DOC 1952 Contractor PREA Questionnaire .pdf
PDF 507 KB Posted
- Attached to
- NNCC Gym Floor Refurbishment
- Solicitation number
- 44DOC-S3730
- Issued by
- Churchill County, Nevada
About this file
This is a PREA (Prison Rape Elimination Act) questionnaire document issued by the Nevada Department of Corrections (NDOC) Management Division, required in compliance with federal regulations 42 U.S.C. 15601 et seq. and 28 C.F.R. 115.17(a). The form applies to contractors and volunteers for the Northern Nevada Correctional Center gym floor refurbishment project who may have contact with offenders or require entry into any NDOC institution, facility, or work release center. Contractors must complete this questionnaire before authorization to enter facilities or interact with offenders.
The questionnaire requires contractors to disclose any history of sexual abuse in detention facilities, convictions or civil/administrative adjudications for sexual activity involving force or coercion, inability to consent, or sexual harassment in community or confinement settings. Contractors must answer yes or no to four specific questions and provide detailed explanations for any affirmative responses on additional pages if necessary. All responses must be certified as true and complete under the understanding that false or misleading statements, including material omissions regarding misconduct, constitute grounds for application denial. This is a mandatory pre-authorization requirement with no exceptions for the contractor selection process.
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Text version
Nevada Department of Corrections PREA Management Division DOC 1952 (revised 1/2023) §115.17
Contractor and Volunteer PREA Questionnaire
The Nevada Department of Corrections (NDOC), in compliance with the Department of Justice, National Standards to Prevent, Detect, and Respond to Prison Rape 42 U.S.C. § 15601, et seq. and 28 C.F.R., §115.17 (a), shall require contractors and volunteers who may have contact with offenders to complete this form before they can be authorized to have any contact with any offenders or entry into any of the agencies institutions, facilities or work release centers. Please answer the following questions.
Have you ever:
Engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or any other place of detention?
☐ Yes ☐ No
Been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse?
☐ Yes ☐ No
Been civilly or administratively adjudicated to have engaged in the activity described above?
☐ Yes ☐ No
Engaged in sexual harassment of any person in the community or confinement setting?
☐ Yes ☐ No
If you answered yes to any of the previous four questions, provide details regarding the incident.
Attach additional pages if necessary.
I affirm that all my responses are true and complete to the best of my knowledge. I also understand that providing false or misleading statements, including material omissions regarding such misconduct shall be grounds for denial of my application.
Signature: Date: ___________________
Print Name:______________________________________
File details come from the government source that posted it. Updated .