OF_2 Offeror Entity Reference Questionnaire.docx

OFFER FORM OF-2

OFFEROR ENTITY REFERENCE FORM

Offeror Entity Reference Form: Offeror is required to fill out Section 1 for a minimum three (3) references to customers who received Unemployment Insurance services relevant to those called out in this RFP. Offeror shall then complete Section 2 for each reference and email to referenced customer to complete Section 3.

Section 1. To be completed by the Offeror and submitted with proposal.

REFERENCES

A minimum of three (3) references are required.

Reference #1:

Name:

Title:

Phone Number:

Email Address:

Duration:

(Start and End MM/YY)

Role:

Reference #2:

Name:

Title:

Phone Number:

Email Address:

Duration:

Role:

Reference #3:

Name:

Title:

Phone Number:

Email Address:

Duration:

Role:

The State may contact all the references listed to inquire about Offeror's equipment, services, performance, and degree of customer satisfaction. Full points for references will not be awarded unless Section 2 and 3 are emailed from referenced customers to the Contract Administrator.

Section 2. To be completed by the Offeror

Customer Phone:

Operating Budget of Organization:

Offeror project roles performed within this Unemployment Insurance system implementation consisted of the following categories (Check all that apply):

Project included implementation of procurement categories listed above in a government and/or education organization:

|_| Yes |_| No

Scope of Project:

Number of employees staffed for this project:

Total One-Time Cost of Project (Estimated/Actual):

Reason for Change in Total One-Time Cost of Project, if applicable:

What was the longest unplanned outages that occurred.

|_| 1 to 12 hours |_| 12 to 24 hours |_| 24 to 48 hours

|_| Greater than 48 hours

Scope of Contractor/Offeror's Involvement in this project:

Number of employees Contractor/Offeror staffed for this project:

Reason(s) for Change in Value:

Estimated Start & Completion Dates: From:

To:

Actual Start & Completion Dates: From:

To:

Reason(s) for Difference Between Estimated and Actual Dates:

Section 3. To be completed by the Offeror’s Customer Reference

Contractor Name:

Customer Organization:

A. Validation of Referenced Project Data Provided by Offeror

Comments from the Customer Organization

B. Past Performance Reference

RATING GUIDELINES

Please explain ratings of 1, 2, or N/A in the Comments section below.

1. The Contractor provided sufficient project resources with appropriate skill sets to meet the project goals and objectives.

2. The Contractor effectively managed its project staff to achieve project goals and objectives.

3. The Contractor met all required tasks and deliverables timely and satisfactorily.

4. The Contractor provided effective training and knowledge transfer to meet project goals.

5. The Contractor satisfactorily managed project scope and risk to adhere to project schedule, control costs, and meet project goals.

6. The Contractor provided effective post-implementation maintenance and operations support.

7. For Criteria with Ratings of 1, 2, or N/A:

General Comments:

As a representative of the Customer Organization listed above, I approved the responses to the previous statements about the performance of the Contractor listed above on the Project identified in Section 2 of this Offeror Experience Reference Form.

OFFER FORM OF-2 3 RFP-23-01-UI