Attachment_2-D__3_.pdf

PDF 813 KB Posted

Attached to
Master Agreement AZ|CTR064201
Contract number
CTR064201
Issued by
Arizona

About this file

This document is a Request for Proposal (RFP) from the State of Arizona, specifically the Department of Child Safety, Office of Procurement & Contracts, located in Phoenix. The solicitation number is BPM004352 and it is for Attachment 2-D, which is a Listing of Employees and Subcontractors form.

The RFP seeks providers of Psychological and Counseling Services, with this specific attachment requiring detailed information about employees and subcontractors who will be engaged in direct client services. The form is designed to capture critical personnel details including employee/subcontractor names, dates of birth, dates of hire, and fingerprinting clearance card numbers. In this instance, the form is currently blank (marked N/A), suggesting it is a template to be completed by the prospective service provider as part of their proposal submission. The document is part of a larger solicitation package, with this being page 28 of 41, and is available online through the APP.AZ.GOV website.

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Other files

File Type Posted
Exhibit A J.K. Principles.pdf PDF
Exhibit B Progress Report CSO-1139A.doc DOC document
Exhibit D DCS Counseling Consultation Services Invoice.xlsx XLSX spreadsheet
Exhibit F ADCS Psychiatric and Psychological Services Invoice.xlsx XLSX spreadsheet
Exhibit I Therapeutic Versus Forensic Evaluations.pdf PDF
Exhibit K Psychological Assessment Behavioral Indicators.pdf PDF
Sigend-Redacted_Offer_and_Acceptance.pdf PDF
Amendment_1.pdf PDF
Attachment_3-E__3__Redacted.pdf PDF
Exhibit 1 Limited English Proficiency Policy.pdf PDF
Exhibit I Quarterly Data Report.xlsx XLSX spreadsheet
Psychological___Counseling_SOW_Amendment_1.pdf PDF
2024-DES.pdf PDF
Amendment_3.pdf PDF
Contract_Amendment_6.pdf PDF
Exhibit C ADJC Service Providers Unusual-Significant Incident Report Protocol.pdf PDF
Exhibit C DCS Unit Consult Log and Verification of Client Services-Clinical-Cnslg.doc DOC document
Exhibit E Progress Report CSO-1139A.doc DOC document
Exhibit H Clinical Family Assessment rev 10-23-15.doc DOC document
2025.pdf PDF
Attachment_3-D__3__Redacted.pdf PDF
Contract_Amendment_2.docx DOCX document
Contract_Amendment_4.pdf PDF
Contract_Amendment_5.pdf PDF
Exhibit B DCS Significant Incident Report CSO-1151A.doc DOC document
Exhibit E ADJC Verification of Juvenile Services-Clinical-Counseling.doc DOC document
Exhibit H Psychological Assessment-Testing Instruments.doc.pdf PDF
Exhibit M ADJC Program Evaluation.pdf PDF
Solicitation_Part_1.docx DOCX document
Show all 29

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