Final_ARFQ_0506_JWH2200000002_1_WV_ARFQ_FORM.PDF
PDF 727 KB Posted
- Attached to
- ARFQ Psychology services to JWH residents
- Solicitation number
- ARFQ 0506 JWH2200000002 1
- Issued by
- Raleigh County, West Virginia
About this file
This is an Agency Request for Quote (ARFQ) form issued by the State of West Virginia, Department of Health and Human Resources, for psychology services at Jackie Withrow Hospital in Beckley, West Virginia. The solicitation requests psychology services to be provided to residents of the hospital for a twelve-month period. The solicitation was issued on August 17, 2021, with a deadline for questions on August 27, 2021, and a bid closing date of September 9, 2021, at 1:00 PM. Bids should be submitted to the Health and Human Resources Operations/Purchasing office located at One Davis Square, First Floor, Room 111, Charleston, West Virginia 25301.
The contract is structured as a fixed-amount agency contract with services to be invoiced to and shipped to Jackie Withrow Hospital at 105 South Eisenhower Drive, Beckley, West Virginia. The commodity code associated with this requirement is 85121608. Interested vendors should direct inquiries to the buyer, Roberta A. Wagner, at (304) 558-0437 or roberta.a.wagner@wv.gov. All offers are subject to the terms and conditions outlined in the complete solicitation documents.
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Other files
| File | Type | Posted |
|---|---|---|
| DHHR TCA Psychology.pdf | ||
| Hippa Agreement.docx | DOCX document | |
| DHHR43 Psychology.pdf | ||
| DHHR pAffidavit.pdf | ||
| Exhibit A Psychology Pricing.docx | DOCX document | |
| ServicesRFQ Psychology 2021.docx | DOCX document |
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Text version
Date Printed: Aug 17, 2021 Page:1 FORM ID: WV-PRC-ARFQ-002 2020/05
State of West Virginia Agency Request for Quote
Service - Prof
Proc Folder: 925327 Reason for Modification:
Doc Description: ARFQ Psychology services to JWH residents
Proc Type: Agency Contract - Fixed Amt
Date Issued Solicitation Closes Solicitation No Version
2021-08-17 2021-09-09 13:00 ARFQ 0506 JWH2200000002 1
BID RECEIVING LOCATION
BUYER - 304-957-0209
HEALTH AND HUMAN RESOURCES
OPERATIONS/PURCHASING
ONE DAVIS SQUARE, FIRST FLOOR RM 111
CHARLESTON WV 25301
US
VENDOR
Vendor Customer Code:
Vendor Name :
Address :
Street :
City :
State : Country : Zip :
Principal Contact :
Vendor Contact Phone: Extension:
FOR INFORMATION CONTACT THE BUYER
Roberta A Wagner
(304) 558-0437 roberta.a.wagner@wv.gov
Vendor Signature X FEIN# DATE All offers subject to all terms and conditions contained in this solicitation
Date Printed: Aug 17, 2021 Page:2 FORM ID: WV-PRC-ARFQ-002 2020/05
ADDITIONAL INFORMATION
INVOICE TO SHIP TO
HEALTH AND HUMAN
RESOURCES
HEALTH AND HUMAN
RESOURCES
JACKIE WITHROW HOSPITAL
105 SOUTH EISENHOWER DR
JACKIE WITHROW HOSPITAL
105 SOUTH EISENHOWER DR
BECKLEY WV BECKLEY WV
US US
Line Comm Ln Desc Qty Unit Issue Unit Price Total Price 1 Psychology Services to the Residents of JWH 12.00000 MO
Comm Code Manufacturer Specification Model # 85121608
Extended Description:
Psychology Services to the Residents of JWH
SCHEDULE OF EVENTS
Line Event Event Date 1 Questions due 13:00 2021-08-27
Document Phase Document Description Page
JWH2200000002 Final ARFQ Psychology services to JWH residents
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File details come from the government source that posted it. Updated .