OF_2 Offeror Entity Reference Questionnaire_Revised_4.27.2023.docx
DOCX document 46 KB Posted
- Solicitation number
- P23001870
- Issued by
- Honolulu County, Hawaii
About this file
This document is a Revised Offer Form OF-2 Offeror Entity Reference Questionnaire for a state and local contract opportunity. The State of Hawaii, Department of Labor and Industrial Relations (DLIR) is seeking proposals from qualified contractors to provide Unemployment Insurance (UI) system modernization software and implementation services. The required reference form includes Sections 1-3 to be completed by the Offeror and the referenced customer. Section 1 requires the Offeror to provide a minimum of three (3) references, at least one of which must be for Unemployment Insurance services. The Offeror must then complete Section 2, and the referenced customer must complete Section 3, which includes a performance rating and comments.
The contract opportunity is for the P23001870 Unemployment Insurance Modernization Project in the State of Hawaii. The project scope includes UI implementation, failover/DR, conversion, ongoing services, design, development, subject matter expertise, system administration, reporting/analytics, change management, and other related services. The contract term, pricing, set-asides, funding sources, and other details are not explicitly provided in this reference form document.
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REVISED 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, at least one must be for 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
| Contractor/Offeror Name: |
| Contractor/Offeror Contact/Name: |
| Project Dates: |
| Contractor/Offeror Contact Phone: |
| Customer Organization: |
| Customer Contact Name: |
Customer Phone:
| Customer Address: |
| Customer Fax: |
Operating Budget of Organization:
Offeror project roles performed within this Unemployment Insurance system implementation consisted of the following categories (Check all that apply):
| |_| UI Implementation | |_| UI Failover/DR | |_| UI Conversion |
| |_| UI Ongoing Services | |_| UI Design | |_| UI Development |
| |_| UI SME Benefits | |_| System Administration | |_| UI SME Appeals |
| |_| UI SME Tax | |_| UI SME LMI | |_| UI SME LEP |
| |_| UI Reporting/Analytics | |_| UI Change Management | |_| UI SME Workflows |
| |_| UI Database Admin | |_| UI Network Support | |_| UI Project Management |
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:
| Original Value of Contractor/Offeror's Contract: |
| Actual Total Contract Value: |
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
| Selection |
| Rating |
| 5 |
| Significantly exceeded your expectations. |
| 4 |
| Somewhat exceeded your expectations. |
| 3 |
| Met your expectations. |
| 2 |
| Somewhat below your expectations. |
| 1 |
| Significantly below your expectations. |
Please explain ratings of 1, 2, or N/A in the Comments section below.
| Criteria |
| Rating |
| Not Applicable |
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.
| Printed Name: |
| Printed Title: |
| Signature: |
| Date: |
OFFER FORM OF-2 REVISED 4/28/2023 3 RFP-23-01-UI
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