ESBD_515780_1778790187304_Attachment 02-OE Application Submission Checklist.pdf
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- Solicitation number
- 3202600156
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- Texas
About this file
This document is an Application Submission Checklist for the Texas Vocational Rehabilitation (VR) program, designed to assist applicants in preparing complete and responsive applications for Occupational Education (OE) provider certification. The checklist serves as a reference tool to ensure applicants submit all required materials, though submission of the checklist itself is not mandatory. The checklist identifies twelve required forms and certifications that must be included in a complete application, including execution of application, tax identification and direct deposit information, child support certification, provider certification standards, conflict of interest certification, insurance verification, and comprehensive entity information documentation.
The required application materials encompass detailed organizational and operational disclosures across multiple forms, specifically addressing headquarters information management and services, physical service locations, and provider staff qualifications with supporting documentation. Applicants are responsible for independently reviewing all application requirements and gathering necessary documentation prior to submission. The forms reference standardized state VR forms (VR 1020, VR 1305, VR 3443, VR 3444, VR 3445, VR 3441A through 3441C, VR 3442A through 3442B, and VR 3455), indicating this is part of the Texas Workforce Commission's established provider certification framework for vocational rehabilitation services.
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ATTACHMENT 2 - OE APPLICATION SUBMISSION
CHECKLIST
This Application Submission Checklist is provided to assist an Applicant in preparing a responsive Application. The checklist is not a requirement and does not need to be attached to the Application. Applicant is responsible for reviewing all Application requirements and ensuring it submits all materials for a complete Application.
□ Form 1 – Execution of Application
□ Form 2 – W-9 and Direct Deposit Form (VR 1020)
□ Form 3 - Child Support Certification (VR 1305)
□ Form 4 – TWC VR Standards for Provider Certification (VR 3443)
□ Form 5 – Conflict of Interest Certification (VR 3444)
□ Form 6 – Provider Insurance Verification (VR 3445)
□ Form 7 – Entity Headquarters Information Management Form
(VR 3441A)
□ Form 8 – Entity Headquarter Information – Services (VR 3441B)
□ Form 9 – Entity Headquarters Information – Location(s) (VR 3441C)
□ Form 10 – Entity’s Physical Location(s) – Part A – Service Contracts Certification (VR 3442A)
□ Form 11 – Entity’s Physical Location(s) – Part B – General Information Service Contracts (VR 3442B)
□ Form 12 – Provider Staff Information Form(s) with Supporting Documentation (VR 3455)
Attachment 2 - oe APPLICATION Submission Checklist
File details come from the government source that posted it. Updated .