SafeUT Third Party Vendor Request

SafeUT Third Party Vendor Request

Thank you for your interest in partnering with SafeUT. Please complete the following information to be reviewed by the SafeUT Third Party Vendor Subcommittee. A member of the subcommittee will follow up with you via email with the applicable next steps.

Note: This form is for information-gathering purposes only, and is not to be interpreted as a commitment to partner or initiate any purchasing process.

Vendor Company Name*

Contact Name*

Contact Email Address*

Contact Phone Number*

Summary of Proposed Partnership*

Please keep your overview to 500 words or less.

What is your company's affiliation?*

Mental Health

Schools

Administration

Technology

Other

Please indicate whether this is a(n):

Select or enter value

Please indicate.

Company Website/Informational Page

Please enter a URL.

How do your company's mission, vision, and values align with SafeUT?*

If your company were to partner with SafeUT, what clinical operations, technical, or other support would be required on a one-time or ongoing basis?*

Relevant SafeUT Platform(s)*

SafeUT (K-12 and higher education)

SafeUTNG (Utah National Guard)

SafeUT Frontline (frontline workers: law enforcement, fire/EMS, healthcare)

What experience does the company have in mental health, school/public safety, and/or information technology?*

How would the proposed partnership benefit SafeUT users or improve current services?*

Would there be any costs associated with the proposed partnership?*

Note: In order to comply with State procurement processes, the SafeUT Third Party Vendor Subcommittee may only gather general categorical information to follow next steps and may not discuss specific dollar amounts, financial details, or proposed contract terms at this time.

No associated costs

Costs that are less than $5000 one-time for the life of the partnership

Costs that are greater than $5000 one-time for the life of the partnership

Additional Information

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