Invitation To bid– Response FORM

Opportunity Information

Opportunity Name
Fee-for-Service Evaluation
Reference Number: 17ITB11
Closing Date: October-25-2016 - Time: 4:00 PM MST
Last Update:10/18/2016 10:10 AM MST / Response Submission
Return Bids To:Sabrina Song
Calgary Homeless Foundation
308 – 925 7 Avenue SW
Calgary, AB T2P 1A5
Tel:403-718-8532
Email:

Vendor/Bidder Information

Bidder Name:Click here to enter text.
Bidder Business Name:Click here to enter text.
Bidder Address:Click here to enter text.
Tel:Click here to enter text.
Fax:Click here to enter text.
Email:Click here to enter text. / Type of Organization:
Sole Proprietorship☐
Partnership☐
Corporation☐
Joint Venture☐
Other (Specify): Click here to enter text.

Opportunity Requirements

Please outline how you will meet the key deliverables/scope of work as set forth through this ITB:
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Please outline how you will meet the opportunity requirements/experience as set forth through this ITB:
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Additional requirements

Please include a resume and 2 references when submitting this Response Form.
Resume(s) attached? Yes/No - Click here to enter text.
References:
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Price proposal

Please complete this price proposal:
Services and Expenses
Please detail all categories (including fixed fee/hourly fee) adding additional rows as needed / Price
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Maximum Fees: / $ Click here to enter text.
In-Kind Services and Expenses
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Total In-Kind: / $ Click here to enter text.

Self Declaration

A Bidder shall disclose any potential, actual or perceived conflicts of interest and existing business relationships it may have with the CHF, its elected or appointed officials, representatives, employees, funded agencies or funders.
A Bidder shall disclose any relationship between any Representative of the Bidder(s) and any Representative of the CHF including where:
(i)the Representative of the Bidder presently or previously serve(d) as a Representative of the CHF;
(ii)a Representative of the Bidder and a Representative of the CHF are Family; or
(iii)it is known that a Representative of the Bidder will become a Representative of the CHF in the future; or
(iv)It is known that a Representative of the CHF will become a Representative of the Bidder in the future.
For the purposes of this Conflict of Interest declaration,
(i)a “Representative” means an employee, director, officer, volunteer or contractor;
(ii)“Family” means a spouse, common-law partner, domestic partner. child, grandchild, great grandchild, parent, parent-in-law, brother, sister, brother-in-law, sister-in-law, son-in-law, daughter-in-law, aunt, uncle, great aunt, great uncle, cousin or second cousin and includes foster and step relationships for any of the above.
The CHF may rely on such disclosure
☐I/We declare no conflicts.
☐I/We declare the following conflicts.
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Name:Click here to enter text.Title:Click here to enter text.
Signature: ______
Date: Click here to enter text.