Form 5 - Document Enclosure Checklist and Verification.pdf
PDF 166 KB Posted
- Solicitation number
- 2139803
- Issued by
- New York
About this file
This is a Document Enclosure Checklist and Verification form (Form 5) for the New York State Unified Court System's Judiciary Civil Legal Services (JCLS) program, a statewide Request for Proposals seeking proposals from not-for-profit legal service providers. The RFP addresses unmet civil legal service needs for low-income New Yorkers in matters involving housing (evictions, foreclosures, homelessness), family matters (domestic violence, children, family stability), access to health care and education, and subsistence income (wages, disability benefits, consumer debts). Awarded organizations will receive general operating support for organizational administration, staffing, facilities, infrastructure, and technology. Applicants may propose direct legal representation services across a broad array of civil case types and may also target specific underserved communities or provide specialized services for populations such as domestic violence survivors, elderly individuals, or non-English speakers.
The funding structure recognizes that the UCS is typically one among multiple funders supporting an organization's civil legal services program, with other potential funding sources including local or municipal funding, federal grants, the New York State Interest on Lawyer Account Fund (IOLA), or the Legal Services Corporation. This comprehensive checklist and verification form ensures that applicants submit all required documentation and meet the proposal submission requirements for the JCLS grant program.
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Other files
| File | Type | Posted |
|---|---|---|
| Form 2 - Proposal Budget.xlsx | XLSX spreadsheet | |
| OCA-DGCP-084 Judiciary Civil Legal Services, Statewide.pdf | ||
| Exhibit 2 Insurance Requirements.pdf | ||
| Exhibit 1 Funding by Judicial District.pdf | ||
| Attachment-I-(Rev.11.13.2025).pdf | ||
| Form 1 - Proposal Document.docx | DOCX document | |
| Attachment III.pdf | ||
| Form 3 - Annual Workload Projection Chart.xlsx | XLSX spreadsheet | |
| Form 4 - Vendor Assurance and Conflict-of-Interest Disclosure.docx | DOCX document |
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OCA-DGCP-084 Judiciary Civil Legal Services, Statewide
Issued October 9, 2026 Due November 20, 2026 at 2:00 PM Eastern Time
DOCUMENT ENCLOSURE CHECKLIST AND VERIFICATION
The documents listed below must be submitted together with applicant’s proposal. Failure to do so as required may disqualify applicant’s response. Documents requiring signature must be duly signed where indicated. The listed documents may not be modified, retyped or amended in any manner.
All documents must be submitted. Failure to provide all documents in the manner required may result in disqualification of an applicant’s proposal.
Proposal Document (Form 1):
▪ Proposal Cover Sheet
▪ Program Description
▪ Organizational Capacity
▪ Budget Narrative
Proposal Budget (Form 2- Microsoft Excel Document)
Annual Projection Chart (Form 3 - Microsoft Excel Document)
Vendor Assurance and Conflict-of-Interest Disclosure (Form 4)
Document Enclosure Checklist and Verification (Form 5- this document)
Certificates of NYS Workers’ Compensation and NYS Disability Benefits Insurance, or
Certificate of Attestation of Exemption and adequate proof evidencing the insurance coverages required by the bid specifications (See Exhibit 2 “Insurance Requirements”).
IRS Determination Letter demonstrating tax-exempt status under Section 501(c)(3)
Attachment I - Standard Request for Bid Clauses & Forms
▪ p.3 - Non-Collusive Bidding Certificate
▪ p.4 - Corporate Acknowledgment
Attachment II – Not Applicable
Attachment III – Vendor Responsibility Questionnaire Attestation
Vendor Responsibility Questionnaire filed online via Office of State Comptroller
VendRep System and certified within 6 months of the bid opening date, or Paper Vendor
Responsibility Questionnaire
OCA-DGCP-084 Judiciary Civil Legal Services, Statewide
Issued October 9, 2026 Due November 20, 2026 at 2:00 PM Eastern Time
Verification
Authorized representative of applicant must complete and sign below to verify that the submitted proposal is complete, including all required attachments.
AUTHORIZED OFFICER’S NAME AND TITLE:
SIGNATURE:
DATE:
File details come from the government source that posted it. Updated .