03 95332421Q0059 RFQ Attach Bio-Data Form.docx

MCC PROPOSED CONTRACTOR BIOGRAPHICAL DATA SHEET | PERSONAL SERVICES CONTRACTORS

1. NAME (Last, First, Middle)

2. MCC PROGRAM AREA ON JOB ANNOUNCEMENT

3. CONTRACTOR’S ADDRESS (include ZIP code)

4. CONTRACTOR PROPOSED SALARY (include proposed pay supplement based on solicitation) Basic Rate of Pay: Click here to enter text.

Pay Supplement (%): Click here to enter text.

Full Labor Rate (Basic Rate of Pay + Proposed Pay Supplement %): Click here to enter text.

5. TELEPHONE NUMBER (include area code)

6. PLACE OF BIRTH

7. COUNTRY OF CITIZENSHIP

Speaking Proficiency Reading

10. EMPLOYMENT HISTORY

1. For last three (3) years list salaries separate for each year. Continue on separate sheet of paper, if required, to list all employment related to duties of proposed assignment.

2. Salary definition: Basic periodic payment for services rendered. Exclude bonuses, profit-sharing arrangements, commissions, consultant fees, extra or overtime work payments, overseas differential or quarters, cost of living, and dependent education allowances.

11. SPECIFIC CONSULTANT SERVICES (give last three (3) years)

in Dollars

12. MILLENNIUM CHALLENGE ACCOUNT (MCA*) INVOLVEMENT (check appropriate box) I have engaged, am engaging, and/or plan to engage in any MCA work. (If Yes, complete the table below.) Yes ☐ No ☐ *An MCA is MCC’s counterpart country entity that implements the Compact or Threshold Programs

13. CERTIFICATION: To the best of my knowledge, the above facts as stated are true and correct.

Signature of Contractor Candidate:

Date:

INSTRUCTION

Indicate your language proficiency in Block 9 using the following numeric Interagency Language Roundtable levels (Foreign Service Institute Levels). Also, the following provides brief descriptions of proficiency levels 2, 3, 4, and 5. “S” indicates speaking ability and “R” indicates reading ability.

1. Limited working proficiency

S Able to satisfy routine special demands and limited work requirements.

R Sufficient comprehension to read simple, authentic written material in a form equivalent to usual printing or typescript on familiar subjects within familiar contexts.

2. General professional proficiency

S Able to speak the language with sufficient structural accuracy and vocabulary to participate effectively in most formal and informal conversations on practical, social, and professional topics.

R Able to read within a normal range of speed and with almost complete comprehension of a variety of authentic prose material on unfamiliar subjects.

3. Advanced professional proficiency

S Able to use the language fluently and accurately on all levels normally pertinent to professional needs.

R Able to read fluently and accurately all styles and forms of the language pertinent to professional needs.

4. Functional native proficiency

S Speaking proficiency is functionally equivalent to that of a highly articulate well-educated native speaker and reflects the cultural standards of a country where the language is natively spoken.

R Reading proficiency is functionally equivalent to that of the well-educated native reader.

The information requested by this form provides MCC an indication of qualifications and helps determine reasonableness of proposed salary. Completion of this form is estimated to average thirty minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.