Confirmation Will Be Provided to Respondents When References Are Received by IDOA

Instructions

The Respondent must secure at least two (2) references which demonstrate experience within the last three (3) years implementing the proposed solutions for projects of similar size and scope, preferably within state government.

The Respondent must request each reference complete this form and submit completed forms directly to Lottie Hooyer via email () by November 27, 2017 Completed forms submitted by the Respondent will not be accepted.

Confirmation will be provided to Respondents when references are received by IDOA.

Required fields are highlighted in Yellow.

SECTION ONE:Customerand Project Profile

Customer Information
Legal Name of Company or Governmental Entity
Contact Person
Contact Phone Number
Contact E-mail
Project Information
Project Name
Project Scope (High level)
Respondent Role / Prime Contractor
Subcontractor
Time Period in which Respondent Participated on Project
Approximate annual system volume
(number of pages scanned per year)
Key technologies utilized in the implementation and/or operation of the system (List all that apply)

SECTION TWO: Performance Rating

For each item below,rate the bidder on a scale of “Would Not Rehire” (lowest) to “Outstanding” (highest). Please add comments explaining your rating. The rating is to be confidential and will be used by the State of Indiana to determine service qualifications for the bidder who uses your State/agency as a customer reference.

Survey

1. How would you rate the bidder's attention to customer service?