Emergency Purchase Statement - TEMP. Nursing Staff CNAs - LPNs-APO signed~2.pdf

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EMERGENCY PURCHASE STATEMENT

State of Illinois Chief Procurement Office for General Services Emergency Purchase Statement V.26.1 Page of

EMERGENCY PURCHASE STATEMENT

Page of State of Illinois Chief Procurement Office for General Services Emergency Purchase Statement v.26.1 Emergency Purchases are conducted pursuant to 30 ILCS 500/20-30 and 44 Ill. Adm. Code 1.2030.

Emergency Purchase Details Emergency Condition (select the appropriate option from the drop-down menu below):

Provide a description and reasons for needing this emergency purchase:

Provide the conditions and circumstances that led to the need for this emergency purchase:

Reason for selection of this particular vendor:

Description of supplies or services to be provided:

Emergency procurements shall be made with as much competition as is practicable under the circumstances, and agencies shall utilize best efforts to include contractors certified under the Business Enterprise Program in its emergency procurement process. 30 ILCS 500/20-30(a).

Describe the actions taken by the agency to make the emergency purchase with as much competition as is practicable under the circumstances:

List the actions taken by the agency that constitute its best efforts to include contractors certified under the Business Enterprise Program in this emergency purchase:

Is there an active State contract available for the required supplies or services?

If Yes is checked above, explain why the existing contract does not meet the need:

This emergency contract was awarded on the earliest of these dates: (choose one) *Pursuant to 44 Ill. Admin. 1.2030 (f)(5), if Estimated is indicated, an Emergency Final Cost form will be submitted by the State agency and published by the State Purchasing Officer no later than the tenth day of the succeeding month. If Actual is chosen and the total cost differs from the amount on this statement, an Emergency Final Cost form must be submitted and published within the same timeframe.

Select the type of funding to be used:

Signature This emergency purchase was made with as much competition as is practicable under the circumstances. Best efforts were utilized to include contractors certified under the Business Enterprise Program in the process.

I am authorized to make this emergency purchase, and I know and understand the contents of this statement and all statements herein are true and correct to the best of my knowledge.

11.0.0.20130303.1.892433.887364

LPNs will under supervision, independently perform a variety of practical nursing functions, for the physically and mentally ill or mentally handicapped geriatric residents in an assigned nursing unit and shift. LPNs will perform selected nursing functions in situations which do not require the specialized knowledge and skill of a Registered Nurse.

CNAs will under general supervision, perform nursing assistance and personal care services for the Facility’s residents with physical and/or mental impairments. CNAs will assist in the physical care, activities of daily living, activity of focused care, resident feeding, bathing, personal hygiene care, ambulation, transfer and repositioning of residents, escorting residents to appointments, dressing and elimination, needs, take and record vital signs, prepare and maintain records and reports, and perform treatment procedures as directed by the licensed nurse