RFP_HUM260527_Employee_Health_Clinic_Services_and_Administration_-_Exhibit_B-_Vendor_Reference_Form.pdf
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- Solicitation number
- RFP# HUM/260527
- Issued by
- Marion County, Orlando City, Florida
About this file
This is an Exhibit B Reference Form for Request for Proposals No. HUM/260527 issued by the City of Ocala, Florida, for Employee Health Clinic Services and Administration. The City seeks a qualified provider to manage, administer, and staff its on-site health clinic located at 2100 NE 30th Avenue, Building 300, Suite 102, Ocala, Florida 34470. The health clinic will provide primary, urgent, and occupational healthcare services to City employees, retirees, and dependents aged two years and older who are enrolled in the City of Ocala's health plan. All service costs will be charged directly to the City.
To be deemed responsive and responsible, proposers must provide three professional references demonstrating relevant experience. The first reference must be from a health center or clinic managed and operated for a municipality or other governmental entity for at least five consecutive years, providing the same type of services at equivalent scale to the number of participants. Proposers must also provide at least two additional references from entities within the United States for whom they provided comparable health clinic management and operational services. For each reference, proposers must submit the entity name, contact person name and title, telephone number, email address, service descriptions, length of business relationship, contract value, and the number of eligible employees or subscribers served. The designated contact person must have direct knowledge of the provider's work and performance.
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Text version
110 SE Watula Avenue, Third Floor
Ocala, Florida 34471 Main Number: (352) 629-8402 www.bidocala.com
City of Ocala Request for Proposals No. HUM/260527 Page B-1 Employee Health Clinic Services and Administration
EXHIBIT B – REFERENCE FORM
In order to be deemed responsive and responsible, Proposer must be able to provide references from: (a) at least one (1) health center/clinic managed and operated for a municipality or other governmental entity for a period of at least five (5) consecutive years, which provided the same type of services as those sought by the City of Ocala and is equivalent in scale to the number of participants; and (b) at least two (2) additional references from entities for whom proposer provided the same type of health center/clinic management and operational services as those sought by the City within the United States.
For each reference identified, proposer must provide the name of the entity, contact person name/title, phone number, email address, a description of the services performed, the length of business relationship, and the contract value. The contact person identified must have direct knowledge of the provider’s work and performance.
REFERENCE #1:
Name of Entity:
Contact Name: Title:
Address:
Telephone: E- Mail:
Length of Business Relationship: Contract
Value:
Description of Services Performed:
Number of Eligible Employees/Subscribers:
Name of Entity:
http://www.bidocala.com/
City of Ocala Request for Proposals No. HUM/260527 Page B-2 Employee Health Clinic Services and Administration
REFERENCE #2:
Contact Name: Title:
Address:
Telephone: E-Mail:
Length of Business Relationship: Contract Value:
City of Ocala Request for Proposals No. HUM/260527 Page B-3 Employee Health Clinic Services and Administration
REFERENCE #3:
Contact Name: Title:
Address:
Telephone: E-Mail:
Length of Business Relationship: Contract Value:
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File details come from the government source that posted it. Updated .