Appendix-11- Billing Attestation Second payment.docx
DOCX document 23 KB Posted
- Attached to
- HOUSING SEARCH ENTITIES 5/22
- Solicitation number
- BD-23-1071-MFP-MF00-89001
- Issued by
- Massachusetts
About this file
This document is an appendix to a billing attestation for the second payment under a housing search contract. The Massachusetts Rehabilitation Commission (MRC) is seeking to create a pool of qualified Housing Search Entities (HSEs) to assist in finding community-based housing for adults with disabilities and elders served by various state-funded programs. The HSEs must complete a set of activities, including completing housing applications, tracking the status of submitted applications, and notifying case managers of any reasonable accommodations needed. The HSE representative and the case manager must both sign the attestation to confirm the completion of these activities before the second payment of $2,000 can be submitted.
The state and local contract opportunity involves the MRC seeking qualified HSEs to perform housing search tasks as outlined in the contract. The contract is for an unspecified term, and the details regarding pricing, set-asides, incumbents, funding requirements, and other salient information are not provided in this document.
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Text version
Appendix 11
Billing Attestation/Activities Completed HSE Part II Payment
Name of Individual:
HSE Agency
HSE Assigned Staff
Staff completing this form
Activities completed as of are checked off below:
Completing all Housing Applications Individual is eligible for included but not limited to LHAND, CHAMP, MA Housing Choice centralized Waiting list, 811, CBH and packaging blank housing applications for
Mailing completed applications and maintaining documentation
Checking on status of submitted applications
Continuing to identify housing options until housing is secured
Visiting available housing with the Individual (or their representatives)
Notifying the Case Manager of any reasonable accommodations needed
Tracking Log for Housing Applications and Communications maintained by the HSE, with updates forwarded monthly to Individual and CM using the Participant Housing Search Tool.
HSE Representative: My signature below indicates that this agency has completed all of the activities listed above, the criteria necessary for submission of request for the second payment ($2000.00) for HSE.
HSE Staff Date CM: My signature below indicates that the above HSE has completed all the activities necessary for submission of the first payment for HSE activities.
Case Manager Date
Revised 4/2023
File details come from the government source that posted it. Updated .