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Page 13 of 53 <br />FORM 4.0 3 QUESTIONNAIRE <br />Suppliers must complete this “Questionnaire,” providing the information in the same order requested <br />below. In their narrative, suppliers may emphasize any areas of their proposal that exceed our <br />requirements. <br />1. Qualifications and Relevant Experience <br />A. Briefly describe your company. Include how long the company has been in business. <br />B. If awarded this contract, who are you proposing will be the primary psychologist(s) for the <br />individual appointments? Include their education, years in the industry, years with the company, <br />details of their experience, etc. If you anticipate sharing the responsibility with other providers, <br />provide the same information as the primaries. <br />C. Describe your experience working with law enforcement recovering from post-traumatic injury or <br />post-traumatic stress disorder. <br />D. Describe your philosophy of practice and what characteristics most distinguish your company <br />from your competitors. <br />2. Technical Capability, Approach, and Capacity <br />A. How will you manage the one-on-one appointment workflow? Describe how employees will <br />schedule appointments with you and what appointment reminders employees can expect to <br />receive. <br />B. What is your company’s availability for this project? Will the proposed primary psychologist be <br />available within the timeframe listed in Section 2.3? How quickly can your psychologists commit <br />to scheduling EPD employees for follow-up appointments? Explain how you will ensure a <br />psychologist will be available for individual appointments. <br />C. Describe how you would conduct individual appointments with officers and civilian staff. <br />D. How does your approach meet or exceed our needs as described in the scope of work? <br />E. Describe any additional services that your company offers, including training and Peer Support <br />team assistance. <br />3. Communication, Customer Services, and Training <br />A. Provide where your office is located and the service hours in Pacific Time. <br />B. Describe how your project manager will keep the City of Everett timely informed of any issues <br />related to delivering the services described in this RFP. <br />C. What is your company’s policy for returning calls and e-mails? <br />D. Describe the ongoing training of your staff to ensure daily working knowledge applicable to this <br />contract. <br />Exhibit C