S-44300-00013646 Attachment D Reference Check Form-word form for use~1.docx

This is a Reference Check Form attachment to an RFP issued by the State of Oregon through OregonBuys for Bid #S-44300-00013646 related to Medicare Cost Report services. The form serves as a standardized template for evaluating potential offerors through reference checks conducted with previous clients. The document is designed to be completed by reference entities who have engaged the offeror's services, with spaces provided for the offeror's name, reference entity information, and contact details including name, telephone number, and email address.

The reference check form contains ten evaluation questions addressing the scope and quality of services previously provided, customer service quality, overall satisfaction with the business relationship, problem resolution methods, likelihood of future engagement, satisfaction with specific service aspects, alignment with proposed timelines, and cost performance compared to initial proposals. The form was originally developed on November 19, 2014, with a version update dated August 16, 2021, by the Department of Administrative Services (DAS) Procurement Services. This standardized assessment tool enables the State of Oregon to gather detailed feedback from prior clients to inform the vendor selection process.