Intake_Questions.docx
DOCX document 40 KB Posted
- Solicitation number
- 260493
- Issued by
- Orange County, California
About this file
This is a Project Manager Information Request Intake Form for the Orange County Transportation Authority (OCTA) in California, related to a Centers for Medicare & Medicaid Services (CMS) Medicare Section 111 Liability Reporting Agent contract (Requisition No. R002515). The procurement seeks a qualified firm to provide CMS Medicare Section 111 reporting services. The contract is structured as a firm-fixed price engagement with an initial three-year term. No specific response dates, site visits, or bidder's conferences are referenced in this intake document, as it represents an internal procurement preparation phase rather than a public solicitation announcement.
The total budget for this engagement is $36,000 for the initial three-year term, with the contract to be encumbered upon award. The procurement type and evaluation methodology have not yet been finalized, with options for either Invitation for Bids (IFB) or Request for Proposals (RFP) remaining open. The funding source has not been specified in the completed sections. Required submittals include an Independent Cost Estimate, Scope of Work, SOW Verification Form, and any supporting documents. If an RFP approach is selected, a minimum of two evaluation committee members will be required, and cost will carry a minimum weight of 25 percent in the evaluation criteria. No certifications have been identified as required at this intake stage, and retention requirements for firm-fixed contracts have not been determined.
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Intake – Project Manager Information Request Requisition No. R002515 Description: CMS Medicare Section 111 Liability Reporting Agent
Please upload/attach the following documents under the “Attachments” tab.
1. Independent Cost Estimate (ICE)
2. Scope of Work (SOW)
3. SOW Verification Form
4. Other Supporting Documents (if applicable) Please provide the following information:
5. Procurement Type:
|_| IFB (Lowest responsive, responsible bidder. Price is the primary factor.)
|_| RFP (Best value based on qualifications, staffing, work plan, and cost.)
6. Funding source(s) for this procurement:
|_| Local |_| State |_| Federal |_| Measure M |_| ______________
7. Previous agreement number (if applicable): ______________
8. Contract term dates:
Initial Term: _____________________________________
Option Term(s): _____________________________________
9. If there are any option term(s), please provide the amount for the initial and option term(s):
| Initial Term Amount: | $____________ | |
| Option Term Amount: | $____________ |
10. (Complete for RFP Only) Identify proposed evaluation committee members. A minimum of two (2) evaluators is required. Please include names, titles, and departments.
| Evaluator 1: | Name, Title, Department |
| Evaluator 2: | Name, Title, Department |
11. (Complete for RFP Only) Provide the weight assignment for each criterion.
| Evaluation Criteria |
| Weight (%) |
| Qualifications of the Firm |
| _____% |
| Staffing / Project Organization |
| _____% |
| Work Plan |
| _____% |
| Cost |
| _____% (must be a minimum of 25%) |
Justification for evaluation criteria and weighting:
12. Contract Type: |X| Firm-fixed |_| Time-and-expense Comment by Rhea Aninzo: From requisition
a. If firm-fixed, will retention be required? (For RFP Only)
|_| Yes, Percentage: ______% |_| No
b. If firm-fixed, should the requisition be encumbered?
|X| Yes |_| No
13. For insurance purposes, are there any certifications required of the firms?
|_| Yes |_| No
14. Comments/Questions (if any):
File details come from the government source that posted it. Updated .