7-HSS-26-020 - Enhanced Communication - Attachment 6 - Subcontractor Information Form.docx
DOCX document 131 KB Posted
- Attached to
- ENHANCED COMMUNICATION State and local contract opportunity
- Solicitation number
- HSS-26-020
- Issued by
- Delaware
About this file
This document is a Subcontractor Information Form for the Delaware Health and Social Services Division of Developmental Disabilities (DDDS) related to the Enhanced Communication contract (HSS-26-020). The contract seeks to provide facilitated communication opportunities for Deaf service recipients receiving residential habilitation services, with a focus on supporting communication between service recipients, housemates, and staff. Additionally, the contract includes educational components for Direct Support Professionals (DSPs) about Deaf Culture and functional American Sign Language (ASL) vocabulary.
The form is designed to capture detailed information about potential subcontractors, including their business classifications such as Women Business Enterprise, Minority Business Enterprise, Disadvantaged Business Enterprise, Veteran Owned Business Enterprise, and Service-Disabled Veteran Owned Business Enterprise. While specific pricing terms are not detailed in this document, the contract emphasizes compliance with state and federal laws, with full service details available in Appendix B of the Scope of Work. The opportunity is specific to Delaware and aims to enhance communication support for individuals with developmental disabilities who are deaf.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 2-HSS-26-020 - Enhanced Communication - Attachment 1 - No Proposal Reply Form.docx | DOCX document | |
| 5-HSS-26-020 - Enhanced Communication - Attachment 4 - Confidential Information.docx | DOCX document | |
| 6-HSS-26-020 - Enhanced Communication - Attachment 5 - Business References Form.docx | DOCX document | |
| 1-HSS-26-020 - Enhanced Communication - Final.docx | DOCX document | |
| 8-HSS-26-020 - Enhanced Communication - Appendix C - PSA, BAA DTI TCs.docx | DOCX document | |
| 3-HSS-26-020 - Enhanced Communication - Attachment 2 - Non-Collusion Statement.docx | DOCX document | |
| 4-HSS-26-020 - Enhanced Communication - Attachment 3 - Exceptions Form.docx | DOCX document |
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Text version
Delaware Health and Social Services
Division of Developmental Disabilities d
Delaware Health and Social Services
Division of Developmental Disabilities d
Attachment 6
SUBCONTRACTOR INFORMATION FORM
PART I – STATEMENT BY PROPOSING VENDOR
1. CONTRACT NO. HSS-26-020
TITLE: Enhanced Communication
2. Proposing Vendor Name:
3. Mailing Address
4. SUBCONTRACTOR
a. NAME
4c. Company OSD Classification:
Certification Number: _____________________
b. Mailing Address:
4d. Women Business Enterprise |_| Yes |_| No 4e. Minority Business Enterprise |_| Yes |_| No 4f. Disadvantaged Business Enterprise |_| Yes |_| No 4g. Veteran Owned Business Enterprise |_| Yes |_| No 4h. Service-Disabled Veteran Owned Business Enterprise |_| Yes |_| No
5. DESCRIPTION OF WORK BY SUBCONTRACTOR
6a. NAME OF PERSON SIGNING
| 7. BY (Signature) |
| 8. DATE SIGNED |
6b. TITLE OF PERSON SIGNING
PART II – ACKNOWLEDGEMENT BY SUBCONTRACTOR
9a. NAME OF PERSON SIGNING
| 10. BY (Signature) |
| 11. DATE SIGNED |
9b. TITLE OF PERSON SIGNING
* Use a separate form for each subcontractor image1.png image2.png
File details come from the government source that posted it. Updated .