MANDATORY EXECUTIVE SUMMARY (LETTER OF INTENT) – ATTACHMENT A

The MANDATORY Executive Summary is due to WDBCO by 5pm on Tuesday, July 2, 2019. The Executive Summary will authorize you to submit a proposal but does not commit the Bidder to submit a proposal. The Executive Summary also allows WDBCO and FCDJFS to effectively plan for the maximum number of proposals for review. Proposals will NOT be accepted if an Executive Summary is not received.

YOU MUST SUBMIT THIS LETTER IN ORDER TO SUBMIT A PROPOSAL

WORKFORCE DEVELOPMENT BOARD OF CENTRAL OHIO1650 LAKE SHORE DRIVE, SUITE 110

COLUMBUS, OHIO 43204

***PLEASE TYPE OR PRINT CLEARLY***

TO: Lisa Patt-McDaniel, President & CEO, WDBCO

FROM: Director/President/CEO: _________________________________________________________

Phone: ____________________ Email Address: ______________________________________

RE: Executive Summary for RFP Title: Achieve More and Prosper Services and Management for In-School Youth and Young Adults

_____________________________________________ (Agency Name) intends to submit a proposal in response to the Request for Proposals indicated above.

Please direct all correspondence related to this RFP to the contact person identified below:

Name: ______________________________________ Title: ___________________________________

Address: __________________________________________ Apt/Ste/Fl: ________________________

City: ________________________________________ State: _______ Zip: ______________________

Phone Number: _____________________________ Fax Number: ______________________________

Email Address: ________________________________________________________________________

Tax ID Number: ________________________________

Submission of this form by 4pm on Friday, June 28, 2019 will ensure all notifications regarding addenda to or clarifications of this RFP. After the Bidders’ Conference, all subsequent questions and answers will be forwarded to Bidders. Failure to submit a Mandatory Executive Summary will result in Bidder’s

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exclusion from this list, which will result in missing notifications of significant information regarding this process. This letter must be received by the established deadline in order to submit a proposal.

______________________________________________________________________________(Signature) (Date)

______________________________________________________________________________(Agency Name) (Title)

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PROPOSAL PACKET COVER SHEET – ATTACHMENT B

2019 ACHIEVE MORE AND PROSPER SERVICES AND MANAGEMENT FOR IN-SCHOOL YOUTH AND YOUNG ADULTS

PROPOSAL PACKET

BIDDER/AGENCY NAME: ______________________________

MAY 2019

A.M.P. RFP ISY

The Workforce Development Board of Central Ohio (WDBCO) and Franklin County Department of Job and Family Services (FCDJFS) requires the following information from Bidders that submit proposals in

response to any WEDBCO and/or FCDJFS Requests for Proposals (RFPs). WDBCO and FCDJFS reserve the right to reject the Bidder’s proposal if not completed accurately, in its totality. Bidders are to provide the

completed and signed information and certifications as the cover pages of their original proposal submitted.

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PROPOSAL PACKET TABLE OF CONTENTS – ATTACHMENT C

Bidder/Agency Name: ______________________________________ Date: _________

Title of RFP: 2019 ACHIEVE MORE AND PROSPER SERVICES AND MANAGEMENT FOR IN-SCHOOL YOUTH AND YOUNG ADULTS

Submit ONE (1) Original Packet (signatures in blue ink) ; ONE (1) Original Required Documents Packet (signatures in blue ink); and ONE (1) Jump Drive that includes both packets

1. Cover Sheet Page(s) # _____

2. 2019 A.M.P. ISY Services and Management Narrative Page(s) # _____

3. Required Attachments Page(s) # _____

a. Job Descriptions for All Positions Page(s) # _____

b. Resumes and Licenses for Existing Program Staff Page(s) # _____

c. Worksite Agreements and Documentation Page(s) # _____

d. Table of Organization for the Agency Page(s) # _____

e. Table of Organization for the A.M.P. Services Page(s) # _____

4. Subcontract/Partnership Agreements (if applicable) Page(s) # _____

5. Optional Attachments Page(s) # _____

6. Budget Document Page(s) # _____

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NARRATIVE HEADER: ORGANIZATIONAL INFORMATION – ATTACHMENT D

RFP TITLE: PROPOSAL DUE DATE:Achieve More and Prosper Services and

Management for In-School Youth and Young Adults

Friday, July 19, 2019

BIDDER’S LEGAL NAME: BIDDER’S FEDERAL TAX ID #:

BIDDER’S MAILING ADDRESS: BIDDER’S CORPORATE ADDRESS:

BIDDER’S PHONE #: BIDDER’S FAX #: BIDDER’S WEBSITE:

TYPE OF ORGANIZATION: FAITH BASED?

☐ 501 (c)(3) Non-Profit

☐ For-Profit Business

☐ Government Entity

☐ Education Institute

☐ Other (please describe):

☐ Faith Based

Note for Faith-Based Organizations: Subaward funds may not be used to fund any inherently religious activities such as worship, religious instruction or proselytization. Bidders may still engage in inherently religious activities, but such activities must be separate in time and/or location from the funded program and participation in such activities by individuals receiving services from the Subrecipient or a Subcontracts must be voluntary.

EXECUTIVE DIRECTOR/PRESIDENT/CEO:

Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

CHIEF FINANCIAL OFFICER:

Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

PROGRAM SUPERVISOR:

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Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

PRIMARY PROGRAM CONTACT:

Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

SECONDARY PROGRAM CONTACT:

Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

PRIMARY BILLING/INVOICE CONTACT:

Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

SECONDARY BILLING/INVOICE CONTACT:

Name:Direct Line:Email:

Is this person authorized to:Sign Contracts: ☐ Yes ☐ NoModify Budgets: ☐ Yes ☐ NoModify Program: ☐ Yes ☐ NoSign Invoices: ☐ Yes ☐ No

REQUIRED DOCUMENTS PACKET COVER SHEET – ATTACHMENT E

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2019 ACHIEVE MORE AND PROSPER SERVICES AND MANAGEMENT FOR IN-SCHOOL YOUTH AND YOUNG ADULTS

REQUIRED DOCUMENTS PACKET

BIDDER/AGENCY NAME: ______________________________

MAY 2019

A.M.P. RFP ISY

The Workforce Development Board of Central Ohio (WDBCO) and Franklin County Department of Job and Family Services (FCDJFS) requires the following information from Bidders that submit proposals in

response to any WEDBCO and/or FCDJFS Requests for Proposals (RFPs). WDBCO and FCDJFS reserve the right to reject the Bidder’s proposal if not completed accurately, in its totality. Bidders are to provide the

completed and signed information and certifications as the cover pages of their original proposal submitted.

REQUIRED DOCUMENTS PACKET TABLE OF CONTENTS – ATTACHMENT F

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Bidder/Agency Name: ______________________________________ Date: _________

Title of RFP: 2019 ACHIEVE MORE AND PROSPER SERVICES AND MANAGEMENT FOR IN -SCHOOL YOUTH AND YOUNG ADULTS

Submit ONE (1) Original Packet (signatures in blue ink) ; ONE (1) Original Required Documents Packet (signatures in blue ink); and ONE (1) Jump Drive that includes both packets

1. Certificate of Professional Liability Insurance Page(s) # _____

2. Certificate of Continued Existence or Certificate of Good Standing from Ohio Secretary of State Page(s) # _____

3. Worker’s Compensation Certificate Page(s) # _____

4. Delinquent Personal Property Tax Affidavit Page(s) # _____

5. Conflict of Interest Disclosure Form Page(s) # _____

6. W-9 Form Page(s) # _____

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DELINQUENT PERSONAL PROPERTY TAX AFFIDAVIT – ATTACHMENT G

This affidavit should be properly completed by the authorized representative of your firm and will be incorporated as part of the Workforce Development Board of Central Ohio and Franklin County Department of Job and Family Services Purchase of Service Subaward/Contractor Agreement with:

_________________________________________________ (Agency Name)

State of Ohio: _________________________________________________

County of Franklin, ss: __________________________________________

________________________________________, being first duly sworn, deposes and says that he/she is

the ______________________________ (Title) of _____________________ (Subrecipient/Contractor)

and as the Subrecipient/Contractor’s duly authorized representative states that as of _________, 2019:

o The Subrecipient/Contractor is not charged with delinquent property taxes on the general list of personal property in Franklin County, Ohio, or any other counties containing property in the taxing districts under the jurisdiction of the Auditor of Franklin County, Ohio.

o The Subrecipient/Contractor is charged with delinquent property taxes on the general list of personal property in Franklin County, Ohio, or any other counties containing property in the taxing districts under the jurisdiction of the Auditor of Franklin County, Ohio.

COUNTY: TOTAL AMOUNT (PENALTIES AND INTEREST):

Franklin $ _________________________

________________ $ _________________________

________________ $ _________________________

__________________________________________________________ (Affiant)

Sworn to and subscribed this _______________________________ day of ______________, 2019.

__________________________________________________________ (Notary Public)

Sections 5719.042 O.R.C. (Seal) My Commission expires _________________________, 20_____.

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CONFLICT OF INTEREST DISCLOSURE FORM – ATTACHMENT H

Name: ________________________________________________________________________

Agency: _______________________________________________________________________

Position in Agency: ______________________________________________________________

Please describe below any and all relationships and/or connections you have to any WDBCO and/or FCDJFS employee(s) that could contribute, or could be viewed as potentially contributing, to a conflict of interest:

o I have no conflict of interest, or potential conflict of interest, to report

o I have the following conflict of interest, or potential conflict of interest, to report (please identify the individual(s) with whom you have, or may have, a personal, familial, or business relationship, or to whom you are otherwise connected):

1. _________________________________________________________________

2. _________________________________________________________________

3. _________________________________________________________________

I hereby certify that the information set forth above is true and complete to the best of my knowledge, and that I have reviewed and agree to abide by the Conflict of Interest and Ethics Compliance Certification and Disclosure provisions contained in the RFP.

_______________________________________________________ ______________________ (Signature) (Date)

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