ITN 10770 Exhibit1 Invoice.pdf
PDF 96 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 Invitation to Negotiate (ITN) 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 within Florida's 20 judicial circuits. The DJJ 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 these residential and non-residential statewide services. The lead agency will contract with local service providers for the delivery of these services to youth between the ages of 8 and 18 and their families.
The DJJ is seeking a single Respondent to provide all of the requested service components. Pricing and funding details are not provided in the document. The ITN indicates that the selected Respondent will be responsible for contracting with local service providers, training, service delivery, contract management, and operations.
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Other files
| File | Type | Posted |
|---|---|---|
| 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 Ex4 StartUpImplementationPlan.docx | DOCX document | |
| ITN 10770 Informational Notice 1.pdf | ||
| ITN 10770 solicitation document.pdf | ||
| ITN 10770 Attachment J.xlsx | XLSX spreadsheet | |
| ITN 10770 Attachment Q.pdf | ||
| ITN 10770 Attachment R.docx | DOCX document |
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Text version
1Assigned by the Provider or use the Contact number/2-digit month/2-digit year format. For example, the invoice number for March 2011 for contract X1234 would be “X1234/03/11”. The invoice number must match the number on the “Summary of Contractual Services Agreement/Purchase Order” form.
2Goods/Services have been satisfactorily received and payment is now due. Revised 8/23/11
EXHIBIT 1
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
INVOICE FOR FIXED PRICE OR FIXED FEE CONTRACT/GRANT
SECTION I:
Provider (Payee)
Name: Contract/Grant No.:
Remittance Address: 1Invoice Number:
Program Name: Invoice Date:
Service Address: Service Period From:
FEID#: Service Period To:
SECTION II:
A B C D E
Unit of Service or Description Total Number of Units
Total Number of Days Unit Cost Total Cost
Payment Amount Requested
SECTION III:
CERTIFICATION
▪ I certify that the expenditures incurred under this contract/grant are for commodities or services, which are reasonable, necessary, allowable and allocable, and the expenditures directly relate to the purpose of the contract/grant.
▪ I certify that the services this individual or entity have provided services in accordance with the terms and conditions specified in the contract/grant.
▪ I certify that this individual or entity, in accordance with the terms and conditions specified in the contract/grant, maintains any documents and proof of payment supporting the expenditures.
Signature of Provider Agency Official Type or Print Name & Title Telephone & Ext. Date
SECTION IV:
FOR DEPARTMENT USE ONLY
Date Invoice
Was Received
Date Goods Or Services
Were Received
2Date Goods Or Services Were
Inspected And Approved
SIGNATURE & TITLE Of Person
Approving Invoice For Payment
PRINT Name Of Person
Approving Invoice Telephone # Signature/Date
Org Code Exp Option Object Code Amount Org Code Exp Option Object Code Amount
1. $ 4. $
2. $ 5. $
3. $ 6. $
File details come from the government source that posted it. Updated .