLUS (PPM+)

Check below if Copies of Instructor Certifications will be Provided Prior to Training Aquatic Facility Operator Certified Pool Operator Practical Pool Management PLUS (PPM+)

Experience Providing Similar Services: Please use the spaces below to describe your organization/company’s past or current experience providing services of a similar/equivalent nature to those outlined in the RFR. Specifically, provide examples that demonstrate your organization/company’s experience with regard to conducting the desired training services. Bidders must provide at least one (1) example but are encouraged to provide up to three (3) examples.

EXPERIENCE 1:

EXPERIENCE 2:

EXPERIENCE 3:

Qualifications and Capacity to Provide Goods & Services: Please describe your organization/company’s qualifications and capacity to provide the training services outlined in the RFR.

Provision of Qualified Staff: Please use the spaces below to list all relevant staff at your organization/company with the necessary qualifications to perform the training services outlined in the RFR. Also, please use the space provided to describe their education, background, experience, and qualifications.

Staff Person 1:

Name: Title/Position:

Education, Background, Experience, & Qualifications:

Staff Person 2:

Staff Person 3:

Staff Person 4:

Geographic Service Areas: Please indicate which Massachusetts counties your organization/company can provide service to:

Please check this box only if your organization/company can provide service throughout the entire Commonwealth of Massachusetts.

If your organization/company is not able to service the entire Commonwealth of Massachusetts, please indicate which counties you are able to provide service. A map of Massachusetts counties is provided on the last page of this Bidder Response Form.

Berkshire County Middlesex County Plymouth County

Franklin County Essex County Barnstable County

Hampshire County Suffolk County Dukes County

Hampden County Norfolk County Nantucket County

Worcester County Bristol County https://ballotpedia.org/Berkshire_County,_Massachusetts https://ballotpedia.org/Middlesex_County,_Massachusetts https://ballotpedia.org/Plymouth_County,_Massachusetts https://ballotpedia.org/Franklin_County,_Massachusetts https://ballotpedia.org/Essex_County,_Massachusetts https://ballotpedia.org/Barnstable_County,_Massachusetts https://ballotpedia.org/Hampshire_County,_Massachusetts https://ballotpedia.org/Government_of_Suffolk_County,_Massachusetts https://ballotpedia.org/Dukes_County,_Massachusetts https://ballotpedia.org/Hampden_County,_Massachusetts https://ballotpedia.org/Norfolk_County,_Massachusetts https://ballotpedia.org/Nantucket_County,_Massachusetts_(Judicial) https://ballotpedia.org/Worcester_County,_Massachusetts https://ballotpedia.org/Bristol_County,_Massachusetts

Minimum and Maximum Class Sizes: Please use the space below to indicate any minimum and/or maximum classes sizes:

Course Name/Description

Minimum Number of Students

Maximum Number of Students

Comments (If Necessary)

Pricing/Rates: Bidders must submit pricing for any products or courses they intend to bid on. Prices should be listed as Price Per Unit OR Price Per Course, but not both. For example, a bidder providing only instructional materials (books, exams, certifications) should list out each product along with Price Per Unit. Bidders providing instructors to teach courses should list the course name and identify whether cost is per unit/student (use Price per Unit) or a flat rate per course (use Price Per Course). Rates must be inclusive of all training equipment, materials, books, handouts and exams for students as well as travel-related expenses. Vendors must submit a copy of their current Schedule of Rates/Rate Sheet with their proposal. Please use the space below to provide your rates:

Course Name/ Product Description

Quantity (or Range of Quantities)

Price Per Unit Price Per

Course Comments

$ OR $

Pricing for Re-Testing: Please use the space below to provide your rates for any student that may require a re-test:

Course Name/Description Rate Per Student Comments

Other Documents, Forms, & Materials: Bidders must also submit the following documents, forms, & materials:

• Copies of Current/Valid Instructor Certifications (or assurance that these will be submitted prior to any scheduled training course)

• Schedule of Rates/Rate Sheet

• Prompt Payment Discount (PPD) Form – see Attachments Tab of the CommBuys bid solicitation

• Environmentally Preferable Products/Practices (EPP) Form – see Attachments Tab of the CommBuys bid solicitation

• Massachusetts W-9 Form

Affirmation: By entering my name and information below, I hereby affirm that I have read, agree to, and will abide by (if awarded a contract) all of the terms and conditions outlined in the Request for Responses (RFR) associated with this procurement and that the information provided in this Bidder Response Form is accurate and truthful.

Name Title Date

Company Name Email Address Phone Number

Company Address City/Town State Zip Code

(Massachusetts County Map on Next Page)