Technical Response PMT-59.pdf
PDF 173 KB Posted
- Solicitation number
- ITB-13206
- Issued by
- Glades County, Florida
About this file
This is a Technical Response document for Invitation to Bid (ITB) 2526 010 issued by the Department of Children and Families (DCF) for milk procurement for state mental health treatment facilities, effective June 14, 2024. The document is a standardized response form requiring bidders to provide detailed information about their organization, including disclosures about related parties, potential conflicts of interest, and any terminated contracts within the past five years. Bidders must complete sections detailing their organizational capabilities, years of experience, references, subcontractor information, and professional qualifications related to the milk supply services.
The technical response template requires respondents to comprehensively document their organization's background, including the number of years in business, subsidiaries, available locations, and experience providing similar services. Bidders must list three reference entities of similar service scale and provide a statement affirming their ability to complete the work as described in the solicitation's scope. The document also mandates disclosure of any proposed subcontractors, their services, contact information, and Federal Employer Identification Number (FEIN). Respondents are instructed to demonstrate their professional qualifications by addressing the requirements outlined in Section 5, Elements of Service, of the Purchase Order Scope of Work.
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Text version
TECHNICAL RESPONSE
DCF ITB 2526 010
MILK FOR STATE MENTAL HEALTH TREATMENT FACILITIES
PMT-59 1 Effective June 14, 2024
1. DISCLOSURES
1.1. RELATED PARTIES
Complete the following table for all affiliates (§287.133(1)(a), Florida Statutes (F.S.)), related parties (§409.987(7)(a)3., F.S.), entities, partnerships, or associations.
☐ Select the checkbox if related parties, as described above, do not exist.
RELATED PARTY
Name Click or tap here to enter text.
Relation to Respondent
☐ Affiliate ☐ Related Party ☐ Entity ☐ Partnership ☐ Association
Address Click or tap here to enter text.
City, State, Zip Click or tap here to enter text.
Phone Number Click or tap here to enter text.
Duplicate table as necessary for additional related parties.
1.2. CONFLICT OF INTEREST
Complete the following table to disclose the name of any officer, director, employee or other agent who is also an employee of the State. Respondents shall also disclose the name of any State employee who owns, directly or indirectly, an interest of five percent or more in the Respondent or its affiliates, related companies, partnerships, or associations.
☐ Select the checkbox if conflicts of interest, as described above, do not exist.
EMPLOYEE OF BOTH RESPONDENT AND STATE OF FLORIDA
Name Click or tap here to enter text.
Title with Responding Organization
☐ Officer ☐ Director ☐ Employee ☐ Other Agent
State Agency Click or tap here to enter text.
Does this employee have an interest of five percent or more in Respondent or its affiliates, related companies, partnerships, or associations?
☐ Yes ☐ No
Duplicate table as necessary for additional conflicts of interest.
1.3. LIST OF TERMINATED CONTRACTS
Complete the following table for any State or Federal government Contract terminated for cause or terminated by the Respondent prior to Contract end within the last five years; provide the terminated Contracts in chronological order. The Department may use information provided on this list or other information about terminated contracts in its assessment of a Respondent’s responsibility.
☐ Select the checkbox if terminated contracts do not exist.
TERMINATED CONTRACT
Respondent Name: Click or tap here to enter text.
PMT-59 2 Effective June 14, 2024
Client’s Name: Click or tap here to enter text.
Term of Terminated Contract:
Click or tap here to enter text.
Description of Services: Click or tap here to enter text.
Termination Party and Brief Summary of Termination Reason(s):
Click or tap here to enter text.
Duplicate table as necessary for additional terminated contracts.
2. QUALIFICATIONS
2.1. CAPABILITY TO PERFORM THE WORK
2.1.1. Provide a description of the Respondent’s organization, including number of years in business, subsidiaries, and details concerning the number of available locations, if applicable.
Click or tap here to enter text.
2.1.2. Provide the number of years of experience providing similar services.
Click or tap here to enter text.
2.1.3. Provide information for three entities that the Respondent has provided services of a similar size and nature of those requested in this Solicitation.
1 Click or tap here to enter text.
2 Click or tap here to enter text.
3 Click or tap here to enter text.
2.1.4. Provide a statement on the Respondent’s and subcontractor(s)' ability to successfully complete the work described in this Solicitation and its appendices, attachments, exhibits and referenced supporting documentation. The Respondent’s and any proposed subcontractor(s)’ information shall be shown separately.
Respondent:
Click or tap here to enter text.
2.2. PROPOSED SUBCONTRACTOR LIST
Complete the following table for any proposed subcontractors to perform work under the Contract(s) resulting from this Solicitation.
☐ Select the checkbox if subcontractors will not be utilized.
PROPOSED SUBCONTRACTOR
Subcontractor Name
Click or tap here to enter text.
Subcontracted Services
Click or tap here to enter text.
Address Click or tap here to enter text.
PMT-59 3 Effective June 14, 2024
City, State, Zip Click or tap here to enter text.
Phone Number Click or tap here to enter text.
FEIN Click or tap here to enter text.
Duplicate table as necessary for additional subcontractors.
2.3. Professional Qualifications
Respondents must provide details regarding meeting the requirements of the Purchase Order Scope of Work, Section 5, Elements of Service.
File details come from the government source that posted it. Updated .