RFA# 202606110 - Development of Programs and Services for Parents Divorcing, Separating, or Living Apart_Final.docx

STATE OF MAINE

Department of Maine Judicial Branch Administrative Office of the Courts

RFA# 202606110

Development of Programs and Services for Parents Divorcing, Separating, or Living Apart

RFA Coordinator

Submitted Questions Due Date

16 July, 2026, no later than 4:00 p.m., local time

TABLE OF CONTENTS

Page

A. PURPOSE AND BACKGROUND

B. GENERAL PROVISIONS

C. ELIGIBILITY TO SUBMIT APPLICATIONS

D. CONTRACT TERM

E. AWARDS

F. APPLICABLE LEGISLATION

A. VENDOR SELF SERVICE SYSTEM (VSS)

B. QUESTIONS

C. AMENDMENTS

D. APPLICATION SUBMISSION

A. EVALUATION PROCESS – GENERAL INFORMATION

B. SCORING WEIGHTS & PROCESS

C. NEGOTIATIONS

D. SELECTION AND AWARD

E. APPEAL OF CONTRACT AWARDS

A. CONTRACT DOCUMENT

B. STANDARD STATE CONTRACT PROVISIONS

PUBLIC NOTICE

State of Maine Department of Maine Judicial Branch

RFA# 202606110

The State of Maine is seeking applications for the distribution of federal Access and Visitation funds for the development of programs and services for parents divorcing, separating, or living apart. The goals of this Request for Application (RFA) are to fund: (1) co-parent education, (2) high-conflict co-parenting services, and (3) supervised visitation.

A copy of the RFA and all related documents can be obtained through the Vendor Self Service System (VSS): https://mevss.hostams.com/PRDVSS1X1/AltSelfService

Applications must be submitted to the Office of State Procurement Services, via the Vendor Self Service System (VSS). Application submissions must be received no later than 4:00 p.m., local time, on 30 July, 2026. Applications will be opened the following business day.

RFA TERMS/ACRONYMS with DEFINITIONS

The following terms and acronyms, as referenced in the RFA, have the meanings indicated below:

State of Maine Department of Maine Judicial Branch Administrative Office of the Courts

RFA# 202606110

Development of Programs and Services for Parents Divorcing, Separating, or Living Apart

PART I INTRODUCTION

A. Purpose and Background

The Maine Judicial Branch (Department) is seeking applications for distribution of federal Access and Visitation funds for the development of programs and services for parents divorcing, separating, or living apart as defined in this Request for Applications (RFA) document. This document provides instructions for submitting applications, the procedure and criteria by which the awarded Applicant(s) will be selected, and the contractual terms which will govern the relationship between the State of Maine (State) and the awarded Applicant(s).

In Public Law 113-183(a)(1)&(2), the United States Congress found that “[t]he separation of a child from a parent does not end the financial or other responsibilities of the parent toward the child…” and “[i]ncreased parental access and visitation not only improve parent-child relationships, and outcomes for children, but also have been demonstrated to result in improved child support collections, which creates a double win for children – a more engaged parent and improved financial security.” In 1997, the United States Congress budgeted $10 million to be allocated annually across all the states and territories in furtherance of this finding. Since 1997, and each year thereafter, the State of Maine Department of Health and Human Services (DHHS) in conjunction with the Maine Judicial Branch has applied for, and has been awarded, federal grant funding under the Access and Visitation Grant program administered by the U.S. Department of Health and Human Services, Administration for Children and Families.

The goals of this Request for Application are to fund: (1) co-parent education, (2) high-conflict co-parenting services, and (3) supervised visitation.

B. General Provisions

1. From the time this RFA is issued until award notification is made, all contact with the State regarding this RFA must be made through the RFA Coordinator identified on the cover page of this RFA. No other person/State employee is empowered to make binding statements regarding this RFA. Violation of this provision may lead to disqualification from the application process, at the State’s discretion.

2. Issuance of the RFA does not commit the Department to issue an award or to pay expenses incurred by an Applicant in the preparation of a response to the RFA. This includes attendance at personal interviews or other meetings, where applicable.

3. All applications must adhere to the instructions and format requirements outlined in the RFA and all written supplements and amendments (such as the Summary of Questions and Answers), issued by the Department. Applications must follow the format and respond to all questions and instructions specified in Part III of the RFA.

4. Applicants will take careful note that in evaluating an application submitted in response to this RFA, the Department will consider materials provided in the application, information obtained through interviews/presentations (if any), and internal Departmental information of previous contract history with the Applicant (if any). The Department also reserves the right to consider other reliable references and publicly available information in evaluating the Applicant’s experience and capabilities.

5. The application must be signed by a person authorized to legally bind the Applicant and must contain a statement that the application and the pricing contained therein will remain valid and binding for a period of 180 days from the date and time of the bid opening.

6. The RFA and the awarded Applicant’s application, including all appendices or attachments, will be the basis for the final contract, as determined by the Department.

7. Following announcement of an award decision, all records and documents regarding this RFA, including bid submissions, will be public records, available for public inspection pursuant to 5 M.R.S. §1825 B (6 &15) and the State of Maine Freedom of Access Act (FOAA) (1 M.R.S. § 401 et seq.). State contracts and information related to contracts, including all records, documents, supporting documents, and bid submissions, are public records unless otherwise excepted by statute (Id).

8. Subject to the above and pursuant to applicable law, in the event that an Applicant believes any information that it submits in response to this RFA is confidential, it must mark that information accordingly, and include citation to legal authority in support of the Applicant’s claim of confidentiality. In the event that the Department receives a FOAA request that includes submissions marked as confidential, the Department shall evaluate the information and any legal authority from the Applicant to determine whether the information is an exception to FOAA’s definition of public record. If the Department determines to release information that an Applicant has marked confidential, it shall provide advance notice to the Applicant to allow for them to seek legal relief.

9. The Department, at its sole discretion, reserves the right to recognize and waive minor informalities and irregularities found in applications received in response to the RFA.

10. If awarded a contract resulting from this RFA, vendors shall be required to disclose, in writing and in accordance with applicable Maine law, any actual or potential conflicts of interest. Such disclosure must include any financial, professional, or personal relationships that could give rise to a conflict of interest or the appearance of a conflict of interest. Failure to disclose a known conflict or appearance of conflict may result in disqualification, contract termination, or other remedies as provided by law.

11. All applicable laws, whether or not herein contained, shall be included by this reference. It shall be the Applicant’s responsibility to determine the applicability and requirements of any such laws and to abide by them.

C. Eligibility to Submit Applications

Non-profit agencies or non-profit entities are eligible to apply. All applicants must provide documentation of non-profit status. If an applicant does not provide this documentation, that applicant will be disqualified. Successful applicants will form a Board of Directors if one does not already exist.

D. Contract Term

The term of anticipated contract period resulting from this RFA is defined in the table below. The dates below are estimated and may be adjusted, as necessary, in order to comply with all procedural requirements associated with the RFA, the specific project awarded, and the contracting process. The actual contract start date will be established by a completed and approved contract.

E. Awards

The Department anticipates making multiple awards as a result of this RFA process. The Department expects to award a total of $95,000 split between successful applicants; the number and size of awards will depend on the number of applications received and available funds. The Department may award all, part, none, or modify this allocation at its discretion.

Awards will be made to the highest scoring applicants (with the potential outcome of not making an award in some categories). Receipt of prior funding does not guarantee future awards. The Department reserves the right to make partial awards, eliminate the lowest scoring application(s) and/or make awards for amounts less than requested, whichever is in the best interest of the State.

If the applicant is requesting funding for more than one type of the eligible programs outlined in Part II of this RFA, the applicant must submit a separate application for each program.

PART II ACTIVITIES AND REQUIREMENTS

A. Organizational Requirements

1. Applicants must be non-profit organizations offering co-parent education, high-conflict co-parenting services, and/or supervised visitation to residents of Maine.

2. Applicants awarded grant funds must utilize the funds for scholarship assistance for any parent or participant who cannot afford to pay the full program fee. Information about scholarship assistance must be clearly stated in program materials and the assistance must be easily attained. While applicants are allowed to utilize awarded funds for administrative costs at the discretion of the Department, priority will be given to applications that primarily allocate the contract award for program participant scholarship assistance.

3. Awarded applicants are required to maintain statewide standards and be trained on domestic abuse and violence dynamics and issues. Awarded applicants may be required to attend training or programs recommended by the Access and Visitation Advisory Committee of the Maine Judicial Branch. Awarded applicants are required to have and demonstrate an initial screening process for issues of domestic abuse and violence. When parent education or other services are not appropriate given personal safety concerns, awarded applicants are expected to make referrals to more appropriate services in the community.

4. Awarded applicants must have access to timely and reliable electronic communication which includes, but is not limited to, Microsoft Office, Adobe Acrobat, and electronic mail.

5. Awarded applicants must be in contact with the Department at least once a month.

6. A site visit by the grant coordinator or any other member of the Access and Visitation Advisory Committee may be required before a contract is issued. Additional site visits after a contract award is granted may be required at the Department’s discretion.

B. Program Requirements

1. Requirements for Co-parenting Education Programs

a. The program will be presented by a minimum of two trainers with gender diversity;

b. Trainers must have prior training and/or experience with parents separated, divorced, or living apart, and must have had training on the dynamics and effects of domestic abuse and violence;

c. The program must have a screening process for domestic abuse and violence;

d. The program must be a minimum of four hours in duration and must meet at least monthly, unless otherwise specified in the contract; and

e. The program must be remotely to maximize geographical availability but may also be offered in person. Applicants should include information on the availability of the program in each format.

2. Requirements for High-Conflict Co-parenting Education Programs

a. The program will be presented by a minimum of two trainers with gender diversity. A mental health professional must serve either as a trainer or advisor to the program;

b. The program must have a screening process for domestic abuse and violence;

c. The program will be specifically tailored to build co-parenting skills for parents who are in a high-conflict situation and consist of multiple sessions; and

d. The program will offer sessions at least quarterly, unless otherwise contracted.

e. The program must be remotely to maximize geographical availability but may also be offered in person. Applicants should include information on the availability of the program in each format.

3. Requirements for Supervised Visitation Programs

a. The program must provide trainings to all staff members on the dynamics and issues of domestic abuse and violence;

b. All employees, volunteers, and interns who work directly with children and families, including intake services, must be required to submit to and pass a criminal background check and DHHS Maine Child Protective Services Central Case Records Research check before any interaction with children and families. The Department reserves the right to request copies of those records;

c. The program must use a visitation facility or facilities that has/have a physical arrangement that prevents contact between parties before and after parent-child visits, such as separate entrances and exits; and

d. The program must provide supervised visitation services in person but, if appropriate, the program may use secure video conferencing tools to provide monitored video contact between geographically separated non-custodial parents and their children.

C. Invoicing and Reporting Requirements

1. Applicants awarded grant funds must expend their grant funds in the time period specified by the awarding contract. To obtain compensation for services rendered, awarded applicants must submit monthly invoices to the Department that include a detailed description of the funds used, including the amounts billed to scholarship assistance and administrative costs. By the 15th of the month following the service month, the applicant must submit an invoice or send an email to the Department stating that there will be no invoice because no services were provided in that month. Failure to adhere to this requirement may result in a termination of the awarding contract.

2. Awarded applicants are also required to submit monthly reports to the Department that document client information, including “Required Outcome” data regarding increased non-custodial parenting time with children because of the services rendered, on a form provided by the Department. By the 15th of the month following the service month, the applicant must submit the report or send an email to the Department stating that there will be no report because no services were provided in that month. Failure to adhere to this requirement may result in a termination of the awarding contract.

PART III KEY PROCESS EVENTS

A. Vendor Self Service System (VSS)

1. The Office of State Procurement Services Vendor Self Service System website is found at the link below: https://www.maine.gov/dafs/bbm/procurementservices/vendors/vendor-self-service-system

2. A copy of the RFA and all associated documents will be published in VSS.

3. Only documents published in VSS will be considered binding.

4. Any interested party may view open solicitations in VSS using the Public Access feature.

5. Vendors must have an active User ID and password in VSS to submit questions and respond to solicitations, including this RFA.

a. Vendor registration instructions and User Guide may be found at the link above, which include steps for searching for an existing account/User ID, or registering for a new account/User ID.

b. Vendors interested in responding to a solicitation are encouraged to obtain a User ID and password for VSS as soon as possible.

6. Vendors must have an active Vendor Code (VC or VS) to contract with the department.

B. Questions

1. General Instructions: It is the responsibility of all Applicants and other interested parties to examine the entire RFA and to seek clarification, in writing, if they do not understand any information or instructions.

a. Questions must be submitted in VSS as soon as possible but no later than the date and time published in VSS.

b. Questions should be clearly stated and reference the applicable section and/or page number of the RFA.

c. The Department assumes no liability for assuring accurate/complete/on time transmission and receipt.

2. Question & Answer Summary: Responses to all questions will be compiled in writing and published in VSS no later than seven (7) calendar days prior to the Application Submission Deadline. It is the responsibility of all interested parties to go to VSS to obtain a copy of the Question & Answer Summary. Only those answers issued in writing in VSS will be considered binding.

C. Amendments

All amendments released in regard to the RFA will be published in VSS. It is the responsibility of all interested parties to go to VSS to obtain amendments. Only those amendments published in VSS are considered binding.

D. Application Submission

1. Applications Due

a. Application submissions must be received no later than the Application Submission Deadline (closing date) published in VSS.

b. Any application submissions or any additional or revised application files received after the Application Submission Deadline will be rejected without exception.

2. Delivery Instructions

a. Application submissions must be submitted to the Office of State Procurement Services via VSS.

b. Only application submissions received via VSS will be considered. The Department assumes no liability for assuring accurate/complete receipt.

c. Submissions containing links to file sharing sites or online file repositories will not be accepted as submissions. Only application submissions that have the actual requested files attached will be accepted.

d. Encrypted submissions received which require opening attachments and logging into a proprietary system will not be accepted. Applicants should work with their Information Technology team to ensure that the application submission will not be encrypted due to any security settings.

e. File size limits are 15MB per file. Applicants may separate their submissions into multiple files, as necessary, due to file size concerns.

3. Submission Format

a. Applicants must submit at least one (1) file, labeled and including the required information as defined below:

File Name: RFA# 202606110 Application Submission – [Applicant’s Name][Program Name]

· Must contain: Applicant’s completed Application Form and all required information and attachments as stated in the form.

b. The Application Form must be submitted as a single, typed file. If including attachments in the same file presents a file size issue, Applicants may submit those attachments as a separate, clearly labeled file.

c. Applicants must include any forms provided in the RFA (such as the Application Form) or reproduce those forms as closely as possible.

d. Applicants are not to provide additional attachments beyond those specified in the RFA or Application Form for the purpose of extending their response. Materials not requested will not be considered part of the application and will not be evaluated.

PART IV APPLICATION EVALUATION AND SELECTION

A. Evaluation Process – General Information

1. An evaluation team, composed of qualified reviewers, will judge the merits of the applications received in accordance with the criteria defined in the RFA.

2. Officials responsible for making decisions on the award selection will ensure that the selection process accords equal opportunity and appropriate consideration to all who are capable of meeting the specifications. The goals of the evaluation process are to ensure fairness and objectivity in review of the applications and to ensure that all contracts are awarded to the Applicants that provide the best value to the State of Maine.

3. The Department reserves the right to communicate and/or schedule interviews/presentations with Applicants, if needed, to obtain clarification of information contained in the applications received. The Department may revise the scores assigned in the initial evaluation to reflect those communications and/or interviews/presentations.

4. Changes to applications, including updating or adding information, will not be permitted during any interview/presentation process and, therefore, Applicants must submit applications that present their rates and other requested information as clearly and completely as possible.

5. Failure to respond to all questions and instructions throughout the RFA may result in the application being disqualified as non-responsive or receiving a reduced score. The Department, and its evaluation team, has sole discretion to determine whether a variance from the RFA specifications will result either in disqualification or reduction in scoring of an application.

B. Scoring Weights & Process

1. Scoring Weights: The score will be based on a 100-point scale and will measure the degree to which each application meets the following criteria. The information required in each section of the Application Form aligns with the Scoring Criteria defined below.

2. Scoring Process: For applications that demonstrate meeting the eligibility requirements defined in Part I, if applicable, the evaluation team will use a consensus approach to evaluate and score all sections listed above. Members of the evaluation team will not score those sections individually but, instead, will arrive at a consensus as to assignment of points for each of those sections.

C. Negotiations

1. The Department reserves the right to negotiate with the awarded Applicant(s) to finalize a contract.

2. The Department reserves the right to terminate contract negotiations with an awarded Applicant who submits a proposed contract significantly different from the application they submitted in response to the advertised RFA.

3. In the event that an acceptable contract cannot be negotiated with an Applicant, the Department may withdraw its award and negotiate with the next-highest ranked Applicant, and so on, until an acceptable contract has been finalized. Alternatively, the Department may cancel the RFA, at its sole discretion.

D. Selection and Award

1. The final decision regarding the award of the contract will be made by representatives of the Department subject to approval by the State Procurement Review Committee.

2. Notification of conditional award selection or non-selection will be made in writing by the Department.

3. Issuance of the RFA in no way constitutes a commitment by the State of Maine to award a contract, to pay costs incurred in the preparation of a response to the RFA, or to pay costs incurred in procuring or contracting for services, supplies, physical space, personnel or any other costs incurred by an Applicant.

4. The Department reserves the right to reject any and all applications or to make multiple awards.

E. Appeal of Contract Awards

Any person aggrieved by the award decision that results from the RFA may appeal the decision to the Director of the Bureau of General Services in the manner prescribed in 5 M.R.S.A. § 1825-E and 18-554 Code of Maine Rules Chapter 120. The appeal must be in writing and filed with the Director of the Bureau of General Services, 9 State House Station, Augusta, Maine, 04333-0009 within fifteen (15) calendar days of receipt of notification of conditional contract award.

PART V CONTRACT ADMINISTRATION AND CONDITIONS

A. Contract Document

1. The awarded Applicant will be required to execute a State of Maine Service Contract with appropriate riders as determined by the issuing department.

All exceptions will be negotiated between the awarded Applicant(s) and the State. The State will not accept any proposed exceptions as part of this RFA process. The State is not obligated to accept, negotiate, or compromise of any proposed exceptions.

The complete set of standard State of Maine Service Contract documents, along with other forms and contract documents commonly used by the State, may be found on the Office of State Procurement Services’ website at the following link: Office of State Procurement Services Forms Page

2. Allocation of funds is final upon successful negotiation and execution of the contract, subject to the review and approval of the State Procurement Review Committee. Contracts are not considered fully executed and valid until approved by the State Procurement Review Committee and funds are encumbered. No contract will be approved based on an RFA which has an effective date less than fourteen (14) calendar days after award notification to Applicants. (Referenced in the regulations of the Department of Administrative and Financial Services, Chapter 110, § 3(B)(i).)

This provision means that a contract cannot be effective until at least fourteen (14) calendar days after award notification.

3. The State recognizes that the actual contract effective date depends upon completion of the RFA process, date of formal award notification, length of contract negotiation, and preparation and approval by the State Procurement Review Committee. Any appeals to the Department’s award decision(s) may further postpone the actual contract effective date, depending upon the outcome. The contract effective date listed in the RFA may need to be adjusted, if necessary, to comply with mandated requirements.

4. In providing services and performing under the contract, the awarded Applicant must act as an independent contractor and not as an agent of the State of Maine.

B. Standard State Contract Provisions

1. Contract Administration Following the award, a Contract Administrator from the Department will be appointed to assist with the development and administration of the contract and to act as administrator during the entire contract period. Department staff will be available after the award to consult with the awarded Applicant in the finalization of the contract.

State of Maine RFA# 202606110 1 Rev. 04/17/2026 – DAFS/Office of State Procurement Services

PART VI APPLICATION FORM

As defined in Part III, D, 3 of the RFA, Applicants must complete the Application Form embedded below and produce all required attachments.

The Application Form may be obtained in a Word (.docx) format by double clicking on the document icon below.

Viewing this RFA in a web browser will likely not allow for opening of the embedded document. Download the RFA and view it in the desktop application to access the embedded Application Form below.

image1.jpeg image2.emf

Microsoft_Word_Document.docx State of Maine

Department of Maine Judicial Branch

RFA# 202606110

APPLICATION COVER PAGE

Applicant’s Name:

Chief Executive - Name/Title:

Tel:

E-mail:

Headquarters Street Address:

Headquarters City/State/Zip:

(Provide information requested below if different from above)

Lead Point of Contact for Application - Name/Title:

Tel:

E-mail:

Street Address:

City/State/Zip:

· This Application and the pricing structure contained herein will remain firm for a period of 180 days from the date and time of the bid opening.

· No personnel currently employed by the Department participated, either directly or indirectly, in any activities relating to the preparation of the Applicant’s Application.

· No attempt has been made, or will be made, by the Applicant to induce any other person or firm to submit or not to submit an Application.

· The above-named organization is the legal entity entering into the resulting contract with the Department should they be awarded the contract.

· The undersigned is authorized to enter contractual obligations on behalf of the above-named organization.

To the best of my knowledge, all information provided in the enclosed application, both programmatic and financial, is complete and accurate at the time of submission.

Name (Print):

Title:

Authorized Signature:

Date:

RESPONSIBLE BIDDER CERTIFICATION

Applicant’s Name:

By signing this document, I certify to the best of my knowledge and belief that the aforementioned organization, its principals and any subcontractors named in this application:

a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from bidding or working on contracts issued by any governmental agency.

b. Have not within three years of submitting the application for this contract been convicted of or had a civil judgment rendered against them for:

i. Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a federal, state, or local government transaction or contract.

ii. Violating Federal or State antitrust statutes or committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.

c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (b) of this certification.

d. Have not within a three (3) year period preceding this application had one or more federal, state, or local government transactions terminated for cause or default.

e. Have not entered into a prior understanding, agreement, or connection with any corporation, firm, or person submitting a response for the same materials, supplies, equipment, or services and this application is in all respects fair and without collusion or fraud. The above-mentioned entities understand and agree that collusive bidding is a violation of state and federal law and can result in fines, prison sentences, and civil damage awards.

f. Is not a foreign adversary business entity (https://www.maine.gov/oit/prohibited-technologies).

g. Is not on the list of prohibited companies (https://www.maine.gov/oit/prohibited-technologies) or does not obtain or purchase any information or communications technology or services included on the list of prohibited information and communications technology and services https://www.maine.gov/oit/prohibited-technologies (Title 5 §2030-B).

Name (Print):

Title:

Authorized Signature:

Date:

APPLICATION

Eligibility

Applicants must provide documentation to demonstrate meeting the eligibility requirements stated in Part I of the RFA.

Is the applicant a non-profit organization?

☐ YES ☐ NO

Applicant must provide documentation of non-profit status.

Organization Qualifications and Experience

Applicants must describe their qualifications and skills to provide the requested services in the RFA. Applicants must include three (3) examples of projects which demonstrate their experience and expertise in performing these services as well as highlighting the Applicant’s stated qualifications and skills.

The projects provided should demonstrate the Applicant’s ability to meet the organizational requirements in Part II(A) of the RFA and the program requirements in Part II(B) of the RFA.

Project 1

Client Name:

Client Contact Person:

Telephone:

E-Mail:

Brief Description of Project

Project 2

Client Name:

Client Contact Person:

Telephone:

E-Mail:

Brief Description of Project

Project 3

Client Name:

Client Contact Person:

Telephone:

E-Mail:

Brief Description of Project

Subcontractors

If subcontractors are to be engaged, Applicants must describe the application and review process the Applicant will use to evaluate the qualifications and experience of potential subcontractors, and how the Applicant will ensure that debarred, suspended, or otherwise ineligible parties are excluded from all subcontract relationships.

Subcontractor 1

Subcontractor Name:

Contact Person:

Telephone:

E-Mail:

Brief Description of Anticipated Role and Qualifications

Subcontractor 2

Subcontractor Name:

Contact Person:

Telephone:

E-Mail:

Brief Description of Anticipated Role and Qualifications

Subcontractor 3

Subcontractor Name:

Contact Person:

Telephone:

E-Mail:

Brief Description of Anticipated Role and Qualifications

Organizational Chart

Applicants must provide an organizational chart. The organizational chart must include the project being proposed. Each position must be identified by position title and corresponding to the personnel job descriptions.

The organizational chart may be included below or may be attached to the application separately and appropriately labeled.

Litigation

Applicants must include a list of all current litigation in which the Applicant is named and a list of all closed cases that have closed within the past five (5) years in which the Applicant paid the claimant either as part of a settlement or by decree. For each, list the entity bringing suit, the complaint, the accusation, amount, and outcome.

Financial Viability

Applicants must provide the following information for each of the past three tax years:

a. Balance Sheets

b. Income (Profit/Loss) Statements

The financial information may be included below or may be attached to the application separately and appropriately labeled.

Certificate of Insurance

Bidders must provide a certificate of insurance on a standard ACORD form (or the equivalent) evidencing the bidder’s general liability, professional liability and any other relevant liability insurance policies that might be associated with the proposed services.

The Certificate of Insurance may be included below or may be attached to the application separately and appropriately labeled.

Proposed Project

Applicants must include the following information below to show compliance with the program requirements in Part II(B) of the RFA as it applies to the type of program for which the applicant is seeking funding. Applicants may provide the information in the space below or attach it to the Application Form marked as “Proposed Project Information.”

1. Co-Parenting Education Programs. Applicants must:

a. Provide a description of its co-parenting education program;

b. Provide a roster of its trainers to the Department and document their prior training and/or experience with parents separated, divorced, or living apart, and also document training on the dynamics and effects of domestic abuse and violence;

c. Certify that it provides program scholarship assistance and describe its screening process for doing so;

d. Describe its screening for domestic abuse and violence;

e. Include information on the program’s Board of Directors; and

f. To the extent the applicant has provided co-parent education programming in prior years and received Access and Visitation grant funds for that programming, provide the following information for federal fiscal years 2020-2025:

i. The total number of parents, grandparents, legal guardians, and children served and the number of courses offered broken down by each federal fiscal year; and

ii. The total amount of Access and Visitation award for each federal fiscal year and total amount actually expended for each federal fiscal year.

2. High-Conflict Co-Parent Education Programs. Applicants must:

a. Provide a description of its high-conflict co-parent education program, including the curriculum;

b. Provide a roster of its trainers to the Department and document their prior training and/or experience with parents separated, divorced, or living apart, and also document training on the dynamics and effects of domestic abuse and violence;

c. Certify that it provides program scholarship assistance and describe its screening process for doing so;

d. Describe its screening for domestic abuse and violence;

e. Include information on the program’s Board of Directors; and

f. To the extent the applicant has provided high-conflict co-parent education programming in prior years and received Access and Visitation grant funds for that programming, provide the following information for federal fiscal years 2020-2025:

i. The total number of parents, grandparents, legal guardians, and children served and the number of courses offered broken down by each federal fiscal year; and

ii. The total amount of Access and Visitation award for each federal fiscal year and total amount actually expended for each federal fiscal year.

3. Supervised Visitation Programs. Applicants must:

a. Provide a description of its supervised visitation program;

b. Provide a roster of its supervisors to the Department and provide documentation on training provided to the supervisors;

c. Certify that it provides program scholarship assistance and describe its screening process for doing so;

d. Provide documentation of trainings to all staff members on the dynamics and issues of domestic abuse and violence;

e. Demonstrate that its visitation facility or facilities has/have a physical arrangement that prevents contact between parties before and after parent-child visits, such as separate entrances and exits;

f. Provide information on the program’s Board of Directors; and

g. To the extent the applicant has provided supervised visitation services in prior years and received Access and Visitation grant funds for that programming, provide the following information for federal fiscal years 2020-2025:

i. The total number of parents, grandparents, legal guardians, and children served and the number of courses offered broken down by each federal fiscal year; and

ii. The total amount of Access and Visitation award for each federal fiscal year and total amount actually expended for each federal fiscal year.

Budget

ACCESS AND VISITATION GRANT FUNDING REQUEST INFORMATION

Total Access and Visitation Grant Request Amount:

Total Amount of Request Designated for Participant Scholarship Funding:

If 100% of amount requests is not being designated for participant scholarship funding, explain for what purpose the money would be allocated, and provide a detailed breakdown of how that money would be expended: