REQUEST FOR QUOTE 18DOH0001 ON-SITE FLU SHOT SERVICES

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PHILIP D. MURPHY Governor SHEILA Y. OLIVER Lt. Governor DEPARTMENT OF HEALTH PO BOX 360 TRENTON, N.J. 08625-0360 www.nj.gov/health SHEREEF M. ELNAHAL, MD, MBA Commissioner REQUEST FOR QUOTE 18DOH0001 ON-SITE FLU SHOT SERVICES Event Date Time Bidder s Electronic Question Due Date October 29th, 2018 2:00 P.M. EST Quote Submission Date November 2nd, 2018 2:00 P.M. EST Date: October 22, 2018

PURPOSE AND INTENT This Request for Quote (RFQ) is issued by the Division of Management and Administration (Division), Department of Health (Department). The purpose of this RFQ is to solicit quotes from qualified providers to administer On-Site Flu Shot Services to Department of Health, State of New Jersey Employees on November 14 th - November 15 th, 2018, between 10AM 2PM EST. Note: All businesses must have a valid Business Registration Certificate (BRC) from the Department of Treasury, Division of Revenue and Enterprise Services, prior to conducting business with the State of New Jersey. Bidders are advised to visit the Division of Purchase and Property (DPP) website located at the link below for additional information on Doing Business with the Division and registering with the Division s new eprocurement system NJSTART. http://www.nj.gov/treasury/purchase/doingbusiness.shtml BACKGROUND The Department s priority is improving population health by strengthening New Jersey s health system. The Department s five branches, Public Health Services, Health Systems, Integrated Health, Office of Population Health and the Office of Policy and Strategic Planning work collaboratively toward that goal. Population health focuses on keeping healthy New Jerseyans well, preventing those at risk from getting sick, and keeping those with chronic conditions from getting sicker. Population health promotes prevention, wellness and equity in all environments, resulting in a healthy New Jersey. BIDDER QUESTIONS All question and inquiries concerning this RFQ must be submitted electronically, to the email address listed below, by due date on cover sheet (October 29th, 2018 2:00 P.M. EST). Email: Aaron.Scott@doh.nj.gov SUBMISSION OF QUOTES The Quotes must be received by the Division at the appropriate location no later than the Quote Submission date indicated on the RFQ cover sheet (November 2nd, 2018 2P.M. EST). Bidders submitting hard copy quotes are cautioned to allow adequate delivery time to ensure timely delivery of Quotes. 2

Hard copy quote must be submitted to the following address: State of New Jersey Department of Health Attention: Aaron Scott Division of Management and Administration 369 S. Warren Street, 7 th Floor Trenton, NJ 08625-0360 Electronic quote must be submitted via email to: Aaron.Scott@doh.nj.gov Definitions Bidder An individual or business entity submitting a quote in response to this RFQ. Provider Medical professional licensed to administer flu shots Division The Division of Management and Administration DOH The State of New Jersey Department of Health. MAY Denotes that which is permissible, not mandatory. RFQ This document which establishes the bidding and purchase order requirements and solicits quotes to meet the needs of the using agency as identified herein. Shall or Must Denotes that which is a mandatory requirement. Failure to meet a mandatory material requirement will result in rejection of a quote as non-responsive. State State of New Jersey. SCOPE OF WORK GENERAL INFORMATION Influenza (flu) is a contagious respiratory illness caused by influenza. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with certain health conditions are at high risk 3

for serious flu complications. The New Jersey Department of Health works closely with the healthcare and public health community to conduct surveillance for seasonal and novel influenza, promote annual influenza vaccinations, respond to season influenza outbreaks, and plan and prepare for the occurrence of novel influenza. PROVIDER DELIVERABLES The provider shall perform the following tasks: 1. Administer on-site Flu Shot Services to approximately 400 DOH Employees on November 14 th - November 15 th, 2018 between 10A.M. 2P.M. EST each day, at the Health and Agriculture building s Board Room. 369 South Warren Street Trenton, NJ 08608 2. All applicable standards must be followed per CDC Standards PRICING 1. The Provider shall administer Flu-Shot Services at no cost to the State. a. The Provider shall be required to bill the Health Insurance Company of the New Jersey DOH employees; and b. With its Quote submission, the Provider shall include the cost per shot that will be billed to the insurance company. WORK SCHEDULE November 14 th and November 15 th, 2018, between the hours of 10 A.M. to 2:00 P.M. EST each day RESUME Quote submission shall include detailed Resume/CV shall be submitted. Resume/CV should emphasize relevant qualifications and experience. QUOTE PREPARATION AND SUBMISSION GENERAL The Bidder is advised to thoroughly read and follow all instructions contained in this RFQ. QUOTE SUBMISSION 4

A quote must arrive at the Division in accordance with this RFQ, within the time frame indicated on the RFQ cover sheet. Bidders submitting hard copy Quotes are cautioned to allow adequate delivery time to ensure timely delivery of Quotes. For Hard Copy Quotes, the Bidder shall label the exterior of its package as follows: Identification number located on the cover page of this RFQ; Name of RFQ; and To be opened by addressee only. QUOTE CONTENT FORMS, REGISTRATIONS AND CERTIFICATIONS REQUIRED WITH QUOTE The Bidder shall complete, including signature of an authorized representative of the Bidder, and submit the Information Sheet and Certification for Delegated Purchasing Authority Transactions. Please Note: all forms are available on the Division of Purchase and Property website at the following link: http://www.nj.gov/treasury/purchase/forms/dpa_packet.pdf In addition to the Information Sheet and Certification for Delegated Purchasing Authority Transactions, the Bidder must also submit the following forms and certifications with its quote: Business Registration Certificate For businesses not registered with the State of New Jersey, Division of Revenue and Enterprise Services, you MUST complete a Business Registration Certificate Application which is located at http://www.nj.gov/njbusiness/starting/. You must have a valid Business Registration to be eligible to do business with the State of New Jersey; Ownership Disclosure Form Pursuant to N.J.S.A. 52:25-24.2, in the event the Bidder is a corporation, partnership or sole proprietorship, the Bidder must complete and sign the attached Ownership Disclosure Form. A current completed Ownership Disclosure Form must be received prior to or accompany the submitted quote. A Bidder s failure to submit the competed and signed form with it quote will result in the rejection of the proposal as non-responsive and preclude the award of a Purchase Order unless the Division has on file a signed and accurate Ownership Disclosure Form dated and received no more than six months prior to the quote submission deadline for this quote; Disclosure of Investment Activities in Iran Form Pursuant to N.J.S.A. 52:25-24.2, the Bidder must utilize this Disclosure of investment Activities in Iran form to certify that neither the Bidder, nor one of its parents, subsidiaries, and/or affiliates as defined in N.J.S.A. 52:32-56 (e) (3), is listed on the Department of the Treasury s List of Persons or Entities Engaging in Prohibited Investment Activities in Iran and that neither the Bidder, nor one of its parents, subsidiaries, and/or affiliates is involved in any of the investment 5

activities set forth in N.J.S.A. 52:32-56(f). If the Bidder is unable to so certify, the Bidder shall provide a detailed and precise description of such activities as directed on the form. A Bidder s failure to submit the completed and signed form with its quote will result in the rejection of the quote as non-responsive and preclude the award of a Purchase Order to said Bidder; MacBride Principles Certification The Bidder must certify pursuant to N.J.S.A. 52:34-12.2 that it is in compliance with the MacBride principles of nondiscrimination in employment as set forth in N.J.S.A 52:18A-89.5 and in conformance with the United Kingdom s Fair Employment (Northern Ireland) Act of 1989, and permit independent monitoring of their compliance; and Delegated Purchasing Authority Terms and Conditions signed and dated. Disclosure of Investigations and Actions Involving Bidder Form The Bidder should submit the Disclosure of Investigations and Actions Involving Bidder Form attached to this quote, with its quote submission. If a Bidder does not submit the form with the quote, the Bidder must comply within seven (7) business days of the Division s request or the Division may deem the quote non-responsive; Source Disclosure Certification Form Pursuant to N.J.S.A. 52:34-13.2, prior to an award of Purchase Order, the Bidder is required to submit a completed Source Disclosure Form. The Bidder s inclusion of the completed Services Source Disclosure Form with the proposal is requested and advised. If a Bidder does not submit the form with the quote, the Bidder must comply within seven (7) business days of the Division s request or the Division may deem the quote non-responsive; Affirmative Action Supplement Form The intended awardee must submit a copy of a New Jersey Certificate of Employee Information Report, or a copy of Federal Letter of Approval verifying it is operation under a federally approved or sanctioned Affirmative Action Program. Intended awardee(s) not in possession of either a New Jersey Certificate of Employee Information Report or a Federal Letter of Approval must complete the Affirmative Action Employee Information Report (AA-302); Notice to All Bidders Set-Off for State Tax; Vendor Certification and Political Contribution Disclosure Form; Two Year Chapter 51/Executive Order 117 Vendor Certification and Disclosure of Political Contributions Form; and Insurance Certificates The Contractor shall provide the State with current Certificates of Insurance for all coverages. 6