Case Record Storage and Retrieval Services RFP (Part I)

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TABLE OF CONTENTS APPENDICES A: SAMPLE CONTRACT ............................................................................................. 50 B: STATEMENT OF WORK (SOW) ........................................................................... 128 C: SOW TECHNICAL EXHIBITS ............................................................................... 163 C-1 Performance Requirements Summary (PRS) ................................ 165-173 C-2 Contract Discrepancy Report ................................................................. 174 C-3 Sample Invoice Open, Closed, & Special Invoice Records .................... 175 C-4 Sample Invoice IHSS Timesheets, GR/NAFS or GR/NACF & Court Case Boxes .................................................................................. 176 C-5 Sample Invoice for Department of Children and Family Services ......... 177 C-6 Estimated Workload ............................................................................... 178 C-7 County Office Addresses ................................................................ 179-183 C-8 Miscellaneous Transmittal (PA 6-1) ....................................................... 184 C-9 Request to Borrow Case Record Segments Transmittal ....................... 185 C-10 Storage of Case Records Transmittal ................................................... 186 C-11 Request to Borrow Box(es) of Closed Cases or Boxed Forms (PA 2241-1) 187 D: RFP REQUIRED FORMS ...................................................................................... 188 D-1 Proposer’s Organization Questionnaire/Affidavit ............................ 190-192 D-2 Prospective Contractor’s References ................................................ 193 D-3 Prospective Contractor’s List of Contracts .............................................. 194 D-4 Prospective Contractor’s List of Terminated Contracts ........................... 195 D-5 Certification of No Conflict of Interest ..................................................... 196 D-6 Familiarity with the County Lobbyist Ordinance Certification .................. 197 D-7 Request for Local SBE Preference Program Consideration and CBE Firm/Organization Information Form ....................................................... 198 D-8 Proposer’s EEO Certification ............................................................. 199 D-9 Attestation of Willingness to Consider GAIN/GROW Participants ........... 200 D-10 County of Los Angeles Contractor Employee Jury Service Program – Certification Form and Application for Exception .................................... 201 D-11 Pricing Sheet ................................................................................... 202-203 D-12 Certification of Independent Price Determination and Acknowledgement of RFP Restrictions ................................................... 204 D-13 County’s Administration .......................................................................... 205 D-14 Contractor’s Administration ..................................................................... 206 CASE RECORD STORAGE AND RETRIEVAL SERVICES (RFP) 2012 iv
TABLE OF CONTENTS D-15 Charitable Contribution Certification ....................................................... 207 D-16 Transitional Job Opportunities Preference Application ........................... 208 D-17 .. Certification of Compliance with the County’s Defaulted Property Tax Reduction Program ........................ 209 D-18 Contractor Acknowledgement and Confidentiality Agreement ........ 210-212 E: TRANSMITTAL FORM TO REQUEST A SOLICITATION REQUIREMENTS REVIEW .................................................................................................... 213 F: COUNTY OF LOS ANGELES POLICY ON DOING BUSINESS WITH SMALL BUSINESS .................................................................................................... 214 G: JURY SERVICE ORDINANCE ....................................................................... 215-217 H: LISTING OF CONTRACTORS DEBARRED IN LOS ANGELES COUNTY ......... 218 I: IRS NOTICE 1015 ................................................................................................. 219 J: SAFELY SURRENDERED BABY LAW ......................................................... 220-224 K: DETERMINATION OF CONTRACTOR NON-RESPONSIBILITY AND CONTRACTOR DEBARMENT ....................................................................... 225-229 L: BACKGROUND AND RESOURCES: CALIFORNIA CHARITIES REGULATION ............................................................................ 230-231 M: DEFAULTED PROPERTY TAX REDUCTION PROGRAM ........................... 232-234 N: HEALTH INSURANCE PORTABILITY ACCOUNTABILITY ACT OF 1996 .. 235-246 O: NOTICE OF INTENT TO REQUEST A PROPOSED CONTRACTOR SELECTION REVIEW ........................................................................................... 247 P: TRANSMITTAL FORM TO REQUEST A RFP PROPOSED CONTRACTOR SELECTION REVIEW ........................................................................................... 248 Q: TRANSMITTAL FORM TO REQUEST A RFP COUNTY REVIEW PANEL ... 249-250 R: TRANSMITTAL FORM TO REQUEST A RFP DISQUALIFICATION REVIEW .... 251 CASE RECORD STORAGE AND RETRIEVAL SERVICES (RFP) 2012 v
Page 1 and 2: REQUEST FOR PROPOSALS FOR CASE RECO
Page 3: TABLE OF CONTENTS 2.10 Jury Service
Page 7 and 8: GENERAL INFORMATION 1.0 GENERAL INF
Page 9 and 10: GENERAL INFORMATION ‣ Q: ‣ R: T
Page 11 and 12: GENERAL INFORMATION 1.10 Contact wi
Page 13 and 14: GENERAL INFORMATION record, with th
Page 15 and 16: GENERAL INFORMATION recommend to th
Page 17 and 18: GENERAL INFORMATION Angeles County.
Page 19 and 20: COUNTY POLICIES AND PROGRAMS and im
Page 21 and 22: COUNTY POLICIES AND PROGRAMS 2.10.1
Page 23 and 24: COUNTY POLICIES AND PROGRAMS progra
Page 25 and 26: PROPOSAL SUBMISSION REQUIREMENTS 3.
Page 27 and 28: PROPOSAL SUBMISSION REQUIREMENTS bu
Page 29 and 30: PROPOSAL SUBMISSION REQUIREMENTS bo
Page 31 and 32: PROPOSAL SUBMISSION REQUIREMENTS
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Page 43 and 44: PROPOSAL SUBMISSION REQUIREMENTS (A
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Page 51 and 52: SELECTION PROCESS AND EVALUATION CR
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SELECTION PROCESS AND EVALUATION CR
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APPENDIX A: SAMPLE CONTRACT RECITAL
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APPENDIX A: SAMPLE CONTRACT 8.38 LI
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APPENDIX A: SAMPLE CONTRACT STANDAR
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APPENDIX A: SAMPLE CONTRACT PARTICI
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APPENDIX A: SAMPLE CONTRACT 1.0 APP
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APPENDIX A: SAMPLE CONTRACT 2.1 Acc
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APPENDIX A: SAMPLE CONTRACT 2.11 Ca
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APPENDIX A: SAMPLE CONTRACT 2.21 Co
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APPENDIX A: SAMPLE CONTRACT 2.32 La
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APPENDIX A: SAMPLE CONTRACT 2.41 Pi
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APPENDIX A: SAMPLE CONTRACT for Cas
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APPENDIX A: SAMPLE CONTRACT 5.0 CON
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APPENDIX A: SAMPLE CONTRACT • Cou
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APPENDIX A: SAMPLE CONTRACT 5.4.6 P
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APPENDIX A: SAMPLE CONTRACT 6.2 Con
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APPENDIX A: SAMPLE CONTRACT 7.5.3 C
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APPENDIX A: SAMPLE CONTRACT breach
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APPENDIX A: SAMPLE CONTRACT 8.7 Chi
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APPENDIX A: SAMPLE CONTRACT 5. Stat
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APPENDIX A: SAMPLE CONTRACT subcont
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APPENDIX A: SAMPLE CONTRACT becomes
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APPENDIX A: SAMPLE CONTRACT should
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APPENDIX A: SAMPLE CONTRACT subject
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APPENDIX A: SAMPLE CONTRACT 8.26.3
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APPENDIX A: SAMPLE CONTRACT compens
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APPENDIX A: SAMPLE CONTRACT entrust
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APPENDIX A: SAMPLE CONTRACT Contrac
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APPENDIX A: SAMPLE CONTRACT 8.43 No
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APPENDIX A: SAMPLE CONTRACT • Dur
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APPENDIX A: SAMPLE CONTRACT request
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APPENDIX A: SAMPLE CONTRACT not hav
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APPENDIX A: SAMPLE CONTRACT 8.63 Wa
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APPENDIX A: SAMPLE CONTRACT 1. Pay
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APPENDIX A: SAMPLE CONTRACT • Pro
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APPENDIX A: SAMPLE CONTRACT IN WITN
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APPENDIX B: STATEMENT OF WORK TABLE
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APPENDIX B: STATEMENT OF WORK STATE
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APPENDIX B: STATEMENT OF WORK until
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APPENDIX B: STATEMENT OF WORK consi
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APPENDIX B: STATEMENT OF WORK 2.0 C
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APPENDIX B: STATEMENT OF WORK • C
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APPENDIX B: STATEMENT OF WORK Syste
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APPENDIX B: STATEMENT OF WORK 4.2.4
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APPENDIX B: STATEMENT OF WORK c. Sp
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APPENDIX B: STATEMENT OF WORK by Co
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APPENDIX B: STATEMENT OF WORK made
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APPENDIX B: STATEMENT OF WORK chang
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APPENDIX B: STATEMENT OF WORK All B
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APPENDIX B: STATEMENT OF WORK When
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APPENDIX B: STATEMENT OF WORK NO DE
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APPENDIX B: STATEMENT OF WORK stora
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APPENDIX C: SOW TECHNICAL EXHIBITS
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1.0 PERFORMANCE REQUIREMENTS SUMMAR
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TECHNICAL EXHIBITS C-1 APPENDIX C:
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SOW TECHNICAL EXHIBITS C-5 APPENDIX
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058 APPENDIX C: SOW TECHNICAL EXHIB
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COUNTY OF LOS ANGELES DEPARTMENT OF
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Case Record Storage and Retrieval Services RFP (Part I)

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