BPM007180_Pre-Solicitation_Documents.pdf

Page 1 of 2PUR-1031A FORFF (5-24) ARIZONA DEPARTMENT OF ECONOMIC SECURITY Division of Financial Operations

Office of Procurement

PROCUREMENT ASSISTANCE (PA) REQUEST

1. PROCUREMENT UNIT NAME: 2. PA NUMBER/SUB-NUMBER: 3. REQUEST DATE:

4. DIVISION/ADMINISTRATION/PROGRAM: 5. DIVISION CONTACT PERSON: 6. TELEPHONE NUMBER:

7. TYPE OF REQUEST/AGREEMENT (check all that apply):

Scope of Work Review

Solicitation

CI /SS /NPTQ Review

Amendment

Extension Yrs/Mos

Corrective Action

Assignment

Contract (Competitive Award)

Direct Contract

Intergovernmental Agreement (IGA)

Interagency Service Agreement (ISA)

Memorandum of Understanding (MOU)

Task Order

IT Agreement/EULA

Set-Aside

COOP

Grant Agreement

If Exempt by Statute A.R.S. No.:

Other

8. DETAILED DESCRIPTION OF REQUEST OR NEED:

9. OTHER DOCUMENTS AND INFORMATION:

Certificate of Insurance (COI) Compliant and Included If CI /SS /NPTQ, No.:

Business Associate Agreement/Data Sharing Agreement Central Registry Check/Fingerprinting Sign and Date when Checked

10. FUNDING SOURCE & AMOUNT (check the appropriate boxes):

Federal State Grant Other Estimated aggregate spend $499K or less

Estimated aggregate spend $500K or more

11. DESCRIPTION OF SERVICES OR CONTRACT TITLE: 12. CONTRACT NUMBER:

13. CONTRACTOR NAME/DBA: 14. FEIN NUMBER:

15. CONTRACTOR CONTACT PERSON’S NAME AND TITLE:

16. E-MAIL ADDRESS/TELEPHONE NO.:

17. CONTRACT ORIGINAL START DATE: 18. MAXIMUM END DATE:

19. CONTRACT CURRENT END DATE: 20. AMENDED END DATE:

21. SINGLE AUDIT STATUS:

Contractor/Vendor

Subrecipient N/A

22. LEGAL AD AUTHORIZATION:

FUNCTION CODE: OBJECT CODE: DEPARTMENT OBJECT CODE:

BA SIGNATURE FOR APPROVAL (Legal Ads):

23. AUTHORIZATIONS (Signatures, NO Initials) & DATES:

24. AUTHORIZED DIVISION REQUESTOR: 25. FINANCIAL SERVICES ADMINISTRATION:

26. ATTORNEY GENERAL (IGA, 3rd Party, etc.): 27. PROCUREMENT OFFICER:

28. PROCUREMENT OFFICER COMMENTS:

Team Stacy DCC-26-009 08/08/2025

CCSD/ADES Erin Brisk (602) 853-6959

Requesting OP's review of Scope of Work for the new Positive Behavior Supports and Expulsion Prevention Program RFP.

[NOTE: Per Veronica Sarver, the complete function code information (section 22 below) is: CSW33518 (75%)CSW34518 (25%).]

Erin Brisk 8/8/25

Positive Behavior Supports and Expulsion Prevention Program

TBD

CSW33518(75%)CSW34518 6861 6991

Page 2 of 2PUR-1031A FORFF (5-24) INSTRUCTIONS

1. PROCUREMENT UNIT NAME – enter name of the assigned procurement team.

2. PA NUMBER / SUB-NUMBER – enter the Program-assigned Procurement Assistance (PA) number, and Sub-number number, if applicable.

Examples: After the SOW is finalized, if there are multiple contracts / agreements awarded for the same service; or a solicitation results in multiple awards, the procurement officer adds /1, /2, /3, etc.

3. REQUEST DATE – enter date program contracts officer begins processing.

4. DIVISION / ADMINISTRATION / PROGRAM – enter abbreviations for the division, administration and program submitting the request to OP.

5. DIVISION CONTACT PERSON – enter the name of the program contracts officer associated with this request.

6. TELEPHONE NUMBER – enter the telephone number of the of the contact person.

7. TYPE OF REQUEST / AGREEMENT – Check ALL applicable boxes considering there should be one PA per procurement action from the moment a need has been identified, until the action is completed i.e. solicitation awarded, contract fully executed, assignment completed.

Examples:

a) For a new solicitation, under section seven (7), the following boxes should be checked:

Scope of Work Review Solicitation

b) For new direct contract, under section seven (7), the following boxes should be checked:

Cl /SS /NPTQ Review Scope of Work Review Direct Contract

c) For new task order, under section seven (7), the following boxes should be checked:

Scope of Work Review Task Order

d) For a direct contract amendment which requires SOW revision, under section seven (7), the following boxes should be checked:

Cl /SS /NPTQ Review Scope of Work Review Amendment Direct Contract

e) For an IGA extension, under section seven (7), the following boxes should be checked:

Extension Yrs/Mos Intergovernmental Agreement (IGA)

f) For a contract action against competitively awarded contract, under section seven (7), the following boxes should be checked:

Contract Action Contract (competitive award)

g) For a competitively awarded contract amendment, under section seven (7), the following boxes should be checked:

Amendment Contract (competitive award)

8. DETAILED DESCRIPTION OF REQUEST OR NEED – provide details of the request. Use memo to expand if necessary.

9. OTHER DOCUMENTS & INFORMATION:

Certificate of Insurance (COI) Compliant and Included – Mark that the certificate of insurance is included and compliant, if applicable.

Business Associate Agreement / Data Sharing Agreement – Check if BAA / DSA is required for the request.

If CI / SS / NPTQ, No – If there is an existing limited competition determination, specify the number and provide electronic copy.

Central Registry Check / Fingerprinting – Division’s contracts officer shall sign and date when check has been completed, if applicable.

10. FUNDING SOURCE & AMOUNT – check the appropriate funding source(s) for the request & check if the total value of the Agreement/Contract. Is estimated aggregate spend $499K or less OR $500K or more?

11. DESCRIPTION OF SERVICES OR CONTRACT TITLE – provide service description or title of contract, as defined in the SOW.

12. CONTRACT NUMBER – enter the contract number, if applicable. If multiple contracts, create separate PAs for each contract.

13. CONTRACTOR NAME / DBA – enter the Contractor name and the doing business as (DBA) name, if applicable.

14. FEIN NUMBER – enter the Federal Employer Identification Number of the contractor, if applicable.

15. CONTRACTOR CONTACT PERSON’S NAME AND TITLE – enter the name and title of the contractor’s designated contact person.

16. E-MAIL ADDRESS / TELEPHONE NUMBER – enter the e-mail address and telephone number of the contractor’s designated contact person.

17. CONTRACT ORIGINAL START DATE – enter the first date when services can be rendered against the contract, if applicable.

18. MAXIMUM END DATE – enter the last possible date that service can be rendered against the contract, if applicable.

19. CONTRACT CURRENT END DATE – enter the last date of the current contract term, if applicable.

20. AMENDED END DATE – enter the amended term end date, if applicable.

21. SINGLE AUDIT STATUS – division staff check the appropriate box. Required only for service/taxonomy contracts

22. LEGAL AD AUTHORIZATION – function code, object code, and department object code provide from the Business Administrator (BA) and BA’s signature for funding approval

23. AUTHORIZATIONS & DATES – signatures of authorized individuals from the respective areas & dates of authorized individuals from the respective areas.

24. AUTHORIZED DIVISION REQUESTOR – signatures and dates of authorized individuals from the respective areas.

25. FINANCIAL SERVICES ADMINISTRATOR (IGA, ISA, IT Projects (including agreements, software, hardware, contractors (Non- FTE)), and non IT procurements with an aggregated spend of $500K and more) - signatures and dates of authorized individuals from the respective areas.

26. ATTORNEY GENRAL (IGA, 3rd PARTY, ETC) – signatures and dates of authorized individuals from the respective areas.

27. PROCUREMENT OFFICER – signatures and dates of authorized individuals from the respective areas.

28. PROCUREMENT OFFICER COMMENTS – Complete as needed.

Shanel Scott <shanelscott@azdes.gov>

Significant Procurement Notification Form 1 message

Google Forms <forms-receipts-noreply@google.com> Tue, May 13, 2025 at 8:15 AM To: shanelscott@azdes.gov

Thanks for filling out Significant Procurement Notification Form Here's what was received.

Edit response

Significant Procurement Notification Form The following information is required to be provided to the State Procurement Administrator by all state governmental units (SGU; agencies, boards, and commissions) as per Standard Procedure 003 - Significant Procurement Role (SP 003 link).

Notes about this Google Form to provide notification of a SPR:

• You will receive a copy of your response via email

• You may edit your response after it is submitted in two ways. To ensure there's no duplication of efforts, please do one of the following:

1) Once you submit the form, you may click on "Edit you response" in the same browser; or

2) If some time has passed and it's necessary to make edits, please check your email for the original submission as it will have an "Edit response" link. If you don’t remember when you

5/13/25, 8:21 AM State of Arizona Mail - Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=a4e783cffe&view=pt&search=all&permthid=thread-f:1832018840258725412&simpl=msg-f:1832018840258725412 1/4 https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?edit2=2_ABaOnucQVV5qLk2PW9P-q2ujBWdxdOz1gU57tUvBmsHiXhDIkDjMsXvNssVY8gMMSM-CXH0&usp=mail_form_link https://docs.google.com/forms/d/e/1FAIpQLSdxSzWnNvO30KUubljXrDSub3gfqJ1GX15weZF0kbYkDUx3Qw/viewform?edit2=2_ABaOnucQVV5qLk2PW9P-q2ujBWdxdOz1gU57tUvBmsHiXhDIkDjMsXvNssVY8gMMSM-CXH0&edit2=2_ABaOnucQVV5qLk2PW9P-q2ujBWdxdOz1gU57tUvBmsHiXhDIkDjMsXvNssVY8gMMSM-CXH0 https://spointra.az.gov/resources/standard-procedures originally submitted your SPR notification, you may check the date and time on the spreadsheet via https://spo.az.gov/contracts/significant-procurement-roles and match it to the email.

• If your entry needs to be deleted, email SPOCompliance@azdoa.gov to provide an explanation for the deletion. If accepted, SPO Compliance will delete the entry.

Please contact the State Procurement Office (SPO) at SPOCompliance@azdoa.gov for any questions.

Email * shanelscott@azdes.gov

What is the name of the person leading the procurement? *

Gloria Pinkerton

Which agency is the procurement for? If it is a mandatory statewide contract, select your agency. *

Economic Security, Department of

What is the title of the procurement? *

5/13/25, 8:21 AM State of Arizona Mail - Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=a4e783cffe&view=pt&search=all&permthid=thread-f:1832018840258725412&simpl=msg-f:1832018840258725412 2/4 https://spo.az.gov/contracts/significant-procurement-roles https://spo.az.gov/contracts/significant-procurement-roles mailto:SPOCompliance@azdoa.gov mailto:SPOCompliance@azdoa.gov mailto:shanelscott@azdes.gov

Positive Behavior Support and Expulsion Prevention

What is the procurement type? *

RFQ - Request for Quotation

IFB - Invitation for Bid

✓ RFP - Request for Proposal

CI - Competition Impracticable (SPO Form 101)

Emergency Procurement (SPO Form 102)

SS - Sole Source (SPO Form 103)

NPTQ - Not Practicable to Quote (Determination Template D301(4))

Other:

What is the date when the first procurement disclosure statement (PDS) was signed (i.e. SPO Form 120 or SPO Form 130)? *

MM

04 /

DD

24 /

YYYY

What is the actual date or estimated date that the purchased materials will be delivered or the purchase of services or construction will begin, per A.R.S. § 41-

5/13/25, 8:21 AM State of Arizona Mail - Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=a4e783cffe&view=pt&search=all&permthid=thread-f:1832018840258725412&simpl=msg-f:1832018840258725412 3/4

753(D)? *

MM

08 /

DD

01 /

YYYY

What is your name (if different from above)?

Shanel Scott

What is your e-mail address (if different from above)?

ShanelScott@azdes.gov

Create your own Google Form Does this form look suspicious? Report

NOTICE: This e-mail (and any attachments) may contain PRIVILEGED OR CONFIDENTIAL information and is intended only for the use of the specific individual(s) to whom it is addressed. It may contain information that is privileged and confidential under state and federal law. This information may be used or disclosed only in accordance with law, and you may be subject to penalties under law for improper use or further disclosure of the information in this e-mail and its attachments. If you have received this e-mail in error, please immediately notify the person named above by reply e-mail, and then delete the original e-mail.

Thank you.

5/13/25, 8:21 AM State of Arizona Mail - Significant Procurement Notification Form https://mail.google.com/mail/u/0/?ik=a4e783cffe&view=pt&search=all&permthid=thread-f:1832018840258725412&simpl=msg-f:1832018840258725412 4/4 mailto:ShanelScott@azdes.gov https://docs.google.com/forms?usp=mail_form_link http://null/

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Public Notice

PUBLIC NOTICE

The Arizona Department of Economic Security (ADES), Child and Community Services Division (CCSD), is soliciting competitive sealed proposals for BPM007180 Positive Behavior Supports and Expulsion Prevention Program (Training).

A virtual Pre-Offer Conference will be held on Monday, September 22, 2025 at 10:00am Phoenix, Arizona Time, as indicated in the Request for Proposal (RFP). Due to changes in the submission requirements for Vendors, attendance is strongly encouraged.

You may obtain a copy of solicitation BPM007180 RFP at https://app.az.gov.

Proposals are due electronically through the State’s eProcurement system on or before October 7, 2025 at 3:00pm Phoenix, Arizona Time. Please submit all questions pertaining to this solicitation through the State’s eProcurement system via the Discussion Forum tab.

Publish: September 16, 2025

Publish: Phoenix Independent, September 16, 2025/30175_1

Publish: Phoenix Independent, September 2, 9, 16, 23, 2025/29329_1

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Proof of Publication 9/16/2025

State of Arizona:

County of Maricopa:

Affidavit of Publication I, Charlene Bisson, Arizona President/CEO of Independent Newsmedia Inc. USA, am autho-rized to make this affidavit of publication. Under oath, I state that the following is true and correct.

The Phoenix Independent (formerly the Daily Independent) is a newspaper which is published Tuesdays and Fridays, is of general circulation and is in compliance with the Arizona Revised Statutes 10-140.34 & 39-201 A & B. I solemnly swear that the notice was published in the regu-lar and entire section of the said newspaper and not in any supplement. The below listed adver-tisement appeared in the following issue(s)

Phoenix Independent: 9/16/2025

CHARLENE BISSON

President/CEO Sworn to and subscribed before me this 9/16/2025

TERRI RODGERS

Notary Public

Name Arizona Department of ECONOMIC

SECURITY

Order Number 30175 Ordered By Nancy Vejar Order Date 9/11/2025 Description BPM007180 Number Issues 1 Pub Count 1 Order Cost $83.20 First Issue 9/16/2025 Last Issue 9/16/2025 Publications Phoenix Independent Pub Dates Phoenix Independent: 9/16/2025

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