DOC 1952 PREA Contractor and Volunteer Questionnaire Form ~1.docx
DOCX document 46 KB Posted
- Attached to
- Septic and Grease Trap Pumping Services
- Solicitation number
- 44DOC-S2219
- Issued by
- Mineral County, Nevada
About this file
This document is a Contractor and Volunteer PREA Questionnaire Form from the State of Nevada Department of Corrections (NDOC). The form is used to comply with the Department of Justice's National Standards to Prevent, Detect, and Respond to Prison Rape. All contractors and volunteers who may have contact with inmates are required to complete this questionnaire. The form asks whether the individual has engaged in or been convicted of sexual abuse or harassment in a prison, jail, or other institution. Providing false or misleading statements can result in termination of entry into NDOC facilities and the rescission of volunteer or contractor status.
The related state and local contract opportunity is for Septic and Grease Trap Pumping Services in Carson City, Nevada. The contract is open to jurisdictions within the state of Nevada.
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Text version
State of Nevada Department of Corrections Contractor and Volunteer PREA Questionnaire Form 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 not enlist the services of any contractor or volunteer who may have contact with inmates. Agency policy requires all contractors and volunteers to complete this questionnaire.
Providing false or misleading statements, including material omissions regarding such misconduct shall be grounds for termination of entry into all NDOC facilities, and volunteer or contractor status will be rescinded.
1. Have you engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or other institution, or have you 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, or have you been civilly or administratively adjudicated to have engaged in the activity described in any part of this question?
YES NO
2. Have you been adjudicated as having engaged in any type of inmate Sexual Harassment, which includes as a staff member, volunteer, contractor, or as any type of service provider coming in contact with an inmate in the facilities mentioned in question 1? Sexual Harassment includes but is not limited to:
· Repeated verbal comments of a sexual nature to an inmate; or
· Demeaning references to gender; or
· Derogatory comments about body or clothing; or
· Repeated profane or obscene language or gestures
YES NO
Signature Date Print Name
DOC 1952 (1/2021)
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File details come from the government source that posted it. Updated .