ANNEX IX
CHECKLIST ON SELECTION CRITERIA OF POINT 17.3. TECHNICAL
AND PROFESSIONAL CAPACITY
The objective of the checklist is to help tenderers to check if their offer complies with the
selection criteria, as described under 17.3 TECHNICAL AND PROFESSIONAL CAPACITY.
Please fill and sign this checklist as mandatory part of evidence (see 17.3.2 of the tender
specifications).
Name of the tenderer: ………………………………………………………………………….
Tenderer's organisation:
1.1 Experience in the specific field of cost analysis,
costing methodologies and models in the area of
healthcare systems and providers.
Name:
How many years of professional experience?
The tenderer has annexed a list with references of 5
annual reports, publications, or other documents
confirming the tenderer’s required experience in the
above mentioned field.
1.2 Experience in health economics, financing and
budgeting of healthcare systems and providers in the
public and private domain,
Name:
How many years of professional experience?
The tenderer has annexed a list with references of 5
annual reports, publications, or other documents
confirming the tenderer’s required experience over time
in the above mentioned field.
1.3 Experience in the area of highly specialised
healthcare
organisation
,
public
health
administration and healthcare managing and
planning
Name:
How many years of professional experience?
The tenderer has annexed a list with references of 5
annual reports, publications, or other documents
confirming the tenderer’s required experience in the
above mentioned field.
1
YES / NO
…
… years
Yes / No
YES / NO
…
… years
Yes / No
YES / NO
…
… years
Yes / No
1.4 Experience in projects and activities involving
healthcare stakeholders (public authorities, expert
panels, healthcare professionals, scientific societies,
patients associations etc.)
Name:
How many years of professional experience?
The tenderer has annexed a list with references of 5
annual reports, publications, or other documents
confirming the tenderer’s required experience over time
in the above mentioned field.
1.5 Knowledge and experience of healthcare systems
at national and EU level
Name:
How many years of professional experience?
The tenderer has annexed a list with references of 5
annual reports, publications, or other documents
confirming the tenderer’s required experience in the
above mentioned field.
YES / NO
…
… years
Yes / No
YES / NO
…
… years
Yes / No
Team Leader:
2.1. The tenderer has a team leader that fulfils the
following:
o a university degree in Economics, specialised in
the area of health economics
o at least 10 years of relevant professional
experience in the field of health economics and other
fields, with relevance to healthcare planning,
management and evaluation .
o at least 5 years' experience in managing
multidisciplinary teams and working in liaison with
healthcare professionals, healthcare managers, highranking governmental officials and other related
stakeholders and
o at least 5 years' experience in the coordination
or participation in national or EU or International
projects related to the field of healthcare and health
economics.
Name of the team leader:
How many years of professional experience?
The team leader has annexed a CV in EUROPASS
format (cf. specifications 17.3.2.).
Team leader has English knowledge at "C2" level
Team members: the tenderer shall have the capacity to
put together a multidisciplinary team including at least
2
YES / NO
…
… years
Yes / No
Yes / No
3 professionals
2.5. One senior member with a university degree in
economics or related areas with specialisation in cost
analysis and budgeting in healthcare with at least 10
years of relevant professional experience in the field
of cost analysis and financial and budgetary aspects
of healthcare systems and providers both in the
private and public sector at national and
international level.
Name of the team member:
How many years of professional experience?
The team member has annexed a CV in EUROPASS
format (cf. specifications 17.3.2.).
2.6. One member with a university degree in
medicine, with specialisation in healthcare
management and planning and at least 10 years
professional experience in the field of highly
specialised healthcare and in the review and
production of technical, scientific and
methodological articles or documents
Name of the team member:
How many years of professional experience?
The team member has annexed a CV in EUROPASS
format (cf. specifications 17.3.2.).
2.7. One member with a university qualification with
at least 5 years of relevant professional experience in
liaising with technical and policy-making bodies and
agencies dealing with healthcare, healthcare
management, and professional experience in the use
of qualitative technics for the management of
experts groups and panels.
Name of the team member:
How many years of professional experience?
The team member has annexed a CV in EUROPASS
format (cf. specifications 17.3.2.).
3.1. All team members have a proven adequate
working knowledge of English with excellent writing
skills (C1 or higher);
The Europass Language Passport template is filled in
for the team leader and all team members
3.2. The tenderer has appropriate administrative
and logistic support for the development of the
project showing experience in the project
management at national or EU/International level
(conduction and management of projects including
administrative, legal and financial matters) ensuring
the content, format, and professional appearance of
3
YES / NO
… years
Yes / No
YES / NO
….
… years
Yes / No
YES / NO
… years
Yes / No
YES / NO
Yes / No
YES / NO
the reports and deliverables of a project
* include more lines as desired
Date
………………………………
Signature
4