Listing_of_Employees___Subcontractors_FSA.pdf
PDF 95 KB Posted
- Attached to
- Master Agreement AZ|CTR055542
- Contract number
- CTR055542
- Issued by
- Arizona
About this file
This document is a "Listing of Contractor Employees and Subcontractors" form issued by the State of Arizona's Department of Child Safety, Office of Procurement, located in Phoenix. The document is associated with Family Service Aides, a contractor with contract/solicitation number CTR055542 / BPM003267. The form requires the listing of all employees and subcontractors who will be engaged in direct client services, including their names, dates of birth, dates of hire, and fingerprinting clearance card numbers.
The form lists five employees/subcontractors: Claudia Bonne-Annee, Kami O'Connell, Korey M Chantawari, Colleen Bruffy, and Jessica Diaz. Most of these individuals have already obtained their fingerprinting clearance cards, with one (Kami O'Connell) still having a pending status. The document was updated on 06/10/21 and appears to be a standard compliance document ensuring that all personnel working directly with clients have appropriate clearance and background checks for a child safety-related contract.
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Text version
LISTING OF CONTRACTOR EMPLOYEES
AND SUBCONTRACTORS
State of Arizona Department of Child Safety
Office of Procurement 3003 N. Central Ave Phoenix, AZ 85012
Contractor Name: Family Service Aides
Contract / Solicitation Number: CTR055542 / BPM003267
Please provide information in the table below for all employees and subcontractors who will be engaged in direct client services under this contract. List the names, date of birth, date of hire, and fingerprinting clearance card number (put pending if card not obtained yet).
Employee/Subcontractor Name Date of Birth Date of Hire Fingerprinting
Clearance Card No.
Claudia Bonne-Annee 1/3/2017 2018B04967
Kami O’ Connell 06/09/21 Pending
Korey M Chantawari 06/28/21 2019K01410
Colleen Bruffy 8/31/20 2019F11617
Jessica Diaz 1/27/21 2019R02140
Updated Date ______06/10/21________
File details come from the government source that posted it. Updated .