Year 1 Budget Request - DHMH - Maryland.gov

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4.1 Two Part Submission Offerors shall submit proposals in separate volumes: � Volume I - TECHNICAL PROPOSAL � Volume II - FINANCIAL PROPOSAL 4.2 Proposals SECTION 4 – PROPOSAL FORMAT 4.2.1 Volume I-Technical Proposal and Volume II-Financial Proposal shall be sealed separately from one another. Each Volume shall contain two (2) unbound originals, so identified, and five (5) copies. The two sealed Volumes shall be submitted together under one label bearing: The RFP title and number, Name and address of the Offeror, The volume number (I or II), and Closing date and time for receipt of proposals To the Procurement Officer (see sub-section 1.5) prior to the date and time for receipt of proposals (see subsection 1.10). 4.2.2 An electronic version of Volume I- Technical Proposal and Volume II- Financial Proposal, both in searchable pdf format, shall also be submitted as separate files for each "Volume", labeled Volume I-Technical Proposal and Volume II-Financial Proposal with the unbound originals, technical or financial volumes, as appropriate. Electronic media is to be submitted on CD and shall bear a label on the outside containing the RFP number and name, the name of the Offeror and the volume number. 4.2.3 A second electronic version of Volume I and Volume II in searchable pdf format shall be submitted on CD for Public Information Act (PIA) requests. This copy shall be redacted so that confidential and/or proprietary information has been removed (see sub-section 1.19). 4.2.4 All pages of both proposal volumes shall be consecutively numbered from beginning (Page 1) to end (Page “x”). 4.2.5 Proposals and modifications will be shown only to State employees, members of the Evaluation Committee, or other persons, deemed by the Department to have a legitimate interest in them. 4.3 Delivery Offerors may either mail or hand-deliver proposals. 4.3.1 For U.S. Postal Service deliveries, any proposal that has been received at the appropriate mailroom, or typical place of mail receipt, for the respective procuring unit by the time and date listed in the RFP will be deemed to be timely. If a vendor chooses to use the United States Postal Service for delivery, the Department recommends that it use Express Mail, Priority Mail, or Certified Mail only as these are the only forms for which both the date and time of receipt can be verified by the Department. A vendor using first class mail will not be able to prove a timely delivery at the mailroom and it could take several days for an item sent by first class mail to make its way by normal internal mail to the procuring unit. 34
4.3.2 Hand-delivery includes delivery by commercial carrier acting as agent for the Offeror. For any type of direct (non-mail) delivery, Offerors are advised to secure a dated, signed, and time-stamped (or otherwise indicated) receipt of delivery. 4.3.3 After receipt, a Register of Proposals will be prepared that identifies each offeror. The register of proposals will be open to inspection only after the procurement officer makes a determination recommending the award of the contract. 4.4 Volume I – Technical Proposal Note: No pricing information is to be included in the Technical Proposal (Volume 1). Pricing will only be included in the Financial Proposal (Volume II). 4.4.1 Format of Technical Proposal Inside a sealed package described in Section 4.2, above, two (2) unbound originals, five (5) copies and the electronic version shall be provided. The RFP sections are numbered for ease of reference, i.e., Section 1 Title and Table of Contents, Section 2 Transmittal Letter, Section 3 Executive Summary, etc. In addition to the instructions below, the Offeror’s Technical Proposal should be organized and numbered in the same manner as this RFP. This proposal organization will allow State officials and the Evaluation Committee to “map” Offeror responses directly to RFP requirements by Section number. 4.4.2 Additional Required Technical Submissions The following documents shall be included in the Technical Proposal; each in its own Section. a. Minimum Qualifications Documentation (Section 2) b. Completed Bid/Proposal Affidavit (Attachment B) c. Completed Living Wage Affidavit (Attachment F-1) d. Federal Funding Required Forms (Attachment G) e. Conflict of Interest Affidavit and Disclosure (Attachment H) f. Business Associate Agreement (Attachment I) 4.4.3 The Technical Proposal shall include the following in this order: 4.4.3.1 Title and Table of Contents The Technical Proposal should begin with a title page bearing the name and address of the Offeror and the name and number of this RFP. A table of contents shall follow the title page for the Technical Proposal organized by Section, sub-section and page number. 4.4.3.2 Claim of Confidentiality Information which is claimed to be confidential is to be noted by reference and included after the Title page and before the Table of Contents, and if applicable, also in the Offeror’s Financial Proposal. An explanation for each claim of confidentiality shall be included (see sub-section 1.19). 4.4.3.3 Transmittal Letter A transmittal letter shall accompany the Technical Proposal. The purpose of this letter is to transmit the proposal and acknowledge the receipt of any addenda. The transmittal letter should be brief and signed by an individual who is authorized to commit the Offeror to the services and requirements as stated in this RFP. 35
Page 1 and 2: Request for Proposals Calvert Count
Page 3 and 4: STATE OF MARYLAND DEPARTMENT OF HEA
Page 5 and 6: 4.3 DELIVERY ......................
Page 7 and 8: n. Normal State Business Hours - No
Page 9 and 10: 1.9 Questions Written questions fro
Page 11 and 12: 1.19 Access to Public Information A
Page 13 and 14: Howard, Anne Arundel, and Baltimore
Page 15 and 16: 2. Filing of protests; 3. Filing of
Page 17 and 18: Purpose SECTION 3 - SCOPE OF WORK 3
Page 19 and 20: 3.2.2.3 Priority Populations The ta
Page 21 and 22: Services to Be Performed by the Con
Page 23 and 24: 3.2.3.2 Follow-Up Services 10. Moni
Page 25 and 26: 14. Use staff to carry out responsi
Page 27 and 28: detection and treatment of breast a
Page 29 and 30: 3.3.3 Criminal Background Check The
Page 31 and 32: circumstance which changes the Proc
Page 33: work under the Contract, or the rep
Page 37 and 38: DHMH reserves the right to request
Page 39 and 40: contractor has committed, including
Page 41 and 42: SECTION 5- EVALUATION CRITERIA AND
Page 43 and 44: SECTION 6 - ATTACHMENTS ATTACHMENT
Page 45 and 46: ATTACHMENT A - STANDARD CONTRACT TI
Page 47 and 48: 5.2 The Contractor agrees that at a
Page 49 and 50: 13.3 Any and all references to the
Page 51 and 52: a. That pursuant to 42 Code of Fede
Page 53 and 54: 31.1 If the Contractor withholds pa
Page 55 and 56: 33 Federal Department of Health and
Page 57 and 58: A. AUTHORITY I HEREBY AFFIRM THAT:
Page 59 and 60: (9) Admitted in writing or under oa
Page 61 and 62: I DO SOLEMNLY DECLARE AND AFFIRM UN
Page 63 and 64: in the aggregate $100,000 or more s
Page 65 and 66: ATTACHMENT D - PRE-PROPOSAL CONFERE
Page 67 and 68: vi. Data entry and data entry super
Page 69 and 70: ATTACHMENT E-1 BUDGET JUSTIFICATION
Page 71 and 72: Justification: Postage costs relate
Page 73 and 74: Offeror’s Name: Year 2 Budget Req
Page 75 and 76: Offeror’s Name: Year 4 Budget Req
Page 77 and 78: Row # Offeror’s Name ____________
Page 79 and 80: imposition of any of the requiremen
Page 81 and 82: The employee(s) proposed to work on
Page 83 and 84: Page two This clause must appear in
Page 85 and 86:
CERTIFICATION REGARDING ENVIRONMENT
Page 87 and 88:
1. Type of Federal Action: a. Contr
Page 89 and 90:
SUMMARY OF ADDITIONAL FEDERAL FUND
Page 91 and 92:
ATTACHMENT I - BUSINESS ASSOCIATE A
Page 93 and 94:
after an incident even if Business
Page 95 and 96:
C. Effect of Termination. 1. Except
Page 97 and 98:
IN WITNESS WHEREOF and acknowledgin
Page 99 and 100:
ATTACHMENT J - BCCP CASE MANAGEMENT
Page 101 and 102:
Initials Case Manager Signature Ini
Page 103 and 104:
ATTACHMENT K - BCCP DATA ENTRY FORM
Page 105 and 106:
BREAST CANCER SCREENING INFORMATION
Page 107 and 108:
CaST ID: LAST NAME: FIRST NAME: ___
Page 109 and 110:
CaST ID: LAST NAME: FIRST NAME: BRE
Page 111 and 112:
BREAST CANCER DIAGNOSTIC AND TREATM
Page 113 and 114:
CERVICAL CANCER DIAGNOSTIC AND TREA
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
ATTACHMENT L - BCCP CONSENT FORM Br
Page 121 and 122:
Part I. The Contractor agrees to: C
Page 123 and 124:
Qualifications and Insurance O. Hav
Page 125 and 126:
45 CFR Parts 160 and 164, (“HIPAA
Page 127 and 128:
L. The following attached documents
Page 129 and 130:
Part I. The Contractor agrees to: R
Page 131 and 132:
K. Obtain and maintain appropriate
Page 133 and 134:
F. 1. The activities covered by thi
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Preamble Laboratory Service Contrac
Page 137 and 138:
H. Send patient results as follows:
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Other W. Not be in arrears with res
Page 141 and 142:
K. The Contract Monitor for the Con
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Hospital Service Contract Maryland
Page 145 and 146:
Billing F. ** Submit all claims for
Page 147 and 148:
provided by the contractor after fu
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In witness whereof, these authorize
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Billing B. ** Submit all claims for
Page 153 and 154:
H. Regarding HIPAA: 5. The activiti
Page 155 and 156:
Preamble Anesthesia Service Contrac
Page 157 and 158:
N. Not bill a patient for any charg
Page 159 and 160:
previously executed grant agreement
Page 161 and 162:
Preamble Colposcopy Service Contrac
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H. See patients referred by the LHD
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AA. Comply with the Health Insuranc
Page 167 and 168:
non-federal funds using Standard Fo
Page 169 and 170:
Part I. The Contractor agrees to: C
Page 171 and 172:
R. Not bill the LHD for any service
Page 173 and 174:
H. The Contract Monitor for the Con
Page 175 and 176:
ATTACHMENT N - MINIMUM STANDARDS FO
Page 177 and 178:
9. Send a copy of the certified let
Page 179 and 180:
6. If patient is contacted and refu
Page 181 and 182:
ATTACHMENT O - BCCP PERFORMANCE MEA
Page 183 and 184:
ATTACHMENT P - REPORTING SCHEDULE B
Page 185 and 186:
DHMH 437 INSTRUCTIONS (continued) Q
Page 187 and 188:
DHMH 437 INSTRUCTIONS (continued) *
Page 189 and 190:
DHMH 438 Instructions (continued) T
Page 191 and 192:
ATTACHMENT S - CONDITIONS OF AWARD
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23. As stipulated in the “Nationa
Page 195:
Work Plan Calvert County Breast and
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Year 1 Budget Request - DHMH - Maryland.gov

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