NDOC PREA Volunteer-Contractor (DOC 052) ~4.docx
DOCX document 32 KB Posted
- Attached to
- Pest Control Services
- Solicitation number
- 44DOC-S2621
- Issued by
- Elko County, Nevada
About this file
The document provided is the State of Nevada Department of Corrections PREA Contractor and Volunteer Questionnaire Form. This form is required for all contractors and volunteers who may have contact with inmates to comply with the Department of Justice National Standards to Prevent, Detect, and Respond to Prison Rape. The form outlines that the Nevada Department of Corrections shall not enlist the services of any contractor or volunteer who has engaged in sexual abuse or sexual harassment of inmates. Contractors and volunteers must complete this questionnaire, and providing false or misleading statements will result in termination of access to all NDOC institutions.
The questionnaire contains two questions that address the contractor or volunteer's history of sexual misconduct or sexual harassment involving inmates. Respondents must indicate if they have engaged in such activities, and failure to answer truthfully will result in their volunteer or contractor status being rescinded.
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| File | Type | Posted |
|---|---|---|
| 10DOC-S2621 - Reference Questionnaire.docx | DOCX document | |
| Facility Tour Registration Form~4.docx | DOCX document | |
| PREA AGENCY ZERO TOLERANCE POLICY~2.docx | DOCX document | |
| Standard Form Contract~18.docx | DOCX document | |
| 44DOC-S2621 Proposed Staff Resume.docx | DOCX document | |
| Attachments for Signatures 2023-04-13~5.pdf | ||
| RFP 44DOC-S2621 - Cost Schedule~2.docx | DOCX document | |
| Background Check Application~3.docx | DOCX document | |
| 44DOC-S2621 - Facility Tour Registration Form - All Facilities.docx | DOCX document | |
| 44DOC-S2621 - Reference Questionnaire.docx | DOCX document | |
| Insurance Schedule~16.pdf | ||
| NDOC Security Regulations Ack (DOC 047)~4.doc | DOC document | |
| 44DOC-S2621 - Pestmaster Services - Letter of Intent.pdf | ||
| Quote Instructions.pdf | ||
| RFP 44DOC-S2621 - Final~1.docx | DOCX document | |
| Reference Questionnaire 2023-04-13~7.docx | DOCX document | |
| Terms and Conditions for Services 2023-04-13~7.pdf |
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Text version
State of Nevada Department of Corrections
PREA Contractor and Volunteer Questionnaire Form
The Nevada Department of Corrections, in compliance with the Department of Justice, National Standards to Prevent, Detect, and Respond to Prison Rape 42 U.S.C. § 15601, et seq. and 28 C.F.R., §115.17 (a) shall not enlist the services of any contractor or volunteer who may have contact with inmates. Agency policy requires all contractors and volunteers complete this questionnaire.
Providing false or misleading statements, including material omissions regarding such misconduct shall be grounds for termination from entry into all NDOC institutions and volunteer/contractor status will be rescinded.
1. Have you engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or other institution, or have you been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse, or have you been civilly or administratively adjudicated to have engaged in the activity described in any part of this question?
YES |_| NO |_|
2. Have you been adjudicated as having engaged in any type of inmate Sexual Harassment, which includes as a staff member, volunteer, contractor, or as any type of service provider coming in contact with an inmate in the facilities mentioned in question 1? Sexual Harassment includes but is not limited to:
· Repeated verbal comments of a sexual nature to an inmate; or
· Demeaning references to gender; or
· Derogatory comments about body or clothing; or
· Repeated profane or obscene language or gestures
YES |_| NO |_|
| __________________________________ | __________ | |
| Signature | Date |
Print Name
DOC 052 (12/16)
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