DMH-Business Reference Form.doc
DOC document 27 KB Posted
- Attached to
- Request for Applications-Parties Interested in Licensing Space at the Quincy Mental Health Center
- Solicitation number
- BD-26-1022-DMH05-5380-123363
- Issued by
- Norfolk County, Massachusetts
About this file
This is a Business Reference Form document from the Massachusetts Department of Mental Health (DMH) designed for use in the Request for Applications to license space at the Quincy Mental Health Center. The form requires bidders to provide up to five business references that can substantiate the bidder's abilities and qualifications relevant to the licensing opportunity. Each reference entry must include the reference name, contact person, address, phone number, and fax/internet address, along with a description and dates of commodities and services previously provided by the bidder.
The Department of Mental Health reserves the right to contact all listed references to verify the bidder's stated capabilities and experience. The department may deem a bidder's response unresponsive if a reference cannot be reached after reasonable attempts to contact. This reference verification process is a standard evaluation component for assessing bidder qualifications and determining fitness to enter into a license agreement for space utilization at the Quincy Mental Health Center facility.
View the file
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| form_contractor-authorized-signatory-listing-for-contractors~2.pdf | ||
| QMHC Space RFR_2026.docx | DOCX document | |
| Quincy MHC_A-2nd Fl.bin | BIN file | |
| form_w-9.pdf | ||
| Quincy MHC_1st Fl.bin | BIN file | |
| Quincy MHC_A-4th Fl.bin | BIN file | |
| Final Long Form State Agency License.docx | DOCX document | |
| Quincy MHC_A-3rd Fl.bin | BIN file |
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Text version
DEPARTMENT OF MENTAL HEALTH
Business Reference Form
Bidder:
RFR Name/Title:
RFR Number:
Reference name:_____________________________________ Contact:
Address: ________________________________________________ Phone: # ( )
Fax/Internet address:
Description and date(s) of commodities and services provided:
Reference name: _______________________________________Contact:
Address: _______________________________________________
Reference name: ______________________________________ Contact:
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.
Sensitivity level – low
File details come from the government source that posted it. Updated .