OCFS-4822, Procurement Lobbying Act Offeror Certification Form – OCFS-4842, State Consultant Services Contractors Planned Employment (Form A) – Vendor Responsibility Questionnaire For-Profit Business Entity OCFS-4715, Confidentiality Non-Disclosure Agreement Form OCFS-4716, Contractor Employee Background Certification A curriculum vita Copy of candidate’s license Copy of current NYS registration Documentation of board certification or board eligibility If the offeror is not an individual psychiatrist, offeror must provide proof of malpractice insurance Three (3) professional references, one of which must be from within the past 12 months. During contract negotiations, awarded offerors will be required to complete the following additional forms: ST-220-TD, Contractor Certification (NYS Dept. of Tax and Finance form) ST-220-CA, Contractor Certification to Covered Agency (NYS Dept. of Tax and Finance form) Proof of Worker’s Compensation & Disability Benefits coverage or Certificate of Attestation of Exemption from NYS Workers’ Compensation Board The bid documents must be submitted by mail, hand delivery, overnight carrier or certified mail in a package showing the following information on the outside, by the date and time identified in Section 1.3 to: NYS Office of Children and Family Services Attn: Warren Hamilton IFB 2017-05 52 Washington Street Room 202 South Rensselaer, NY 12144 Specifications Product/Service Specifications Minimum Requirements The offeror must meet the following minimum requirements: Have a valid license to practice medicine in New York State. Be board-certified or board-eligible in general psychiatry. Preferably board-eligible or board- certified in child and adolescent psychiatry by the American Board of Psychiatry and Neurology. Have a satisfactory reference check. Please note that although not required, the preferred candidate will have one (1) year of professional experience providing psychiatric services to children and adolescents as a member of the psychiatric staff of a psychiatric hospital and/or in the psychiatry department of a general hospital or in another setting, during or after general psychiatry residency. Experience working in a juvenile justice setting or with a juvenile justice population is also preferred.
OCFS-4822, Procurement Lobbying Act – Offeror Certification Form OCFS-4842, State Consultant Services – Contractors Planned Employment (Form A) Vendor Responsibility Questionnaire For-Profit Business Entity OCFS-4715, Confidentiality Non-Disclosure Agreement Form OCFS-4716, Contractor Employee Background Certification A curriculum vita Copy of candidate’s license Copy of current NYS registration Documentation of board certification or board eligibility If the offeror is not an individual psychiatrist, offeror must provide proof of malpractice insurance Three (3) professional references, one of which must be from within the past 12 months. During contract negotiations, awarded offerors will be required to complete the following additional forms: ST-220-TD, Contractor Certification (NYS Dept. of Tax and Finance form) ST-220-CA, Contractor Certification to Covered Agency (NYS Dept. of Tax and Finance form) Proof of Worker’s Compensation & Disability Benefits coverage or Certificate of Attestation of Exemption from NYS Workers’ Compensation Board The bid documents must be submitted by mail, hand delivery, overnight carrier or certified mail in a package showing the following information on the outside, by the date and time identified in Section 1.3 to: NYS Office of Children and Family Services Attn: Warren Hamilton IFB 2017-05 52 Washington Street Room 202 South Rensselaer, NY 12144 Specifications Product/Service Specifications Minimum Requirements The offeror must meet the following minimum requirements: Have a valid license to practice medicine in New York State. Be board-certified or board-eligible in general psychiatry. Preferably board-eligible or board- certified in child and adolescent psychiatry by the American Board of Psychiatry and Neurology. Have a satisfactory reference check. Please note that although not required, the preferred candidate will have one (1) year of professional experience providing psychiatric services to children and adolescents as a member of the psychiatric staff of a psychiatric hospital and/or in the psychiatry department of a general hospital or in another setting, during or after general psychiatry residency. Experience working in a juvenile justice setting or with a juvenile justice population is also preferred.
IFB2017-05-Fall-2017-Psychiatric.docx