Terp Data Sheet 2016 Version.docx
DOCX document 80 KB Posted
- Solicitation number
- BD-18-1067-MCD01-MCD01-26742
- Issued by
- Massachusetts
About this file
The document is a data sheet for interpreter/CART (Communication Access Real-Time Translation) providers seeking to contract with the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH), a department of the Massachusetts Executive Office of Health and Human Services. The data sheet collects contact information, communication skills, geographic availability, and willingness to accept different types of assignments such as ceremonies, education, legal, medical, and social services. The related state and local contract opportunity, MCD06 ASL Interpreters and Transliterators for the Deaf and Hard of Hearing, identifies Suffolk County and the City of Boston as the jurisdictions involved. The contract term is not specified, but responses are due two weeks after downloading the contract documents, which include a checklist, instructions, and 22 individual forms.
The contract documentation provides pricing, set-aside, and other salient details. Funding sources and amounts are not included. The current environment and incumbent information are also not provided in the documents reviewed.
View the file
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Text version
The Commonwealth of Massachusetts Executive Office of Health and Human Services Massachusetts Commission for the Deaf and Hard of Hearing 600 Washington Street Boston, Massachusetts 02111 Tel. (617) 740-1600
TTY (617) 740-1700
VP (617) 326-7546
Fax (617) 740-1880 www.mass.gov/mcdhh
Department of Interpreter/CART Services
INTERPRETER/CART PROVIDER DATA SHEET
Complete and return with your contract documents Please inform the Department of Interpreter/CART Services of any changes in this information
| First Name: |
| Last Name: |
Street Address:
| City/Town: |
| State |
| Zip + 4 |
| Home phone: |
| Primary email: |
| Work phone: |
| Videophone: |
| Mobile phone: |
| Alternate email/contact number: |
Pager
| Communication Skills (check all that apply): |
| CART Provider |
| Oral Transliterator |
Interpreter
CDI/SDI
Transliterator
| I am willing to be contacted for work in the following regions (check all that apply): |
| Boston/Metro |
| Western |
| Northeast |
| Southeast |
| Central |
| Cape Cod/Islands |
DeafBlind - Tactile DeafBlind – Close Vision DeafBlind – Rochester DeafBlind – Other:
DeafBlind – Tracking DeafBlind - ProTactile
I carry the following insurance:
Liability insurance
Malpractice insurance
Other insurance (specify)
I am willing to be contacted for the following (check all that apply):
Ceremony/Weddings/Birth/Funeral Court Education 0-12 Education/Post-Secondary Education/Meeting Education/Personal Growth Education Conference/Workshop Employment/Conference/Workshop Employment/General Employment/Meeting General Audience Jury Duty Legal Conference/Workshop Legal Emergency MCDHH Referral/Interpreter Substitute Medical Conference/Workshop Medical Emergency Medical Meeting Medical/Clinic Medical/Doctor Office Medical/Hospital Medical/Residence Mental Health Conference/Workshop Mental Health Emergency Mental Health Meeting Mental Health/In-patient Mental Health/Out-patient Miscellaneous Meetings Non-court Legal Personal Business/Meeting Social Services Social Services – Conference/Workshops Social Services/Emergency Substance Abuse Support Groups (e.g. AA/NA) Substance Abuse Workshop/Training Substance Abuse/Detox Substance Abuse/Out-patient Services Substance Abuse/Residential Treatment Support Group/Other (e.g. cancer, bereavement, etc)
I am willing to be contacted by hospitals for after business hours and weekend emergencies I am willing to be contacted by private colleges and universities for post secondary work I am willing to be contacted by requestors for theater/performing arts work
Signature
Date
2016_Version_TerpDataSheet_150421 image1.wmf oleObject1.bin
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