04 Attachment B - OVR Contractor Personnel Confidentiality Form_OVR-142.pdf
PDF 576 KB Posted
- Attached to
- 12 OVR Enhanced Driving and Ancillary Services
- Solicitation number
- 6100059505
- Issued by
- Carbon County, Dauphin County, York County, Wolfdale CDP, Pennsylvania
About this file
This document is an Invitation for Bids (IFB) issued by the Pennsylvania Department of Labor and Industry (DLI), Office of Vocational Rehabilitation (OVR), on behalf of the Bureau of Vocational Rehabilitation Services (BVRS) and the Bureau of Blind and Visual Services (BBVS). The IFB is seeking qualified transportation suppliers to provide professional, on-demand Non-Emergency Business Transport Services for OVR employees and clients, who may be blind, visually impaired, or have other disabilities that prevent them from driving themselves. The services are required at the 21 total BBVS and BVRS OVR District offices located throughout the Commonwealth of Pennsylvania. The IFB also requires suppliers to provide assistive, ancillary services, such as scribe work, reading, sighted guide, and safety surveys, at the request of OVR personnel.
The IFB is a DGS Small Business Reserve Procurement, and only self-certified small business suppliers are eligible to bid. Suppliers must be registered with the Commonwealth to access the PA Supplier Portal and bid documents. All questions regarding the IFB must be submitted by January 15, 2024, and all questions and responses will be considered an addendum to the IFB.
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Text version
OVR-142
7/10 ALL Department of Labor & Industry
Office of Vocational Rehabilitation
I, (Print name.)
agree that I will not solicit, disclose, receive or make use of any information concerning, persons applying for or receiving vocational rehabilitation services, directly or indirectly derived from the execution of my duties as a Driver pursuant to contract # .
I understand that I must not divulge this information to any person or entity. Breach of this confidentiality may result in termination of the contract.
Further, I agree to maintain the confidentiality of information obtained in the course of my duties with respect to all matters relating to employees and customers of the Pennsylvania Office of Vocational Rehabilitation, whether such information is written, verbal or observed.
Driver Signature Date
OVR Staff Signature Date
Auxiliary aids and services are available upon request to individuals with disabilities. Equal Opportunity Employer/Program
Refers to Numbered Memo 10-100.02
CONFIDENTIALITY
CONFIDENTIALITY
Sherrie Bruegman
OVR-142
7/10
ALL
Department of Labor & Industry Office of Vocational Rehabilitation I, (Print name.)
agree that I will not solicit, disclose, receive or make use of any information concerning, persons applying for or receiving vocational rehabilitation services, directly or indirectly derived from the execution of my duties as a Driver pursuant to contract # I understand that I must not divulge this information to any person or entity. Breach of this confidentiality may result in termination of the contract.
Further, I agree to maintain the confidentiality of information obtained in the course of my duties with respect to all matters relating to employees and customers of the Pennsylvania Office of Vocational Rehabilitation, whether such information is written, verbal or observed.
Driver Signature Date OVR Staff Signature Date Auxiliary aids and services are available upon request to individuals with disabilities. Equal Opportunity Employer/Program Refers to Numbered Memo 10-100.02
CONFIDENTIALITY
| Print or Type the driver's name.: |
| Type or Print the Contract number.: |
| Resets the form: |
| Prints the form.: |
File details come from the government source that posted it. Updated .