ESBD_516615_1778878774996_Attachment 02-OE Application Submission Checklist.pdf

PDF 154 KB Posted

Attached to
3202600157 Open Enrollment (OE) for Independent Living Services for Older Individuals who are Blind (ILS-OIB)
Solicitation number
3202600157
Issued by
Texas

About this file

This is an OE (Offer of Employment) Application Submission Checklist for a Texas state contract opportunity. The document serves as a guide for applicants submitting proposals or applications in response to the contract solicitation. The checklist outlines the required documentation and materials that must be included with any application submission to ensure completeness and compliance with the state's submission requirements. While specific contract details such as products, services, quantities, response deadlines, and award dates are not detailed in the checklist itself, the document functions as a quality control tool to verify that all mandatory components have been addressed before final submission.

The checklist emphasizes procedural compliance and administrative accuracy in the application process. It does not address pricing terms, set-asides, incumbent information, or funding sources, as these elements would be specified in the primary solicitation documents rather than in an application submission checklist. Applicants are expected to use this document to verify their completeness before submitting to the state of Texas, ensuring that no required attachments, certifications, or supporting materials are omitted from their proposal package.

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Other files

File Type Posted
ESBD_516615_1779307246615_Open Enrollment (OE) (ILS-OIB) 3202600157.pdf PDF
ESBD_516615_1779307212706_3202600157 Addendum No 1.pdf PDF
ESBD_516615_1778878880223_Form 03-Child Support Certification (VR 1305).pdf PDF
ESBD_516615_1778878747252_Attachment 01-VR OE T&Cs (12-18-2025).pdf PDF
ESBD_516615_1778878921482_Form 05-Conflict of Interest Certification (VR 3444).pdf PDF
ESBD_516615_1778878971443_Form 08-Entity Headquarters Information-Services (VR 3441B).pdf PDF
ESBD_516615_1778879042111_Form 12-Provider Staff Information Form (VR 3455).pdf PDF
ESBD_516615_1778878848810_Form 01-Execution of Application.pdf PDF
ESBD_516615_1778879002330_Form 10-Entity’s Physical Location(s) Part A (VR 3442A).pdf PDF
ESBD_516615_1778878865305_Form 02-W-9 and Direct Deposit Form (VR1020).pdf PDF
ESBD_516615_1778878791207_Attachment 03-VR2891 ILS-OIB Customer Serv.pdf PDF
ESBD_516615_1778879018659_Form 11-Entity’s Physical Location(s) Part B (VR3442B).pdf PDF
ESBD_516615_1778878806607_Attachment 04-VR2954 Comprehensive Assess.pdf PDF
ESBD_516615_1778879117573_Open Enrollment (OE) (ILS-OIB) 3202600157.pdf PDF
ESBD_516615_1778878985560_Form 09-Entity Headquarters Info-Location(s) (VR 3441C).pdf PDF
ESBD_516615_1778878822245_Attachment 05-VR5053 Application Statement.pdf PDF
ESBD_516615_1778878937496_Form 06-Provider Insurance Verification (VR 3445).pdf PDF
ESBD_516615_1778878954923_Form 07-Entity Headquarters Info Management Form (VR 3441A).pdf PDF
ESBD_516615_1778878904683_Form 04-TWC VR Standards for Providers Certification (VR 3443).pdf PDF
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Text version

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 .