T3093 Bid Solicitation Checklist 060818.docx
DOCX document 241 KB Posted
- Attached to
- T3093 - SHBP and SEHBP Medicare Advantage Plans
- Solicitation number
- 19DPP00265
- Issued by
- Mercer County, New Jersey
About this file
This document is a Bid Solicitation Checklist from the State of New Jersey Department of the Treasury, Division of Purchase and Property related to a contract opportunity for State Health Benefits Program and School Employees Health Benefits Program-Medicare Advantage Plans, Bid Solicitation #19DPP00265. The checklist outlines the required forms and certifications that must be submitted by vendors with their quote, as well as additional forms that should be submitted prior to the award of the contract. The contract opportunity involves the jurisdictions of Mercer County and Trenton City. The checklist does not provide details on the specific products or services requested, response due dates, award dates, or contract term.
The document focuses on the administrative requirements for vendors to submit a responsive quote, including ownership disclosure, Iran disclosure, subcontractor utilization plan, investigations disclosure, political contribution disclosure, and affirmative action compliance. It does not contain information about pricing terms, set asides, incumbents, funding requirements, or other salient details about the contract opportunity.
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Other files
| File | Type | Posted |
|---|---|---|
| T3093 Amend 1.docx | DOCX document | |
| Attachment 2 PPO CMS ACCESS Match.xlsx | XLSX spreadsheet | |
| T3093 Amend 2 QA Final.docx | DOCX document | |
| T3093 SHBP RFP 6-8-18~1.docx | DOCX document | |
| T3093 Offer and Acceptance Page 060818~1.pdf | ||
| Med Adv_Pricing 5718.xlsx | XLSX spreadsheet | |
| Attachment 3 Service Area Match.xlsx | XLSX spreadsheet | |
| Attachment 4 Statement of Assurances.docx | DOCX document | |
| Attachment 1 CMS STAR rating.xlsx | XLSX spreadsheet | |
| T3093 SHBP RFP 6-19-18.docx | DOCX document | |
| T3093 SHBP RFP 6-29-18.docx | DOCX document |
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Text version
STATE OF NEW JERSEY
DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
BID SOLICITATION CHECKLIST
| BID SOLICITATION #: |
| 19DPP00265 |
| BID SOLICITATION TITLE: |
| State Health Benefits Program and School Employees Health Benefits Program-Medicare Advantage Plans |
THIS CHECKLIST WAS CREATED AS A GUIDE TO ASSIST VENDORS {BIDDERS} IN PREPARING A COMPLETE AND RESPONSIVE QUOTE. IT IS THE VENDOR’S {BIDDER’S} RESPONSIBILITY TO ENSURE THAT ALL REQUIREMENTS OF THE BID SOLICITATION HAVE BEEN MET.
PART 1
FORMS, REGISTRATIONS AND CERTIFICATIONS THAT MUST BE
SUBMITTED BY THE VENDOR {BIDDER} WITH THE QUOTE
OFFER AND ACCEPTANCE PAGE (See Bid Solicitation Section 4.4.1.1)
OWNERSHIP DISCLOSURE FORM (See Bid Solicitation Section 4.4.1.2.1)
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN FORM (See Bid Solicitation Section 4.4.1.2.2)
SUBCONTRACTOR UTILIZATION PLAN (See Bid Solicitation Section 4.4.1.3)
PART 2
FORMS, REGISTRATIONS AND CERTIFICATIONS THAT SHOULD BE
SUBMITTED BY THE VENDOR {BIDDER} WITH THE QUOTE.
THESE FORMS MUST BE SUBMITTED PRIOR TO THE AWARD
OF THE MASTER BLANKET PURCHASE ORDER.
DISCLOSURE OF INVESTIGATIONS AND OTHER ACTIONS INVOLVING VENDOR {BIDDER}
(See Bid Solicitation Section 4.4.2.2)
TWO-YEAR CHAPTER 51/EXECUTIVE ORDER 117 VENDOR CERTIFICATION AND DISCLOSURE OF POLITICAL CONTRIBUTIONS (See Bid Solicitation Section 7.1.1)
AFFIRMATIVE ACTION COMPLIANCE (See Bid Solicitation Section 7.1.3) Submit one of the following:
· NEW JERSEY CERTIFICATE OF EMPLOYEE INFORMATION REPORT
· FEDERAL LETTER OF APPROVAL VERIFYING A FEDERALLY APPROVED OR SANCTIONED AFFIRMATIVE ACTION PROGRAM (Dated within 1 year of the Quote submission)
· AFFIRMATIVE ACTION EMPLOYEE INFORMATION REPORT (FORM AA302)
SOURCE DISCLOSURE FORM (See Bid Solicitation Sections 4.4.2.3 and 7.1.2)
| DPP Rev. 4.25.18 |
| Page 1 of 1 |
DPP Revised 4.17.17 image1.png
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