Attachment C - Attestation DETA-19513-P.docx
DOCX document 25 KB Posted
- Solicitation number
- ILA0030-A
- Issued by
- Wisconsin
About this file
This is an attestation form issued by the Wisconsin Department of Workforce Development for the Youth Apprenticeship (YA) Consortium Bridging Outcomes initiative, funded through a US Department of Labor grant (AP-35130-20-60-A-55, effective August 26, 2022). The form serves as a payment request documentation mechanism for YA consortia with executed Blanket Agreements seeking reimbursement for bridging outcomes achieved under the RFA ILA0030A. The attestation certifies that regional coordinators or consortium representatives have actively engaged in specified activities for apprentices transitioning from Youth Apprenticeship programs to Registered Apprenticeship (RA) contracts, including representation during meetings with employers and sponsors to define advanced standing and on-the-job learning parameters, facilitation of connections with the Bureau of Apprenticeship Standards and Apprenticeship Navigators, and execution of all bridging activities in accordance with the consortium's Wisconsin Youth Apprenticeship Local Grant Application.
The form accommodates documentation for up to five apprentices per submission and requires the Regional Coordinator's signature and date to validate that all attestation criteria have been satisfied. The initiative specifically targets Wisconsin YA consortia that have successfully bridged their YA completers into active RA contracts, with grant-funded payments provided as compensation for bridging outcomes achieved. This attestation document represents a key administrative requirement for consortia seeking payment reimbursement under the federally-funded program.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| YA Request for Applications DETA-19514-P.docx | DOCX document | |
| Attachment A - Blanket Agreement Application DETA-19515-P.docx | DOCX document | |
| Attachment B - Request for Payment DETA-19245-1-E -.xlsx | XLSX spreadsheet |
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Text version
ILA0030A Attachment C YA Consortium Bridging Outcomes Attestation – For Multiple Apprentices Wisconsin SAE 2020 Grant – YA Consortia Outcomes Funding for Bridging YA Completers to RA Contracts US Dept of Labor Grant: AP-35130-20-60-A-55 (Effective date: 8/26/2022)
Instructions for use:
Consortia with executed Blanket Agreements with the Wisconsin Department of Workforce Development may submit Requests for Payment along with this Attestation form to request payment for bridging outcomes in accordance with Request for Application (RFA) ILA0030A.
Consortium's Name:
| Apprentice # from Appendix C |
| Name of Apprentice |
#1 Apprentice
#2 Apprentice
#3 Apprentice
#4 Apprentice
#5 Apprentice
As the Regional Coordinator, I attest that the following activities were performed for each listed apprentice:
☐ I, or a Consortium representative, actively represented the bridged Apprentice named above during meetings with employers, sponsors, or committees to define the advanced standing related to the registered apprenticeship contract, on-the-job learning, and related technical instruction.
☐ I, or a Consortium representative, facilitated connections with the Bureau of Apprenticeship Standards (BAS) Apprenticeship Training Representative (ATR) and/or Apprenticeship Navigators on behalf of the employer and the bridged Apprentice.
☐ All bridging activities were carried out as described in the Consortium's Wisconsin Youth Apprenticeship Local Grant Application for the year(s) that the bridged Apprentice named above participated in the Youth Apprenticeship program.
Regional Coordinator Signature: __________________________________ Date: _____________
DETA-19513-P (N. 08/2022)
File details come from the government source that posted it. Updated .