Attachment_6-_VR_Attestation_-_Copy.pdf

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Attached to
RFA #20770 / SFS # MSWP12026 and MSWP22026: Migrant and Seasonal Worker Program
Solicitation number
2136085
Issued by
New York

About this file

This Vendor Responsibility Attestation document pertains to the New York State Department of Health's Request for Applications (RFA #20770) for the Migrant and Seasonal Worker Program. The attestation requires vendors to comply with vendor responsibility requirements by completing an online Vendor Responsibility Questionnaire through the New York State Office of State Comptroller (OSC) website or by certifying exempt status. The RFA seeks qualified service providers to deliver culturally and linguistically appropriate health and social support services to migrant and seasonal workers and their families across New York State. The contract period extends for four years with an annual allocation of $351,431, totaling $1,405,724 over the contract term. The program encompasses two components: services to migrant and seasonal workers and their families in designated economic development regions, and services specifically targeting children of migrant and seasonal workers.

The funding for this initiative derives from both New York State and federal sources, with the Department of Health's Office of Health Equity and Human Rights administering the grants to public and not-for-profit, community-based health and human service organizations. Applicants must demonstrate recognized ties to the migrant and seasonal worker population in New York State and commitment to health equity principles. The attestation document serves as a required compliance verification, with organizations required to either maintain a current online questionnaire certified within the preceding six months or qualify for exemption under specified categories, including governmental entities, public authorities, public colleges and universities, public benefit corporations, and Indian Nations.

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Text version

Attachment 6

Vendor Responsibility Attestation

To comply with the Vendor Responsibility Requirements outlined in Section IV, Administrative

Requirements, K. Vendor Responsibility Questionnaire, I hereby certify:

Choose one:

☐ An on-line Vender Responsibility Questionnaire has been created, updated, and certified at OSC's website: https://www.osc.state.ny.us/state-vendors/vendrep/vendrep-system within the last six months.

☐ A Vendor Responsibility Questionnaire is not required due to an exempt status.

Exemptions include governmental entities, public authorities, public colleges and universities, public benefit corporations, and Indian Nations.

Signature of Organization Official:

Print/type Name: Click here to enter text.

Title: Click here to enter text.

Organization: Click here to enter text.

Date Signed: Click here to enter text.

File details come from the government source that posted it. Updated .