[BIDDER’S NAME]DSHS RFP #1834-681

AttachmentD - Bidder Response Form

This form is broken into the followingsix (6) sections:

Section D-1. Administrative Response;

Section D-2. Minimum Requirements Response;

Section D-3. Management, Experience and QualificationsResponse;

Section D-4. Technical/Functional Response;

Section D-5. Cost Proposal;

Section D-6. Bidders’References

Bidders must respond to all questionsin all sections of this Attachment in the expandable space provided or as directed. If a question requires Bidder to submit additional documents, please attach them (do not imbed the document) to this documentand label them clearly as part of your response to this AttachmentD. If an attachment is provided, please include the name of the attachment in the Response field.

Please follow instructions for each section. Failure to respond to instructions specific to any section may result in Bidder’s disqualification.

SECTION D-1 – ADMINISTRATIVE RESPONSE (PASS/FAIL)

Instructions: Bidder’s Response to the questions in this Section D-1, combined with the information provided in referenced required Attachments, demonstrates compliance with the Administrative Requirements of this Solicitation. While the Administrative Response is not given a numbered score, information provided as part of Bidder’s Administrative Response may cause the Bidder Response to be disqualified and may be considered in evaluating Bidder’s qualifications and experience.

# / Response Requirements Checklist: / Please Indicate:
YES/NO
1 / Attachment B -Bidder’s Letter of Submittalis attached, containing required responses and signed.
2 / AttachmentC - Bidder’s Certification and Assurances form is signed and attached.
This AttachmentD – Bidder Response Form:
3 / Section D-2 – Minimum Qualifications Response completed.
4 / Section D-3 – Management/Experience/Qualifications Response completed.
5 / Section D-4 – Technical/Functional Response completed.
7 / Section D-5 – Cost Proposal completed.
9 / Section D-6 – Bidders’ Referencescompleted.

SECTION D-2 – MINIMUM QUALIFICATIONS RESPONSE (PASS/FAIL)

Instructions: Bidder’s response to the questions in this Section D-2 documents how Bidder meets the Minimum Qualifications. All Minimum Qualifications must be responded to and are evaluated as Pass/Fail. Failure to respond or demonstrate how the requirements are met may cause Bidder to be deemed unresponsive and may be disqualified.

Please ensure that your answer to this question includes all information that you wish DSHS to consider in determining whether you meet the Minimum Qualifications set forth in the Solicitation Document.

# / Minimum Qualifications: / MAXIMUM TOTAL POINTS
1 / Licensed to do business in the State of Washington or provide a commitment that it will become licensed in Washington within thirty (30) calendar days of being selected as the Apparently Successful Contractor. For exceptions to this requirement, please go to the Washington State Business Licensing Service website more information at: Dept. of Revenue Link / Pass/Fail
RESPONSE:
2 / Have at least three (3) years’ experience in conducting staffing analysis and developing staffing models. / Pass/Fail
RESPONSE:
3 / Have experience conducting staffing analysis for governmental correctional or other institutional facilities. / Pass/Fail
RESPONSE:

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[BIDDER’S NAME]DSHS RFP #1834-681

AttachmentD - Bidder Response Form

SECTION D-3 – MANAGEMENT/ EXPERIENCE/ QUALIFICATIONS RESPONSE (SCORED)

Instructions: Please describe the experiences, skills and qualifications your organization and proposed staff possesses that are relevant to an evaluation of your ability to perform the Contract that is the subject of this Solicitation. Please ensure that your answers to these questions include all information that you wish DSHS to consider in determining whether you meet the requirements and qualifications set forth in the Solicitation Document. Please include any relevant experience that distinguishes your organization or makes it uniquely qualified for the Contract.

All questionsmust be responded to and will be scored. Failure to respond or demonstrate how the requirements/qualificationsare met may cause Bidder to be deemed unresponsive and may be disqualified.

# / Requirements/Qualifications: / MAXIMUM TOTAL POINTS / FOR EVALUATION PURPOSES ONLY
MANAGEMENT/ EXPERIENCE/ QUALIFICATIONS / 50
1 / Describe the Consultant’s experience and qualifications necessary for successfully completing the services required by this RFP. Include an overview of the Consultant’s firm, its history, and experience working with government organizations, interviewing approaches, developing and presenting information to management, writing concise and comprehensive reports. / 25
RESPONSE:
2 / Describe the make-up of the project team. Identify the project personnel, including any subcontractors, and succinctly state their qualifications and relevant experience. Include references for each team member (name, identifying information, telephone number, and e-mail address). / 15
RESPONSE:
3 / Include a list of contracts the Consultant has had during the last three years that relate to the Consultant’s ability to perform the services needed under this RFP. List contractor name, summary of the scope of work, contract period of performance, deliverables, and maximum consideration. / 5
RESPONSE:
4 / Provide a one (1) to three (3) page written sample of an analysis relevant to this project. / 5
RESPONSE:

SECTION D-4 – TECHNICAL/ FUNCTIONAL RESPONSE (SCORED)

Instructions:Please describe how your project intends to address the gang or youth violence problem affecting your community. Please ensure that your answers to these questions include all information that you wish DSHS to consider in determining whether you meet the requirements and qualifications set forth in the Solicitation Document. Please include any relevant experience that distinguishes your organization or makes it uniquely qualified for the Contract.

All questions must be responded to and will be scored. Failure to respond or demonstrate how the requirements/qualifications are met may cause Bidder to be deemed unresponsive and may be disqualified.

# / Requirements/Qualifications: / MAXIMUM TOTAL POINTS / FOR EVALUATION PURPOSES ONLY
TECHNICAL RESPONSE / 50
1 / Succinctly describe the proposed approach or methodology that would be undertaken in providing the requested services, include how you will organize, manage, communicate, and report on the status of the project. This section should convey the Consultant’s understanding of the proposed project. / 20
RESPONSE:
2 / Provide a detailed work plan that includes a full description of the project scope, objectives, tasks, sub-tasks, level of effort, schedule and timelines, specific personnel assignments, and deliverables necessary to accomplish the scope of the project defined in the RFP. This section of the technical proposal must contain sufficient detail to convey to members of the evaluation team the Consultant’s knowledge of the subjects and skills necessary to successfully complete the project. Include any required involvement of Agency staff. / 25
RESPONSE:
3 / The Consultant must identify potential risks that are considered significant to the success of the project and how the Consultant would propose to effectively monitor and manage these risks. / 5
RESPONSE:

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[BIDDER’S NAME]DSHS RFP #1834-681

AttachmentD - Bidder Response Form

SECTION D-5– COST PROPOSAL (SCORED)

Instructions: Provide a detailed breakdown of the fee structure and costs associated with fulfilling the requirements of the scope of work. The Cost Proposal must identify the proposed personnel by name, type of work, number of project days, number of days to be spent working on site, and payment methodology (e.g., daily or hourly rates, fixed rate).

The total number of available points is 25 points.

Identify all costs including expenses to be charged for performing the services necessary to accomplish the objectives of the contract. The Consultant is to submit a fully detailed budget including staff costs, administrative costs, and any other expenses necessary to accomplish the tasks and to produce the deliverables, under the contract. Compensation for travel expenses shall be at current state travel reimbursement rates. Washington State sales tax, if applicable, are required to be collected and paid.

Costs for subcontractors are to be broken out separately. Please note if any subcontractors are certified by the Washington State Office of Minority and Women’s Business Enterprises.

Attachment D – Bidder Response FormPage 1 of 8

[BIDDER’S NAME]DSHS RFP #1834-681

AttachmentD - Bidder Response Form

SECTION D-6 – BIDDERS’REFERENCES (PASS/FAIL)

Instructions: Please list three (3) names and contact information for each of the references whom JR may contact for this project.

Name, Agency, Phone # and Email.
Reference #1
Reference #2
Reference #3

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