SECTION I:



Department of Family and Support Services

Outreach and Engagement - Daytime Supportive Service Centers

Application and instructions

1. Proposal Deadline and Pre-Submittal Conference

A. Information

Please submit one (1) original and two (2) copies by 4:30 p.m. on

December 30, 2011 to:

Tami Cole

Director of Homeless Services

Department of Family and Support Services

1615 W. Chicago Ave., 3rd Fl.

Chicago, Illinois 60622

Additionally, please e-mail an exact and complete scanned copy of your proposal, budget and ALL attachments to: soneill@ by, December 30, 2011, 4:30 p.m. Both the paper original and e-mailed copies are required for the submission to be considered complete.

Proposals will be accepted prior to the due date, from 9:00 a.m. to 4:00 p.m. Monday – Friday at the same location. All proposals must be complete. Incomplete proposals may not be reviewed. In-person or bonded messenger delivery of proposals is encouraged. Time-stamped receipts will be issued as proof of timely submittal.

No proposal will be considered complete and therefore reviewed unless the original copy is delivered and received at DFSS office.

Proposals received after the due date and time may be deemed NON-RESPONSIVE and, therefore, subject to rejection.

B. Questions

Respondents are strongly encouraged to submit all questions and comments related to the RFP via e-mail. For answers to program-related questions please contact:

Susan O’Neill: soneill@

All other questions regarding the administrative aspects of this RFP may be directed to: Julia Talbot: jtalbot@

C. Pre-Proposal Conference

A Pre-Proposal conference will be held on:

Wednesday, December 21, 2011 from 2:00 – 3:00

Department of Family and Support Services,

1615 W. Chicago Ave., Room 249A.

Attendance at this conference is not mandatory but is highly advised.

To request reasonable accommodation for the pre-submittal conference, please contact, Monica Rafac, monica.rafac@ . Requests for accommodations will be accepted up to 48 hours prior to the event.

D. Timeline

This is the anticipated timeline for the funded programming:

|Proposal Release Date: |December 15, 2011 |

|Bidders Conference: |December 21, 2011 |

|Proposal Due: |December 30, 2011 |

|Anticipated Contract Start Date: |January 1, 2012 |

2. Application Requirements

A. Formatting

Submitted proposals must adhere to all of the following requirements:

• One original and two copies will be submitted for each proposal

One complete set of the proposal containing original signatures in blue ink signed by an authorized representative of the organization will be marked “Original”. Additionally, one complete scanned copy of the proposal will be emailed to the following address by December 30, 2011 to soneill@

• Recycled paper

• 8 1/2 x 11 letter size

• Double-sided printing

• One inch margins

• At least 1.5 -spaced

• At least 11-point font

The complete application packet should consist of the following items, in this order:

1. Agency Application Information Form (page 6)

2. Executive Summary (2 page limit, page 7)

3. Program Narrative (15 page limit, page 7)

4. Budget - Instructions (page 10)

5. Attachments

The Narrative portion of the proposals should be no longer than 15 pages in length.

Failure to submit a complete proposal and/or to respond fully to all requirements may cause the proposal to be deemed unresponsive and, therefore, subject to rejection.

Receipt of a final proposal does not commit the department to award a grant to pay any costs incurred in the preparation of an application.

3. Evaluation and Selection Procedures

A. Evaluation Process

An evaluation committee selected by DFSS will evaluate and rate all proposals based on the evaluation criteria outlined below. Each proposal will be evaluated on the strengths of the proposal and the responsiveness to the selection criteria outlined below. DFSS reserves the right to consult with other city departments or public or private funders during the evaluation process. Selected Respondent must be ready to proceed with proposed program at the time of contracting.

Failure to submit a complete proposal and/or to responds fully to all requirements may cause the proposal to be deemed unresponsive and, therefore, subject to rejection.

B. General Selection Criteria

The Proposals will be evaluated on the Respondent’s ability to provide Outreach and Engagement as defined in this RFP. The following criteria will be used in evaluating all proposals:

1. Previous Programmatic Experience

Respondent should demonstrate knowledge of the populations to be served or similar populations and in the way in which these populations should be served as evidenced by previous or current operation of a successful program of a similar nature.

2. Administrative/Fiscal Capacity and Experience

Respondent should demonstrate the resources and expertise to assume and meet all administrative and fiscal requirements. This includes the Respondent’s fiscal (including financial management systems), technological, management, administrative and staff capabilities

3. Program Design and Administration

Respondent should demonstrate program and administrative design specifically tailored to the goals of the program.

Proposals will be rated within each program model based on the criteria and considerations listed above. System level considerations (such as geographic location, need to target underserved populations, etc.) may be taken into account in final ratings and funding decisions. The selection process will also consider how all programs fit together to achieve a comprehensive, citywide system of care that supports The Plan to End Homelessness and aligns with anticipated HEARTH standards.

The Commissioner, upon review of recommended agencies, may approve or reject these recommendations. Selections will not be final until the City and the Respondent have fully negotiated and executed a contract. The City assumes no liability for costs incurred in responding to this RFP or for costs incurred by the Respondent in anticipation of a fully executed contract.

C. Additional Evaluation Criteria

In addition to general selection criteria, proposals will be evaluated on the following criteria:

• Respondent’s program experience and capacity, including experience operating the program model or a program of similar nature, and experience serving the target population.

• Respondent’s cost per client served. Proposals will be evaluated based on their proposed budget request and the number of clients to be served.

• Respondent’s demonstrated fiscal and administrative capacity. DFSS will consider all DFSS program and fiscal monitoring reports, as well as expenditure reports indicating agency’s ability to expend funds in a timely manner.

• Respondent’s program implementation, scope, and outcomes. The Respondent’s program design must be consistent with the program models described in this RFP. Proposals will be evaluated on the expertise and ability of the agency to address the required key elements of the proposed program model and fulfill the required program outcomes. The agency must demonstrate an evaluation strategy that is feasible and can reasonably measure program impact. Proposals will be evaluated based on the Respondent’s prior performance for the program model being implemented. Prior performance be evaluated based on the Respondents’ narrative response to this RFP as well as review of programs’ prior performance (based on DFSS quarterly reports).

• Respondent’s proposed staffing. Proposals will be evaluated on the extent to which the Respondent demonstrates staffing patterns necessary to operate the program in accordance with the program model’s design and outcomes.

• Service coordination and integration. Respondents must demonstrate their capacity to locate and leverage new neighborhood partners on an on-going basis. Proposals will be evaluated on the extent to which the Respondent has linkage agreements and partnerships with providers of the following services: Case Management; Employment Training, Placement, and Retention; Health Care; Housing Placement; Substance Abuse Detox and Recovery Treatment; Mental Health Assessment and Treatment (for adults and children); Child Care and After-school Programs (for family programs); Legal Assistance; Credit Counseling; Life Skills Training. Proposals will be evaluated on the extent to which clients will have the ability to access these services either on-site or at a nearby location.

• Homeless Management Information System (HMIS). For Respondents with prior experience working with the HMIS system, DFSS staff will produce and consider reports indicating prior HMIS performance. Participation in HMIS will be evaluated based on agency’s entry and exit of clients, and entry of universal data elements into the HMIS system.

The following priorities may be taken into consideration when making final funding decisions. Priority may be given to programs that:

• Align with the goals of The Plan and anticipated HEARTH standards by focusing on rapid re-housing and supportive services needed to keep individuals and families housed.

• Target underserved populations and exhibit flexible admissions criteria, to assure that there are sufficient programs available to respond to system needs.

• Best represent outcome-based programming. This is programming that can be measured by meaningful outcomes, rather than solely by the reporting of activities.

• Substantially leverage other non-DFSS public and private funding sources. The intent of this RFP is to fund a portion of a program’s total annual budget, and not to be a program’s sole funding source.

• Provide a match level of 25% or more.

For Respondents with prior contracts with DFSS, the following will be considered:

• DFSS program and fiscal monitoring reports for the Respondent agency.

• Prior performance, as indicated in quarterly reports submitted to DFSS.

• Complaints, both resolved and unresolved, pertaining to the service provider.

DFSS reserves the right to seek clarification of information submitted in response to this RFP and/or to request additional information during the evaluation process and make site visits and/or require Respondents to make an oral presentation or be interviewed by the review subcommittee, if necessary.

DEPARTMENT OF FAMILY AND SUPPORT SERVICES

Outreach and Engagement - Daytime Supportive Service Centers

Agency Application Information Form

|Legal Name of Agency | FEIN Number |

| | |

|Administrative/Mailing Address |DUNS Number |

|Executive Director |Executive Director’s Phone Number |

| | |

|Executive Director’s Fax Number |Executive Director’s Email Address |

| | |

|Contact Person for Proposal |Contact Person’s Phone Number |

|Contact Person’s Fax Number |Contact Person’s Email Address |

Type of Organization (check one)

| |Not-for-Profit Agency | | For-Profit Agency | |Faith-Based Agency |

| |Other, if yes Description: | |

Amount Requested: $______________________

Agency Statement of Certification

This proposal has been duly authorized by the governing body of the proposed. The proposed activities, dates, availability of resources, staff, cost, and all statements made are true and correct. The Respondent will comply with all rules and regulations of the funding agency and will revise this proposal if necessary.

| | |

|Authorized Signer’s Name |Authorized Signature |

| | |

|Authorized Signer’s Title |Date Signed |

Application

Executive Summary

Please attach an Executive Summary, which briefly describes your organization’s qualifications, and relevant experience to operate an Outreach and Engagement - Daytime Supportive Service Centers homeless program. The Executive Summary may be no more than two pages. The Executive Summary must include:

• An overview of the qualifications of the Respondent;

• A statement of the Homeless Services program model to be implemented, and whether this is a new program or an expansion of a current program. If this is an expansion of a current program, state whether or not the program is currently funded by DFSS.

• A brief discussion of the current operating site located in desired geographic location of the program.

• Briefly describe the target population (chronic, substance abuse, etc.) and the process your agency engages in to determine the need for your program in your target community and among your target population.

• The name and telephone number of the lead contact person for the proposal.

Program Narrative

Please write a narrative that provides information and description about your organization’s capacity, vision and plans on the following areas in reference with respect to operating an Outreach and Engagement - Daytime Supportive Service Centers homeless program in no more than 15 pages.

A. In a clear and concise manner, provide a brief narrative summary of the project; its scope, problems addressed, and results anticipated.

• Describe any special needs of clients (mental health issues, HIV/AIDS, substance abuse), and agency experience and strategy in addressing these needs.

• Describe eligibility requirements for clients coming into the program, as well as any client issues or characteristics that would exclude a client from your program.

• If clients are not accepted into this program, describe whether or not your agency provides these individuals support in finding other shelter or housing.

• Specifically describe how clients will be assessed to determine homelessness.

• Describe the agency’s grievance procedures, client voluntary discharge procedures, and involuntary client termination procedures, including shelter placement options for clients who are terminated from the program.

• Describe any outreach to or recruitment of clients into the program. Describe where clients come from e.g.: other agency operated programs, the street, referrals from other agencies.

B. Specifically describe the project’s prior accomplishments and the year it began operation.

• Briefly describe your agency’s mission and history.

• Describe the agency’s history in operating homeless programs, and programmatic capacity to operate the project as described.

• Specifically state the year that the proposed program began.

• Describe prior success in achieving specific program outcomes such as placement in permanent housing, housing retention, increase in income, increase in skill level, etc based on the proposed program model.

• Describe the role of case management in ensuring that clients achieve positive outcomes.

C. Financial, physical, and human resources being leveraged

• Describe the financial, physical, and human resources that are being leveraged for the program.

• Clearly indicate the amount and sources of other funding for the program (should align with budget submission “Other Share”)

• State whether the agency has a line of credit or an operating reserve to cover one month of payroll, OR can document having met payroll obligations for the past 12 months.

• Describe your agency’s capacity to locate and leverage additional resources on an on-going basis.

• Is your facility ADA compliant? If not, please describe how reasonable accommodations can and will be made.

D. Please explain how access to a comprehensive array of social academic, occupational, and other support services related to the program objectives will be provided through collaboration with public and private agencies, referral systems, shared locations, or another approach.

• Describe how the program will ensure that the following service needs are addressed, as appropriate, for clients while they are enrolled in your program as well as once clients are placed in permanent housing: Case Management; Employment Training, Placement, and Retention; Housing Placement; Substance Abuse Detox and Recovery Treatment; Mental Health Assessment and Treatment (for adults and children); Child Care (for family programs); Credit Counseling; Health Care and Life Skills.

• Specifically describe which services are provided directly by your program, and which are provided through linkage agreements with service providers. State whether each linkage agreement is formal (written) or informal.

• Describe how clients are assessed for and connected to the services.

Monitoring & Evaluation

E. Describe the methods your agency will employ to evaluate the project’s progress and record project accomplishments.

• Describe how client progress and outcomes will be assessed and tracked, and how the agency will determine if the program is achieving its intended outcomes.

• Describe the process for conducting follow-up with clients who have exited the program. State the percentage of clients that receive follow-up, and when.

• Describe the agency’s status in implementing the HMIS system. Indicate the number of users trained and the number of staff members utilizing the system.

• Describe the process for ensuring that data are entered within 24 hours of clients entering the program and exiting the program.

• Describe the procedure(s) which will be in place to provide program reports as may be required by DFSS in regard to client information and program performance.

F. Describe how your agency will monitor program expenditures and ensure that appropriate fiscal controls and records are in place.

• Describe the agency’s fiscal and administrative procedures for operating the program and managing the grant, if funded.

• If the agency has received DFSS homeless services grants in the past, describe previous expenditure rates (for a minimum of the past 3 years: 2008, 2009, and 2010) and explain any difficulties in expending funds.

• Please describe how your agency assures the confidentiality of all client information and records.

Outcomes

Describe the strategies and activities the program will employ to achieve client performance measure outcomes. Some performance measures are provided and are considered standard outcomes. Please address each performance measure outcome listed under its associated program model that has not already been provided.

Outreach and Engagement - Daytime Supportive Service Centers Outcome Performance Measures:

90 % of Households receive physical, psychological, and housing needs assessments

__ % of Households linked to services and community supports indicated by the

physical, psychological and housing needs assessments. Examples of services and supports include mental health and substance abuse treatment services, employment services/training, and support groups

__ % of Households referred to shelter programs (interim or overnight) (Provide percentage and describe activities that will be performed to achieve this outcome)

__% of Households referred to permanent supportive housing programs (Provide percentage and describe activities that will be performed to achieve this outcome)

__% of Households assessed and applied for public benefits within three months. (Provide percentage and describe activities that will be performed to achieve this outcome)

Provider should have linkages and referral networks in place to address the needs of homeless youth (aged 18 to 24). Please list your agency’s linkages in this area, and strategies and procedures for serving this population.

Charts and Attachments

Please provide the following information as attachments:

Please include/attach a job description and resume for the critical staff. Please submit your proposed staffing plan for the program.

• Please include a chart outlining all your formal and informal linkages.

• Please attach a table outlining all of your current grants.

|Name of program |Source of funding (please be as |Grant Amount |Grant start/end |Data tracking software |

| |specific as possible) | |dates |used (if any) |

| | | | | |

| | | | | |

| | | | | |

• Please list what languages and ethnic populations your agency currently works with. Please outline your agency’s plan to provide assistance for non-English speaking clients. When appropriate identify specific agencies, community groups and ethnic associations that you plan to coordinate with and any that you currently have a working relationship with.

| | |

|Ethnic/non English Speaking Population |Language Speaking |

| |Staff Member currently on staff? |

| | |

| | |

____ My agency only works with English speaking clients.

• Please indicate your anticipated hours of operation.

____ Weekdays (Monday to Friday) Hours: _______________

____ Saturday Hours: _______________

____ Sunday Hours: _______________

Other: Specify:

Budget Instructions

Please develop a budget for one year covering from January 1, 2012 through December 31, 2012.

Budget Forms - Instructions

BUDGET SUMMARY- Form 1

The purpose of this form is: 1) to summarize, by item of expenditure, the total budget of a program or project to be funded by the City of Chicago, Department of Family and Support Services and identify any additional funds that will be leveraged for this program either cash or in-kind; and 2) to specify the share of total cost charged to the awarded grant program and the share of total cost charged to other matching or supplemental funding sources.

Please show both the expenses that will be paid for with awarded funds and those that will be paid for with other share. Numbers should be rounded to the nearest dollar. Please remember that for this application, a 25% cash match is required.

A. Respondent- Name of Respondent Agency.

B. Department Program - Filled out by City Department.

C. Project Name - Name of project.

D. Department - Filled out by City Department.

E. Contract Term - Indicate beginning (month/day/year) and ending (month/day/year) of contract period.

F. Allocation – Indicate the amount of awarded funds allocated for this project.

G. Vendor Code Number - Filled out by City Department.

H. Service Contract Number - Filled out by City Department.

I. Fund/Dept./Organization #: Filled out by City Department.

J. Project Budget - Columns (1) and (2): Item of expenditure and account number - The required information has already been provided in these two columns. Respondent budgets are limited to the accounts listed on the Budget Summary. In exceptional cases, City Departments may obtain approval to use "other" accounts by contacting their budget analyst at the Office of Budget and Management.

Personnel Costs (Account 0005) - salaries, stipends, overtime, salary adjustments.

Fringe Benefits (Account 0044) - term life insurance, worker’s compensation, health insurance, unemployment insurance, dental plan, Medicare.

Operating/Technical Costs (Account 100) - accounting, auditing (if anticipating expending $500,000 or more in federal funds), legal, publications, rental of property, rental of equipment/services, repair/maintenance of property, repair/maintenance of equipment, utilities, telephone, local transportation, postage, advertising, technical meeting costs, general liability insurance, reproduction, dues, promotions, memberships, messenger service.

Professional and Technical Services (Account 0140) - consultants/subcontractors.

Materials and Supplies (Account 0300) - stationery and office supplies, tools, materials and supplies, books and related material.

Equipment Costs (Account 0400) - office machinery, furniture and furnishings, equipment, and communication devices. If purchases are $5,000 or greater a property inventory must be maintained.

Other Program Costs (Account 0999) - All other expenses that do not fit in the other account categories.

Insurance - The City Comptroller’s Office has established minimum insurance requirements for Respondents awarded City of Chicago, state and federal funds. If all insurance requirements have not been met, the City Comptroller will withhold reimbursement from a Respondent until such requirements are met. The types of insurance required include worker’s compensation; general liability; a fidelity bond (if applicable); automobile liability; and professional liability. The City Comptroller reserves the right to require additional types of insurance, if deemed necessary. City Departments should contact the City Comptroller’s Insurance Division, Maria Santiago at (312) 744-7923 with questions regarding your agencies’ insurance requirements.

Local Transportation - The automobile allowance for Respondent staff is the same as the allowance for City employees - .505 cents per mile. The per-person reimbursement cannot exceed $250 per month.

Column (3): Provider Share of Cost - Summarize by budget line item the of the awarded budget allocation for this program or project.

Column (4): Other Share - Summarize by budget line item the share of the project’s cost which will be funded with matching or supplemental public or private funds. If funding is supporting the agency's general operations then "Other Share" should represent all non-funded awarded operating support.

Column (5): Total Cost - Add columns (3) and (4) to derive the amount of the total budget for the program or project.

K. Percentage of Total Project Costs Paid by Other Share - Column 4 divided (÷) by Column 5. Please indicate any leveraged or matching funds allocated to this program.

Personnel Budget - Form 2

The purpose of this form is to estimate the total personnel costs the sub-recipient expects to incur in operating its funded project, and to provide a brief summary of job responsibilities for each budgeted position.

A. Name of Respondent: Self-explanatory.

B. Department: Filled out by Department.

C. Project Name: Self-explanatory.

D. Federal Employer Identification Number - The Internal Revenue Service (IRS) assigns a 9-digit Federal identification number to every organization employing one or more individuals. Indicate the sub-recipient's number in the space provided. Should an agency have questions concerning its identification number, call the IRS at (800) 829-1040.

E. Personnel Budget Allocation

Column (1): Position Title - List all positions (even those for which the salary will be paid exclusively with an "other share" funding source) that will be funded under this project.

Columns (2) and (3): Number and Rate - For each position listed in Column (1) indicate the number of employees to be funded and the corresponding salary rates (either annually or hourly). If there are different rates for the same position, list the rates one under another.

Column (4): % of Time Spent on Project - Often an employee spends only a fraction of his or her time on the funded project because they are engaged in other sub-recipient projects. Please indicate for each employee to be funded, percentage (%) of time that will be spent on this project. If the employee is part time, please show the percentage (%) of the hours they work on this project out of the total hours they work.

Column (5): Grant Award Share of Total Cost - For each position listed, please indicate the amount of total salary cost to be paid with grant funds.

Column (6): Total Cost - To determine the total salary cost for each position; multiply Column (3) by Column (2) for each position/rate. Then multiply this amount by the percentage of time to be spent on the project Column (4) and put the final amount in Column (6).

Column (7): Brief Summary of Job Responsibilities - Describe briefly the duties and responsibilities associated with each position listed in Column (1).

Line (8): Positions/Salaries Subtotals - Add the number of positions to be funded for this project and indicate the number at the bottom of Column (2). Also, subtotal Columns (5) and (6) to derive respectively the funded share of total cost and the total salary cost.

F. Fringe Benefits and Total Personnel Costs: Both the federal and state governments require employers to pay various employee taxes and contributions. These taxes and contributions, along with certain fringe benefits that a sub-recipient may wish to offer its employees, are funded eligible expenses. The share of fringe costs to be borne by funded amount must be reasonably proportional to the share of the salary costs borne by funded amount. Please estimate these various costs on the form where indicated. You must have written organizational policies to support those costs.

Line (9): F.I.C.A. and Medicare - Federal Insurance Contribution Act tax otherwise known as the Social Security Tax and Medicare.

Line (9a): The Social Security Tax is computed every payroll period 6.2% of total payroll, up to $ 106,800 per employee year.

Line (9b): The Medicare Tax is computed every payroll period as 2.9% of total payroll per employee year.

For further information regarding the F.I.C.A., contact the Internal Revenue Service at 800-829-1040 or refer to Publication 15 - Circular E. Calculate the funded share of the total F.I.C.A. cost for the annual value of the contract in columns (5) and (6) respectively.

Line (10): State Unemployment Insurance - It is likely that your organization is liable for Unemployment Insurance. For further information contact the Illinois Department of Employment Security hotline at (312) 793-1905. In Columns (5) and (6) show respectively the share of this total to be borne by funded share and the total State Unemployment Insurance Cost.

Line (11): State Worker's Compensation Insurance - This insurance is computed at a rate determined by the employee's type of business or organization. How often an employer must pay worker's compensation is based on the size of its insurance premium. All Respondents are encouraged to call the National Council of Compensation Insurance (NCCI) at 800-622-4123 for technical assistance in this matter. In Columns (5) and (6) show respectively the share of this total to be borne by funded share and the total State Worker's Compensation Insurance cost.

Lines (12-13): Other - Please list any other employer expenses or benefits the agency will offer its employees. Most non-profit agencies do not have to pay the Federal Unemployment Tax, which is computed every payroll period as .008 of total payroll up to $7,000 per employee per year. This rate is subject to change and will be determined by the Internal Revenue Service. Check with the IRS at (800) 829-1040 to determine if your agency is exempt. An agency should also check with the lead City department to determine whether additional benefit(s) it wishes to offer are grant awarded eligible expenses. In Columns (5) and (6) show the GRANT AWARD share and the total cost for each benefit listed.

Line (14): Subtotal Fringe Benefits - Add lines (9) through (13) to obtain the total fringe benefits (account number 0044).

Line (15): Total Personnel Costs - Add lines (8) and (14) in both Column (5) and (6), to obtain both the Grant award Share of the total costs and the Total Personnel Costs for the project.

Non-Personnel Budget - Form 3

The purpose of this form is to estimate and justify the non-personnel line item amounts shown on the Budget Summary (Form 1).

A. Name of Respondent.

B. Self-explanatory.

C. Self-explanatory.

D. Federal Employer Identification Number - The Internal Revenue Service (IRS) assigns a 9-digit Federal identification number to every organization employing one or more individuals. Indicate the sub-recipient's number in the space provided. Should an agency have questions concerning its identification number, call the IRS at (800) 829-1040.

E. Detailed Schedule of Non-Personnel Allocations

Columns (1) and (2): Item of Expenditure and Account Number - List the account descriptions and the corresponding account numbers specified on the Budget Summary (Form 1) which are applicable to this project. Do not include the personnel account.

Column (3): Grant Award Share of Cost - Indicate the share of the total cost listed in Column (3) that will be paid from awarded Grant.

Column (4): Total Cost - Indicate the total amount of funds budgeted for each item of expenditure specified in Column (1).

Column (5): Line Item Description and Justification - Each amount of budgeted funds listed in Column (4) must be justified. Please show all calculations. Include quantities and unit costs wherever possible (add additional sheets if necessary).

Column (6): Total - Indicate the totals for Columns (3) and (4).

Each Respondent must submit a complete line-item budget and budget narrative.

Additional Required Attachments

Please include/submit the following documents as part of your application packet.

1. IRS statement of tax exempt status

2. Federal Employer Identification Number (FEIN)

3. Copy of Official Articles of Incorporation

4. Respondent’s most recent fiscal audit report or pre-approved equivalent.

5. Certificate of Insurance (Attachment A).

Checklist for Submission of the Proposal

Use the following list as a guide to make sure your application is complete.

Proposal:

1. Original application plus two (2) copies

a. Executive Summary

b. Narrative

2. Budget Forms

Charts and Attachments:

3. Job Descriptions and resumes.

4. Staffing Plan

5. Chart outlining formal and informal linkages.

6. Table of Current Grants.

7. Language List

8. Anticipated Hours of Operation

Other Critical Documents:

9. IRS statement of tax exempt status

10. Federal Employer Identification Number (FEIN)

11. Copy of Official Articles of Incorporation

12. Respondent’s most recent fiscal audit report or pre-approved equivalent.

13. List of Board of Directors

14. Certificate of Insurance (Attachment A).

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