ITN 10770 Attachment R.docx
DOCX document 65 KB Posted
- Attached to
- PRE - CINS/FINS and Respite Services
- Solicitation number
- ITN-07405
- Issued by
- Leon County, Florida
About this file
This document is an Attachment R Certification of Experience form for ITN 10770, issued by the Florida Department of Juvenile Justice (DJJ) to select a Respondent to provide Children In Need of Services/Families In Need of Services (CINS/FINS), Statewide Detention Respite Care Services, Probation Respite Bed Services, Respite Bed Services for Civil Citation Youth, and evidence-based or promising practices delinquency programming services across Florida's 20 judicial circuits. The Respondent must demonstrate at least 3 years of relevant experience within the last 5 years to the services specified in Attachments A, A-1, A-2, and A-3. The ITN is seeking proposals from community, faith-based, not-for-profit organizations, LLCs, and/or divisions of local government to design, create, develop, implement, manage, and ensure coordination of local delivery of the required residential and non-residential statewide services.
The ITN also requires the selected lead agency to subcontract with local service providers to deliver statewide support services, data collection and reporting, management, and enforcement of the service provisions. The lead agency will oversee all components of training, service delivery, contract management, and operations of the local service providers for the Statewide Detention Respite Care Services, Probation Respite Bed Services, and Respite Bed Services for Civil Citation Youth.
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Other files
| File | Type | Posted |
|---|---|---|
| ITN 10770 Ex4 StartUpImplementationPlan.docx | DOCX document | |
| ITN 10770 Informational Notice 1.pdf | ||
| ITN 10770 solicitation document.pdf | ||
| ITN 10770 Attachment T.docx | DOCX document | |
| ITN 10770 Exhibit3 SampleYouthDischargeForm.pdf | ||
| ITN_10770_FinalAgencyDecision.pdf | ||
| ITN 10770 Ex7 ServiceUtilizationReport.xlsx | XLSX spreadsheet | |
| ITN_10770_Attachment_N.docx | DOCX document | |
| ITN 10770 Attachment J.xlsx | XLSX spreadsheet | |
| ITN 10770 Attachment Q.pdf | ||
| ITN 10770 Exhibit1 Invoice.pdf |
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Text version
ATTACHMENT R
CERTIFICATION OF EXPERIENCE
THIS FORM SHALL BE COMPLETED BY THE RESPONDENT AND SIGNED BY A PERSON AUTHORIZED TO MAKE STATEMENTS ON BEHALF OF THE RESPONDENT. RETURN OF THE COMPLETED AND SIGNED FORM IS A MANDATORY REQUIREMENT.
COMPANY NAME:
DATE ESTBLISHED:
PRIMARY BUSINESS:
TOTAL NUMBER OF EMPLOYEES:
NUMBER OF EMPLOYEES ENGAGED IN ACTIVITIES RELEVANT TO THIS ITN: (NOT INCLUDING LOCAL SERVICE PROVIDERS)
NUMBER OF YEARS OF PROVIDER EXPERIENCE IN SERVICES RELEVANT TO THE PROVISION OF MANAGEMENT AND OVERSIGHT OF PROGRAMS SERVING VULNERABLE YOUTH POPULATIONS:
LIST ENTITIES FOR WHOM THE COMPANY HAS PROVIDED SERVICES WITHIN THE LAST FIVE YEARS, THE DATES OF THE PERFORMANCE (RESPONDENT MUST DEMONSTRATE THREE YEARS EXPERIENCE WITHIN THE LAST FIVE YEARS), THE BUSINESS NAME AND CONTRACT MANAGER’S NAME, PHONE NUMBER AND EMAIL ADDRESS:
ITN #10770
I, , CERTIFY THAT THE RESPONDENT KNOWN AS HAS AT LEAST YEARS EXPERIENCE WITHIN THE LAST FIVE YEARS RELEVANT TO THE PROVISION OF SERVICES SPECIFIED IN THE ATTACHMENT A (SERVICES SOUGHT), ATTACHMENT A-1 (STATEWIDE DETENTION RESPITE CARE SERVICES), ATTACHMENT A-2 (PROBATION RESPITE BED SERVICES), AND ATTACHMENT A-3 (SPITE BED SERVICES FOR CIVIL CITATION YOUTH).
Signature
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Title
Date
File details come from the government source that posted it. Updated .