Attachment J-2 SEC_0008_Credit_Release_Form.pdf
PDF 85 KB Posted
- Attached to
- Psychosexual Risk Assessments Federal contract opportunity
- Solicitation number
- 9594CS24Q0002
About this file
This document is a Credit Release Form from the Court Services and Offender Supervision Agency (CSOSA) for the District of Columbia. It authorizes CSOSA to obtain one or more consumer/credit reports about the applicant for employment purposes, including evaluating fitness for employment, promotion, reassignment, retention, or access to classified information.
The related federal contract opportunity is a solicitation (Solicitation Number: 9594CS24Q0002) for Psychosexual Risk Assessments. CSOSA is seeking comprehensive psychosexual risk assessments, sexual history polygraph examinations, psychosexual risk assessment reports, and corresponding treatment recommendations. The work will be performed at CSOSA's facility in Washington, DC, and some services may be provided virtually. The solicitation is a total Small Business Set-Aside under NAICS code 621330, Offices of Mental Health Practitioners. The resultant award is anticipated to be a total of 5 years (one 12-month base period plus four 12-month option periods). All quotes submitted must comply with the submission requirements outlined in Section L.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 9594CS24Q0002 Amd 0001.pdf | ||
| Attachment J-1 SEC0010-Temp-Contractor-Form-10182013.pdf | ||
| Attachment J-7 Past Performance Questionnaire.docx | DOCX document | |
| Attachment J-8 Solicitation Price Sheet.docx | DOCX document | |
| Solicitation 9594CS24Q0002.pdf | ||
| Attachment J-4 Contractor Confidentiality and Nondisclosure Agreement.docx | DOCX document | |
| Attachment J-3 PIV_Request_Form_051409.pdf | ||
| Attachment J-6 Cover Letter.docx | DOCX document | |
| Attachment J-5 FAR 52.212-3 Offeror Reps & Certs - Comm Items & Svcs.docx | DOCX document |
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Text version
Court Services and Offender Supervision Agency for the District of Columbia
MEMORANDUM
This is a release for the Court Services and Offender Supervision Agency to obtain one or more consumer/credit reports about you in connection with your application for employment or in the course of your employment with the Court Services and Offender Supervision Agency. One or more reports about you may be obtained for employment purposes, including evaluating your fitness for employment, promotion, reassignment, retention, or access to classified information.
I,______________________________________, hereby authorize the Court Services and
Offender Supervision Agency to obtain such report(s) from any consumer/credit reporting agency for employment purposes.
Signature
Date
Social Security Number
CSOSA-SEC-0008 Revision: 11/2002
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File details come from the government source that posted it. Updated .