consltfm.doc
DOC document 29 KB Posted
- Attached to
- Shelter Staffing Services
- Solicitation number
- BD-21-1013-PPN00-PLN01-53906
- Issued by
- Massachusetts
About this file
This document is a Consultant Contractor Mandatory Submission Form associated with a state and local contract opportunity in Massachusetts. The form requires the bidder to disclose any additional income from the Commonwealth of Massachusetts, individuals with a financial interest in the contract, and key personnel who will be assigned to the contract performance. The related state and local contract opportunity is for Shelter Staffing Services in the state of Massachusetts. The contract duration and any renewal options are not specified.
The document outlines pricing and financial terms related to the contract, including requirements for the bidder to disclose financial interests and income from the Commonwealth. However, the specific pricing information, set asides, incumbent details, funding requirements, and other salient commercial terms are not provided in the document.
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Other files
| File | Type | Posted |
|---|---|---|
| 2 CFR 200.326 (Appendix II).docx | DOCX document | |
| busreffm.doc | DOC document | |
| EFT_FORM.pdf | ||
| Shelter Staffing RFR for Posting.docx | DOCX document | |
| w_9.doc | DOC document | |
| other-specs.doc | DOC document | |
| CommonwealthTermsAndConditions.pdf | ||
| ppd~1.doc | DOC document | |
| sdp-plan-form-1-commitment.docx | DOCX document | |
| req-specs.docx | DOCX document | |
| sdp-rplan-form-2-declaration.docx | DOCX document | |
| StandardContractForm~2.docx | DOCX document | |
| sdp-rplan-form-3-reporting.xlsx | XLSX spreadsheet | |
| instructions-for-vendors-responding-to-bids.docx | DOCX document | |
| eppform.doc | DOC document | |
| casl-form.docx | DOCX document | |
| consig.doc | DOC document | |
| SIRS Staffing Job Action Sheets - Complete.pdf | ||
| Appendix II to Part 200.docx | DOCX document |
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Text version
Consultant Contractor Mandatory Submission Form
COMPLETE THE FOLLOWING ONLY FOR CONSULTANT CONTRACTS
(Within HH and NN and UU Object Classes)
Bidder: ________________________________________________________________________
RFR Name/Title: ________________________________________________________________
RFR Number: # _________________________________________________________________
Additional Income Disclosure. Pursuant to the provisions of M.G.L. c. 29, s. 29A, the following amounts represent any contracts, grants or other income due from the Commonwealth of Massachusetts, including any political subdivision or public authority, during the period of a contract. You may attach additional sheets as necessary.
FORMCHECKBOX
Please check if N/A.
Disclosure of Persons with Financial Interest (other than the bidder). Pursuant to the provisions of M.G.L. c. 29, s 29A and c. 7A, s. 6, the following individuals have a financial interest in a contract and/or with more than one percent (1%) interest in the capital stock of the contractor. You may attach additional sheets as necessary.
FORMCHECKBOX
Please check if N/A.
Key Personnel. Attach a resume or statement of qualifications for all key personnel specifically named in bidder's response to be assigned to the performance of a contract.
FORMCHECKBOX
Please check if N/A.
The information submitted herein is certified by the bidder to be accurate under the pains and penalties of perjury.
Signature of Authorized Signatory for Bidder: __________________________________________________
Title of Authorized Signatory for Bidder: _____________________________________________________
Date: __________________________________________________________
Updated 11/1/05
Sensitivity level - low
File details come from the government source that posted it. Updated .