ESBD_424949_1748980839897_6-2-25 Applicant Survey(5211652.1).pdf

6-2-25 Applicant Survey

Applicant Survey

Instructions

1. Submit your completed Survey by August 1, 2025 at 3:00 pm Central time to psteinkraus@utsystem.edu.

The completed Survey and all accompanying materials must be scanned and attached to the email. Hard copies will not be accepted.

2. Responses to questions that require a written explanation or an attachment should be limited to three pages.

3. All policy and procedure documents responsive to the Survey questions should be attached. The application will be evaluated solely on the basis of information provided in the Survey responses. If the information is publicly accessible via the internet, a link to the location would be acceptable as an alternative to attaching the information to the Survey responses.

Organization Profile

1. Organization Name: _______________________________________________________

2. Street Address: _____________________________________________________________

City: ____________________ State: _________________ Zip Code: _________

3. Contact Person: _____________________________________________________________

4. Title: ______________________________________________________________________

5. Telephone No.: _____________________________________________________________

6. Email: ____________________________________________________________________

7. Organization Type:

___ Corporation ___ Partnership ___ Govt. Agency ___ Other

8. Years in Business: ________

9. Parent Company including affiliates and subsidiaries:

10. Federal Employer Identification Number (FEIN): ___________________

11. Provide a list of officers (name, title, and years with organization).

12. Number of Employees: _____________________ mailto:psteinkraus@utsystem.edu

13. Number of entities using your GPO contracts: _______________________

14. Provide any details of all past or pending litigation or claims filed against your organization that would affect your organization’s performance under an agreement with UT System.

15. Has your organization, or any of its parents or subsidiaries, ever had a bankruptcy petition filed in its name, voluntarily or involuntarily? If yes, specify the date, circumstances, and resolution.

16. Is your organization currently in default on any loan agreement or financing agreement with any bank, financial institution, or other entity? If yes, specify date(s), details, circumstances, and prospects for resolution.

17. Is your organization currently for sale or involved in any transaction to expand or to become acquired by another business entity? If yes, please explain the impact both in organizational and directional terms.

18. Provide your organization’s DUNS number . ____________ If you did not provide your DUNS number, please provide two financial references (one trade reference and one financial institution/bank reference).

List should include company name, mailing address, telephone number, contact person and length of financial relationship.

Contract Portfolio

Q.1 Indicate the total number of contracts and approximate spend in your portfolio that are available to entities that use your GPO contracts:

Number: _____________ Total Spend: $________________

Your response should include a listing of the commodities/categories (e.g., IT, Telecom, Clinical/Patient

Care, Research, Business & Administrative, Facilities, etc.) covered by your contract portfolio and the number of contracts per each category.

Q.2 Of the total number of contracts indicated in Q.1, what percentage of these contracts were competitively bid and awarded by your organization? _____________

Q.3 Of the total number of contracts indicated in Q.1, what percentage of these contracts were competitively bid and awarded by an entity that uses your contracts? ___________

Q.4 Of the total number of contracts indicated in Q.1, what percentage of these contracts were competitively bid and awarded by others (e.g., an entity or organization that does not use your contracts)? __________

Q.5 Of the total number of contracts indicated in Q.1, what percentage of these contracts were purely a negotiated arrangement (i.e., not competitively awarded)? ________

Q.6 What are your criteria for awarding a contract on a purely negotiated/non-competitive basis? Please explain.

Q.7 Of the total number of contracts indicated in Q.1, what percentage of these contracts are multi-sourced

(multiple awards)? ___________________

Q.8 What are your criteria for awarding multi-source contracts versus single-source award? Please explain.

For multi-source contracts, do you provide any guidance to the purchaser or require that more than one available supplier be considered? If so, please describe or attach a copy of the guidance or requirements.

Q.9 Do you have a mandatory term limit on your contract awards? ___ Y ___ N

Q.10 If you answered Yes to question Q.9, check the box below that most closely aligns with your mandatory term limit contract

___ 3 Years ___ 5 Years ___ 7 Years ___ 10 Years ___>10 Years

Q.11 What percentage of your contracts in Q.1 were awarded to minority, small, women- owned and/or disadvantaged suppliers ? _____%

Sourcing Process

Q.12 For those contracts competitively bid and awarded by your organization, answer the following:

Q.12.1 Are your solicitations publically advertised and open to all bidders who wish to respond?

___ Y ___ N

Q.12.2 If you answered Yes to question Q.12.1, please provide details of your public advertisement procedure/policy and the url address normally used. Indicate location of postings - for example, post on your website, publish on trade website, newspaper, etc.

Q.12.3 Are your solicitations sent only to pre-screened and pre-qualified suppliers?

Q.12.4 If you answered Yes to question Q.12.3, please provide details of your supplier screening and qualification process.

Q.12.5 If you answered No to Q.12.1 and Yes to Q.12.3, please provide details of how you determine which suppliers are invited to participate in sourcing events.

Q.12.6 Do you have procedures in place to ensure that minority, small, women- owned and/or disadvantaged suppliers are provided opportunity to compete for your contact awards?

___ Y ___ N If yes, please attach a copy of your procedures.

Q.12.7 If you answered Yes to question Q.12.6, do you have staff dedicated to support and actively engage minority, small, women-owned and/or disadvantaged suppliers?

Q.12.8 Are bids/proposals evaluated and contracts awarded under a “best value” methodology?

Q.12.9 If you answered Yes to question Q.12.8, please provide details of your “best value” methodology and include criteria generally used in the selection of a supplier.

Q.12.10 If you answered No to question Q.12.8, please provide details of how you select a supplier for a contract (e.g., lowest-responsive bidder, etc.).

Q.12.11 Are entities that use your contracts part of the bid/proposal evaluation and contract award selection committee?

Q.12.12 If you answered Yes to question Q.12.11, please describe the role of the entities that use your contracts in the evaluation/selection process.

Q.12.13 Do you have a management review and approval process prior to the award of a contract?

Q.12.14 If you answered Yes to question Q.12.13, please describe your management review and approval process prior to the award of a contract.

Q.12.15 Do you have procedures and controls in place to manage all aspects of your sourcing process?

___ Y ___ N If yes, please provide a narrative describing the controls you have in place.

Q.12.16 Are all bid documents (e.g., RFP, bids/proposals, evaluation worksheet and award recommendation, etc.) made available to all entities that use your contracts for review and record purposes?

___ Y ___ N If yes, how long are bid documents retained?

Q.13 For those contracts competitively bid and awarded by an entity that uses your contracts, answer the following:

Q.13.1 Are their solicitations publically advertised and open to all bidders who wish to respond?

Q.13.2 Are their solicitations sent only to pre-screened and qualified suppliers?

Q.13.3 Are they required to have procedures in place to ensure that minority, small, women-owned and disadvantaged suppliers are provided opportunity to compete for your contract awards?

Q.13.4 Are member-solicited bids/proposals evaluated and contracts awarded under a “best value” methodology?

Q.13.5 Do you have a set of minimum standards by which you will or will not accept a contract into your portfolio from an entity that users your contracts?

Q.13.6 If you answered Yes to question Q.13.5, please provide details of your acceptance/rejection requirements for the inclusion of contracts into your portfolio from an entity that uses your contracts.

Q.13.7 Are contract documents (e.g., RFP, bids/proposals, evaluation worksheets and award recommendation, etc.) made available to all other entities that use your contracts for review and record purposes?

Q.14 For those contracts competitively bid and awarded by others (e.g., an entity or organization that does not use your contracts), answer the following:

Q.14.1 Are their solicitations publically advertised and open to all bidders who wish to respond?

Q.14.2 Are their solicitations sent only to pre-screened and qualified suppliers?

Q.14.3 Are they required to have procedures in place to ensure that minority, small, women-owned and disadvantaged suppliers are provided opportunity to compete for your contact awards?

Q.14.4 Are bids/proposals evaluated and contracts awarded under a “best value” methodology?

Q.14.5 Do you have a set of minimum standards by which you will or will not accept a contract into your portfolio from others?

Q.14.6 If you answered Yes to question Q.14.5, please provide details of your acceptance/rejection requirements for inclusion of contracts into your portfolio from others.

Q.14.7 Are bid documents (e.g., RFP, bids/proposals, evaluation worksheet and award recommendation, etc.) made available to all entities that use your contracts for review and record purposes?

Compliance/Contract Management

Q.15 For those contracts awarded by your organization, answer the following:

Q.15.1 Do you have procedures in place to monitor supplier and subcontractor performance on a regular, on-going basis?

___ Y ___ N If yes, describe or attach a copy of the procedures.

Q.15.2 Do you have procedures in place to ensure contract pricing remains aligned to the market during the term of the agreement?

___ Y ___ N If yes, describe or attach a copy of the procedures.

Q.15.3 Do you have policies and procedures in place to ensure conflicts of interest are avoided in contract awards?

___ Y ___ N If yes, describe or attach a copy of the policies and/or procedures.

Q.15.4 Do you have procedures and controls in place to manage all aspects of your contract management process?

___ Y ___ N If yes, describe or attach a copy of any other procedures or controls already not noted/included.

Q.15.5 Do you validate that all contracts in your portfolio comply with federal requirements such as

SAMs (Excluded Parties Lists)?

___ Y ___ N If yes, indicate all federal requirements you ensure your contracts are in compliance with prior to their being added to your contract portfolio.

Q.15.6 Do you permit an entity that uses your contracts to locally negotiate terms and conditions?

Q.15.7 If you answered Yes to question Q.15.6, please describe any restrictions placed on an entity that uses your contracts.

Q.15.8 Do you permit an entity that uses your contracts to locally negotiate service or scope changes?

Q.15.9 If you answered Yes to question Q.15.8, please describe any restrictions placed on an entity that uses your contracts.

Q.15.10 Do you permit an entity that uses your contracts to locally negotiate pricing?

Q.15.11 If you answered Yes to question Q.15.10, please describe any restrictions placed on an entity that uses your contracts.

Q.15.12 Do you have a supplier suspension/disbarment procedure?

___ Y ___ N If yes, describe or attach a copy of your procedures.

Q.16 For those contracts in your portfolio awarded by an organization other than your own, answer the following:

Q.16.1 Do you have procedures in place to monitor supplier performance on a regular, on-going basis?

Q.16.2 Do you have procedures in place to ensure contract pricing remains aligned to the market during the term of the agreement?

Q.16.3 Are locally negotiated terms and conditions by an entity that uses your contracts permitted?

Q.16.4 Are locally negotiated service or scope changes by an entity that uses your contracts permitted?

Q.16.5 Is locally negotiated pricing by an entity that uses your contracts permitted?

Operations/Transparency

Q.17.1 Are all procedures and controls managing your sourcing process and contract management process reviewed and updated on regularly scheduled intervals?

Q.17.2 If you answered Yes to question Q.17.1, please indicate the last time a review was performed, by whom, and when the next review is scheduled.

Q.17.3 Are the procedures and controls managing your sourcing process and contract management process audited by an outside entity, such as a public accounting firm or external agency, on regularly scheduled intervals?

Q.17.4 If you answered Yes to question Q.17.3, please indicate the last time an audit was performed, by whom, and when the next audit is scheduled. Include a copy of the report as part of your response.

Q.17.5 Do you have a published ethics policy in place for all employees?

___ Y ___ N If yes, please attach a copy of your policy.

Q.17.6 Do you have a published ethics policy in place for all suppliers?

___ Y ___ N If yes, please attach a copy of your policy.

Q.17.7 Are all personnel involved in the bid/proposal evaluation, contract award decision making, and/or contract preparation and execution processes required to sign and maintain disclosure of possible conflicts of interest?

Q.17.8 Do you have certification requirements for your sourcing and contract management personnel?

Q.17.9 Are your sourcing and contract management practices certified by any Federal, State or public entity?

Q.17.10 If you answered Yes to question Q.17.9, please provide a listing of certifications received including the name of the issuing authority and date.

HUB-Related Questions

Q.18.1 How do you notify minority-owned, women-owned, and service-disabled veteran-owned small businesses in the State of Texas about contracting opportunities on an ongoing basis?

Q.18.2 Would you be willing to send periodically, to minority-owned, women-owned, and service-disabled veteran-owned small businesses certified by the State of Texas as historically underutilized businesses (HUBs), information about upcoming contracting opportunities?

Q.18.3 What was the total dollar value of expenditures during calendar year 2021 by users of your contracts with minority-owned, women-owned, and service-disabled veteran-owned small businesses operating in the State of Texas?

Q.18.4 Would you be willing to speak about your contracting process and opportunities and your special initiatives for minority-owned, women-owned, and service-disabled veteran-owned small businesses in the State of Texas at least once a year at events hosted by or recommended by the UT System HUB Office?

CERTIFICATIONS

In completing the above Survey, the undersigned organization certifies that the above responses are current, complete, true and accurate, and that the individual providing this certification is authorized to do so. We acknowledge that UT System will rely on such statements, information and representations in evaluating whether to accredit us as a potential supplier of GPO contracts to UT System or its institutions.

[NAME OF ORGANIZATION]

Signed: _______________________________________________________

Printed Name: _______________________________________________________

Title: _______________________________________________________

Date: _______________________________________________________