ࡱ>  ( bjbj ËË>& & & & & @*""l 4"%"%^%%%[&u& &>3@3@3@3@3@3@3$6O9Xd3i& &[&[&&&d3& & %%3'''&F& %& %>3'&>3''1|2%0.&B2*3304T29'R9$29& 24&&'&&&&&d3d3'&&&4&&&&9&&&&&&&&& :  SOQ APPLICATION PART II DVSS SOQ APPLICATION PART II TABLE OF CONTENTS PageSOQ Part II Summary Form 164Exhibit A-Certification of No Conflict of Interest 167Exhibit B-Proposers EEO Certification 168Exhibit C-Familiarity With The County Lobbyist Ordinance Certification 169Exhibit D-Attestation of Willingness to Consider GAIN/GROW Participants 170Exhibit E-Los Angeles County Contractor Employee Jury Service Program Certification Form & Application For Exception 171Exhibit F-Charitable Contributions Certification 172Exhibit G-Certification of Compliance with Countys Defaulted Property Tax Reduction Program 173Exhibit H-Pending Litigation And Judgments174 _________________________________________________________________ Proposers Legal Name SOQ Part II EXHIBITS PAGE  SOQ PART II SUMMARY FORM ___ to___A.CERTIFICATION OF NO CONFLICT OF INTEREST ___ to___B.PROPOSERS EEO CERTIFICATION ___ to___C.FAMILIARITY WITH THE COUNTY LOBBYIST ORDINANCE CERTIFICATION  ___ to___D.ATTESTATION OF WILLINGNESS TO CONSIDER GAIN/GROW PARTICIPANTS  ___ to___E.LOS ANGELES COUNTY CONTRACTOR EMPLOYEE JURY SERVICE PROGRAM CERTIFICATION FORM & APPLICATION FOR EXCEPTION  ___ to___F.CHARITABLE CONTRIBUTIONS CERTIFICATION ___ to___G.CERTIFICATION OF COMPLIANCE WITH COUNTYS DEFAULTED PROPERTY TAX REDUCTION PROGRAM  ___ to ___H.PENDING LITIGATION AND JUDGMENTS___ to___ SOQ Part II (Continued) ATTACHMENTSPAGE1.ARTICLES OF INCORPORATION AS FILED WITH SECRETARY OF STATE  ___ to___I2.California Good Standing Certificate or California Certificate of Existence issued by the California Secretary of State.  ___ to___3.MOST RECENT STATEMENT OF INFORMATION AS FILED WITH THE CALIFORNIA SECRETARY OF STATE.  ___ to___4.FINANCIAL STATEMENTS  FOR YEAR ENDING _______ (insert year) ___ to___FOR YEAR ENDING _______ (insert year) ___ to___FOR YEAR ENDING _______ (insert year) ___ to___5. IRS LETTER GIVING TAX EXEMPT STATUS___ to___6.STATE OF CALIFORNIA FRANCHISE TAX BOARD NON-PROFIT DETERMINATION LETTER  ___ to___7.COPY OF MOST RECENT FILING UNDER REGISTRY OF CHARITABLE TRUSTS ___ to___ SOQ PART II SUMMARY FORM Proposers Legal NameCorporate headquarters Address, City & Zip Code: Supervisorial District Where Proposers Corporate Headquarters is physically located:Contact PersonTitle:Email Address:Phone: The Proposers Part II Exhibits and Attachments are incorporated herein Proposers SOQ for the indicated Service Categories in the indicated Supervisorial District as follows: Type of Service Proposed to Directly Provide: (Check ALL that apply)Supervisorial District (SD) to be Served for Type of Service Listed on LeftSD 1SD 2SD 3SD 4SD 5pCase Management - CalWORKs pCase Management - GR and GROWpLegal Services  CalWORKspLegal Services  GR AND GROW CERTIFICATION OF NO CONFLICT OF INTEREST The Los Angeles County Code, Section 2.180.010, provides as follows: CONTRACTS PROHIBITED Notwithstanding any other section of this Code, the County shall not contract with, and shall reject any proposals submitted by, the persons or entities specified below, unless the Board of Supervisors finds that special circumstances exist which justify the approval of such contract: Employees of the County or of public agencies for which the Board of Supervisors is the governing body; Profit-making firms or businesses in which employees described in number 1 serve as officers, principals, partners, or major shareholders; Persons who, within the immediately preceding 12 months, came within the provisions of number 1, and who: Were employed in positions of substantial responsibility in the area of service to be performed by the contract; or Participated in any way in developing the contract or its service specifications; and 4. Profit-making firms or businesses in which the former employees, described in number 3, serve as officers, principals, partners, or major shareholders. Contracts submitted to the Board of Supervisors for approval or ratification shall be accompanied by an assurance by the submitting department, district or agency that the provisions of this section have not been violated. ____________________________________________________ Contractor Name ____________________________________________________ Contractor Official Title ____________________________________________________ Officials Signature PROPOSERS EEO CERTIFICATION __________________________________________________________________________________ Company Name __________________________________________________________________________________ Address __________________________________________________________________________________ Internal Revenue Service Employer Identification Number GENERAL In accordance with provisions of the County Code of the County of Los Angeles, the Vendor certifies and agrees that all persons employed by such firm, its affiliates, subsidiaries, or holding companies are and will be treated equally by the firm without regard to or because of race, religion, ancestry, national origin, or sex and in compliance with all anti-discrimination laws of the United States of America and the State of California. CERTIFICATION YES NO Proposer has written policy statement prohibiting discrimination in all phases of employment. ( ) ( ) Proposer or periodically conducts a self-analysis or utilization analysis of its work force. ( ) ( ) Proposer has a system for determining if its employment practices are discriminatory against protected groups. ( ) ( ) When areas are identified in employment practices, Proposer has a system for taking reasonable corrective action to include establishment of goal and/or timetables. ( ) ( ) __________________________________________________________________________________ Signature Date __________________________________________________________________________________ Name and Title of Signer (please print) FAMILIARITY WITH THE COUNTY LOBBYIST ORDINANCE CERTIFICATION The Proposer certifies that: it is familiar with the terms of the County of Los Angeles Lobbyist Ordinance, Los Angeles Code Chapter 2.160; that all persons acting on behalf of the Contractor organization have and will comply with it during the proposal process; and it is not on the Countys Executive Offices List of Terminated Registered Lobbyists. __________________________________________________________________________________ Signature Date __________________________________________________________________________________ Name and Title of Signer (please print) ATTESTATION OF WILLINGNESS TO CONSIDER GAIN/GROW PARTICIPANTS As a threshold requirement for consideration for contract award, Prospective Contractor shall demonstrate a proven record for hiring GAIN/GROW participants or shall attest to a willingness to consider GAIN/GROW participants for any future employment opening if they meet the minimum qualifications for that opening. Additionally, Prospective Contractor shall attest to a willingness to provide employed GAIN/GROW participants access to the Prospective Contractors employee mentoring program, if available, to assist these individuals in obtaining permanent employment and/or promotional opportunities. Prospective Contractors unable to meet this requirement shall not be considered for contract award. Prospective Contractor shall complete all of the following information, sign where indicated below, and return this form with the SOQ being submitted: Prospective Contractor has a proven record of hiring GAIN/GROW participants. ______YES (subject to verification by County) ______NO Prospective Contractor is willing to consider GAIN/GROW participants for any future employment openings if the GAIN/GROW participant meets the minimum qualifications for the opening. Consider means that Prospective Contractor is willing to interview qualified GAIN/GROW participants. ______YES ______NO Prospective Contractor is willing to provide employed GAIN/GROW participants access to its employee-mentoring program, if available. ______YES ______NO ______N/A (Program not available) Prospective Contractors Organization: ___________________________________________ Signature: __________________________________________________________________ Print Name: _________________________________________________________________ Title: ________________________________________ Date: ________________________ Tel.#: _______________________________ Fax #: _______________________________ COUNTY OF LOS ANGELES CONTRACTOR EMPLOYEE JURY SERVICE PROGRAM CERTIFICATION FORM AND APPLICATION FOR EXCEPTION The Countys solicitation for this Request for Statement of Qualifications is subject to the County of Los Angeles Contractor Employee Jury Service Program (Program), Los Angeles County Code, Chapter 2.203. All Proposers, whether a contractor or subcontractor, must complete this form to either certify compliance or request an exception from the Program requirements. Upon review of the submitted form, the County department will determine, in its sole discretion, whether the Vendor is exempted from the Program. Company Name:Company Address:City: State: Zip Code:Telephone Number:Solicitation For ____________ Services: If you believe the Jury Service Program does not apply to your business, check the appropriate box in Part I (attach documentation to support your claim); or, complete Part II to certify compliance with the Program. Whether you complete Part I or Part II, please sign and date this form below. Part I: Jury Service Program is Not Applicable to My Business My business does not meet the definition of contractor, as defined in the Program, as it has not received an aggregate sum of $50,000 or more in any 12-month period under one or more County contracts or subcontracts (this exception is not available if the contract itself will exceed $50,000). I understand that the exception will be lost and I must comply with the Program if my revenues from the County exceed an aggregate sum of $50,000 in any 12-month period. My business is a small business as defined in the Program. It 1) has ten or fewer employees; and, 2) has annual gross revenues in the preceding twelve months which, if added to the annual amount of this contract, are $500,000 or less; and, 3) is not an affiliate or subsidiary of a business dominant in its field of operation, as defined below. I understand that the exception will be lost and I must comply with the Program if the number of employees in my business and my gross annual revenues exceed the above limits. Dominant in its field of operation means having more than ten employees and annual gross revenues in the preceding twelve months, which, if added to the annual amount of the contract awarded, exceed $500,000. Affiliate or subsidiary of a business dominant in its field of operation means a business which is at least 20 percent owned by a business dominant in its field of operation, or by partners, officers, directors, majority stockholders, or their equivalent, of a business dominant in that field of operation. My business is subject to a Collective Bargaining Agreement (attach agreement) that expressly provides that it supersedes all provisions of the Program. OR Part II: Certification of Compliance My business has and adheres to a written policy that provides, on an annual basis, no less than five days of regular pay for actual jury service for full-time employees of the business who are also California residents, or my company will have and adhere to such a policy prior to award of the contract. I declare under penalty of perjury under the laws of the State of California that the information stated above is true and correct. Print Name:Title:Signature:Date: CHARITABLE CONTRIBUTIONS CERTIFICATION ___________________________________________________________________________ Company Name ___________________________________________________________________________ Address ___________________________________________________________________________ Internal Revenue Service Employer Identification Number ___________________________________________________________________________ California Registry of Charitable Trusts CT number (if applicable) The Nonprofit Integrity Act (SB 1262, Chapter 919) added requirements to Californias Supervision of Trustees and Fundraisers for Charitable Purposes Act which regulates those receiving and raising charitable contributions. Check the Certification below that is applicable to your company. ( Contractor has examined its activities and determined that it does not now receive or raise charitable contributions regulated under Californias Supervision of Trustees and Fundraisers for Charitable Purposes Act. If Contractor engages in activities subjecting it to those laws during the term of a County contract, it will timely comply with them and provide County a copy of its initial registration with the California State Attorney Generals Registry of Charitable Trusts when filed. OR ( Contractor is registered with the California Registry of Charitable Trusts under the CT number listed above and is in compliance with its registration and reporting requirements under California law. Attached is a copy of its most recent filing with the Registry of Charitable Trusts as required by Title 11 California Code of Regulations, sections 300-301 and Government Code sections 12585-12586. ___________________________________________ ____________________________ Signature Date ___________________________________________________________________________ Name and Title of Signer (please print) CERTIFICATION OF COMPLIANCE WITH THE COUNTYS DEFAULTED PROPERTY TAX REDUCTION PROGRAM Company Name:Company Address:City: State: Zip Code:Telephone Number: Email address:Solicitation/Contract For ____________ Services: The Proposer/Bidder/Contractor certifies that: % It is familiar with the terms of the County of Los Angeles Defaulted Property Tax Reduction Program, Los Angeles County Code Chapter 2.206; AND To the best of its knowledge, after a reasonable inquiry, the Proposer/Bidder/Contractor is not in default, as that term is defined in Los Angeles County Code Section 2.206.020.E, on any Los Angeles County property tax obligation; AND The Proposer/Bidder/Contractor agrees to comply with the Countys Defaulted Property Tax Reduction Program during the term of any awarded contract. - OR - % I am exempt from the County of Los Angeles Defaulted Property Tax Reduction Program, pursuant to Los Angeles County Code Section 2.206.060, for the following reason: ____________________________________________________________________________________________________________________________________________ I declare under penalty of perjury under the laws of the State of California that the information stated above is true and correct. Print Name:Title:Signature:Date: PENDING LITIGATION AND JUDGMENTS _____________________________ PROPOSERS LEGAL NAME Identify by name, case, and court jurisdiction any pending litigation in which the Proposer is involved, or judgments against Proposer in the last five (5) years. Describe the size and scope of any judgment, pending or threatening litigation against the Proposer or principals of the Proposer. Use additional sheets, if necessary.       APPENDIX E SOQ APPLICATION PART II ________________________________________________________________________________________________ DVSS RFSQ Page  PAGE \* MERGEFORMAT 162 November 2015 __________________________________________________________________________________________________ DVSS RFSQ Page  PAGE \* MERGEFORMAT 163 December 2015 __________________________________________________________________________________________________ DVSS RFSQ Page  PAGE \* MERGEFORMAT 167 December 2015 APPENDIX E SOQ APPLICATION PART II EXHIBIT A APPENDIX E SOQ APPLICATION PART II EXHIBIT B __________________________________________________________________________________________________ DVSS RFSQ Page  PAGE \* MERGEFORMAT 169 December 2015 APPENDIX E SOQ APPLICATION PART II EXHIBIT C APPENDIX E SOQ APPLICAT!OQXY[\wyz{) , - . w z { | + . / 0 : İ~~~~~~~e0hhBn\@OJQJ\^JfHq hBn\OJQJ\^J hhBn\hhBn\OJQJ\^J#hhBn\CJ$OJQJ\^JaJ$&hhBn\5CJ$OJQJ\^JaJ$&hhBn\5CJ,OJQJ\^JaJ,"hhBn\5CJOJQJ\^J)hhBn\5CJOJQJ\]^JaJ'!>PQRS 8 lX $Ifgd  8 lX gdBn\$ 8 lX $ a$gdBn\$ $ xa$gdBn\$ 8 lX a$gdBn\$a$gdBn\SXYZ[v 8 lX $Ifgd _kd$$Ifl0f!$! t644 lapyt $ 8 lX $Ifa$gd [\uvz$ 8 lX $Ifa$gd  $Ifgd _kdg$$Ifl0f!$! t644 lapyt z{$ 8 lX $Ifa$gd  $Ifgd _kd$$Ifl0f!$! t644 lapyt $ 8 lX $Ifa$gd  $Ifgd _kd5$$Ifl0f!$! t644 lapyt ( ) - $ 8 lX $Ifa$gd  $Ifgd _kd$$Ifl0f!$! t644 lapyt - . v w { $ 8 lX $Ifa$gd  $Ifgd _kd$$Ifl0f!$! t644 lapyt { | o$ 8 lX $Ifa$gd  $Ifgd 8$If^8`gd _kdj$$Ifl0f!$! t644 lapyt  * + / $ 8 lX $Ifa$gd  $Ifgd _kd$$Ifl0f!$! t644 lapyt / 0 o$ 8 lX $Ifa$gd  $Ifgd 8$If^8`gd _kd8$$Ifl0f!$! t644 lapyt     " , - ? @ e f   d e    tdhhBn\5OJQJ\^J&hhBn\5CJOJQJ\^JaJ&hhBn\5CJOJQJ\^JaJ'hhBn\5@CJOJQJ^JaJhhBn\5@OJQJ^Jh, uhBn\5@OJQJ^JhhBn\@OJQJ^J hhBn\hBn\OJQJ\^JhhBn\OJQJ\^J $ 8 lX $Ifa$gd  $Ifgd _kd$$Ifl0f!$! t644 lapyt     " xeeeT$ h! ]a$gdBn\$ h! x]a$gdBn\ h! x]gdBn\ 8 lX 8^8`gdBn\_kd$$Ifl0f!$! t644 lapyt " # $ , - . 7 8 9 > ? $$Ifa$gd  $Ifgd $ h! ]a$gdBn\$]^a$gdBn\ ? @ A Z [ e $Ifgd kkdm$$IfTlF$0* t*6    44 layt Te f i $Ifgd Xkd$$IfTl0$0*$ t*644 layt T $Ifgd kkd#$$IfTlF$0* t*6    44 layt T  $Ifgd kkd$$IfTlF$0* t*6    44 layt T   X Y Z d $Ifgd kkd$$IfTlF$0* t*6    44 layt Td e h $Ifgd kkdI$$IfTlF$0* t*6    44 layt T   $Ifgd kkd$$IfTlF$0* t*6    44 layt T   o p q | zo x$Ifgd $If^`gd  $Ifgd kkd $$IfTlF$0* t*6    44 layt T n | } -./02®ŠxmmmTm0h|ahBn\@OJQJ\^JfHq hBn\OJQJ\^J#hhBn\CJOJQJ\^JaJ&hhBn\5CJOJQJ\^JaJhhBn\5@OJQJ^J'hhBn\5@CJOJQJ^JaJhhBn\5OJQJ\^J hhBn\hhBn\OJQJ\^J0hhBn\@OJQJ\^JfHq | } $Ifgd mkdo$$IfTlF$0* t*6    44 layt T kkkkb $Ifgd $ h! $If]a$gd  $$Ifa$gd gdBn\mkd$$IfTlF$0* t*6    44 layt T } $Ifgd  $$Ifa$gd mkd;$$IfTlF$0* t*6    44 layt T } $Ifgd  $$Ifa$gd mkd$$IfTlF$0* t*6    44 layt T !"#- $Ifgd mkd $$IfTlWF$0* t*6    44 layt T-.2v$  @ $Ifa$gd  $Ifgd kkdm $$IfTlF$0* t*6    44 layt T! $Ifgd kkd $$IfTlF$0* t*6    44 layt T!"#<=Wepq   abcǼܪܪܪǼǼǼǜwjhhBn\OJQJ^J hhBn\CJOJQJ^JaJ&hhBn\5:CJOJQJ^JaJhhBn\5OJQJ^J#hhBn\CJOJQJ\^JaJhBn\OJQJ\^J hhBn\hBn\hxOJQJ\^JhhBn\OJQJ\^J*hBn\@OJQJ\^JfHq "!"%;< $Ifgd kkd1 $$IfTlF$0* t*6    44 layt T<=>?efp||| <$If^<gd  $Ifgd mkd $$IfTl F$0* t*6    44 layt Tpqr|m<<$If^<gd  <$If^<gd  $Ifgd mkd $$IfTl F$0* t*6    44 layt T|m<<$If^<gd  <$If^<gd  $Ifgd mkd_ $$IfTl F$0* t*6    44 layt T }r <$Ifgd  $$Ifa$gd  $Ifgd mkd $$IfTl F$0* t*6    44 layt T   UVWa $Ifgd mkd+ $$IfTl F$0* t*6    44 layt Tabe $Ifgd kkd $$IfTlF$0* t*6    44 layt T{{mX$$8&P#$/Ifa$gd  (# xgdBn\$ (# xa$gdBn\$a$gdBn\kkd $$IfTlF$0* t*6    44 layt T}}} $Ifgd gdBn\skdU $$Iflc t 6P80644 layt  7=EGvwxyz]^ :<FHJLʼʗʗʗʗʗ#hhBn\6CJOJQJ^JaJ hhBn\CJOJQJ^JaJ'hhBn\CJOJPJQJ\^JaJhhBn\6OJQJ^J hhBn\hhBn\OJQJ^JhBn\5CJOJQJ^JaJ#hhBn\5CJOJQJ^JaJ4offf $Ifgd kd $$Ifl0~ $~ l  t 044 lalpyt of $Ifgd kd$$Ifl 0~ $~ l  t 044 lalpyt  vw~~ $Ifgd xkd$$Ifl$$  t 044 lalp yt wxyof $Ifgd kd=$$IflM0~ $~ l  t 044 lalpyt yz~~~~ $Ifgd xkd$$Ifl$$  t 044 lalp yt 3*** $Ifgd kd$$Ifl^\~ ^$~ \    t044 lalp(yt *"$a$gdBn\kd $$Ifl^\~ ^$~ \    t044 lalp(yt  $Ifgd ]^_ $$Ifa$gd $a$gdBn\dgdBn\I===== $$Ifa$gd kds$$IflFn@|)n<  t06    44 lalpyt  <>@BDFHLFfFf P$If^`Pgd  $Ifgd Ff $$Ifa$gd  "$&(|~:_i0﹨r`R@"hhBn\5CJOJQJ\^JhBn\CJOJQJ^JaJ#hhBn\5CJOJQJ^JaJ)hhBn\5>*CJOJQJ\^JaJhhBn\CJOJQJ^J"hhBn\5CJOJQJ\^J hhBn\CJOJQJ^JaJhhBn\5OJQJ\^J hhBn\hhBn\OJQJ^J#hhBn\6CJOJQJ^JaJ hhBn\CJOJQJ^JaJ "$&(z| $ a$gdBn\$a$gdBn\ (# gdBn\$ (# dha$gdBn\$a$gdBn\Ff" P$If^`Pgd Ff $Ifgd |~9:./$ & Fda$gdBn\ $ Ta$gdBn\$ TP^Pa$gdBn\$ & F d^`a$gdBn\ $ `a$gdBn\$ ^a$gdBn\$@&gdBn\ $ a$gdBn\ef)*_yzgdBn\ $ a$gdBn\$ h"^`"a$gdBn\$ T^`a$gdBn\$ & Fda$gdBn\$ T;^;a$gdBn\9FG./089 $ , !@&gdBn\ $ *$] a$gdBn\ $*$a$gdBn\$$ @&a$gdBn\ $*$a$gdBn\$$ H@&a$gdBn\089  { "F"H"##$$$4''1(@,C,,,-ϮϏϜpϏaRhhBn\CJOJQJ^JhhBn\CJOJQJ^JhhBn\5OJQJ\^JhhBn\CJOJQJ^JhhBn\OJQJ^J"hhBn\5CJOJQJ\^J(hhBn\5>*CJOJQJ\]^JhBn\CJOJQJ^JhhBn\CJOJQJ^JhhBn\5CJOJQJ^J"hhBn\5CJOJQJ\^J  =z{! i j !!!"!#!v! $*$a$gdBn\ !gdBn\$  !*$a$gdBn\$  !h*$^ha$gdBn\$ & F  !d*$a$gdBn\$  !*$a$gdBn\v!!!!""""""%"F"G"H"e"f""$ & F  ddh]da$gdBn\dhdh]d^hgdBn\dhgdBn\ $$@&a$gdBn\gdBn\ !(gdBn\ $*$a$gdBn\ !gdBn\ !gdBn\""U#V#######$$$j$$$$$gdBn\ !(gdBn\ !gdBn\ $*$a$gdBn\ !gdBn\ $dha$gdBn\$ & F  ddh]da$gdBn\d dh]d^ gdBn\$$$$$$$3'4'''0(1(~(t$ & F 8 da$gdBn\$ 8 0^`0a$gdBn\ 8 gdBn\$ 8 a$gdBn\ 8 gdBn\$ 8 a$gdBn\ (# dhgdBn\ ~(((())))s*t******$ 8 a$gdBn\$ 8 0^`0a$gdBn\$ & F 8 da$gdBn\$ 8 0^`0a$gdBn\$ 8 0^`0a$gdBn\*M+N+++++@,A,B,C,,,,... $$Ifa$gd $a$gdBn\$a$gdBn\$ (# dha$gdBn\gdBn\$ 8 Ha$gdBn\$ 8 Ha$gdBn\---$.....]/^/p/q////0013363334455̵xfT"hhBn\5CJOJQJ\^J"hhBn\5CJOJQJ\^J%hhBn\5>*CJOJQJ\^J)hhBn\5>*CJOJQJ\^JaJ(hhBn\56CJOJQJ\]^J,hhBn\56CJOJQJ\]^JaJ hhBn\hhBn\CJOJQJ^JhBn\>*CJOJQJ^JhhBn\>*CJOJQJ^J....]/%gkdA%$$Iflg''0644 lalyt  $$Ifa$gd gkd$$$Ifl:''0644 lalyt ]/^/p/q//%gkd1&$$IflU''0644 lalyt  $$Ifa$gd gkd%$$Ifl^''0644 lalyt ///00124kP$ & F 8h hd^ha$gdBn\$ & F phhd^ha$gdBn\ $ ha$gdBn\$a$gdBn\gkd&$$Ifl^''0644 lalyt 455667778`9l9s9 $Ifgd $ & F 8h hd^ha$gdBn\$ & F 8hhd^ha$gdBn\$ hh^ha$gdBn\$a$gdBn\$lh]l^ha$gdBn\ 555~66667777788888`9k9l9s9t9999˺˨˅˅saZZKhhBn\CJOJQJ^J hhBn\"hhBn\6CJOJQJ]^J"hhBn\6CJOJQJ]^JhhBn\>*CJOJQJ^J%hhBn\5>*CJOJQJ\^J"hhBn\5CJOJQJ\^J hhBn\CJ OJQJ^JaJ hhBn\CJOJQJ^J"hhBn\5CJOJQJ\^J&hhBn\5CJ OJQJ\^JaJ s9t999|| $Ifgd zkd!'$$Ifl0'%0644 lalyt 99999999 : :W:sccZZZZZZ $*$a$gdBn\$$ H@&a$gdBn\$ (# dha$gdBn\zkd'$$Ifl0'%0644 lalyt  999X<<<<<<>>>>j@=A>ABAAAAAAAfBhBBB\C^CC°°ߍ{j[T[T[T[T[T hhBn\hhBn\CJOJQJ^J hhBn\CJOJQJ^JaJ"hhBn\5CJ OJQJ\^J&hhBn\5CJOJQJ\^JaJhhBn\CJ OJQJ^J" jrhhBn\CJOJQJ^JhhBn\5OJQJ\^JhhBn\OJQJ^JhhBn\CJOJQJ^J"hhBn\5CJOJQJ\^JW:_:`::::1;v;w;W<X<<<>>>>j@k@ !gdBn\$  !0*$^`0a$gdBn\$  !*$a$gdBn\$ 0*$^`0a$gdBn\$ , !@&gdBn\ $*$a$gdBn\k@l@@@@@A=A>A?A@AAABApAAAA $Ifgd  7$8$H$gdBn\ $7$8$H$a$gdBn\$ p t"a$gdBn\ !gdBn\ !gdBn\ !gdBn\AAAAmkd($$Ifl~'F~' t0644 lBalyt  $Ifgd mkd-($$IflQ~'F~' t0644 lBalyt AfBhBBmkd])$$Iflw~'F~' t0644 lBalyt  $Ifgd BB\C^Cmkd*$$Iflw~'F~' t0644 lBalyt  $Ifgd mkd)$$Ifln~'F~' t0644 lBalyt ^C`CCCrDsD_E`EEEEEPG5H6HHHH $Ifgd  x^gdBn\^gdBn\$dh7$8$H$^a$gdBn\ $7$8$H$a$gdBn\$07$8$H$^`0a$gdBn\ $7$8$H$a$gdBn\CCnDqDrDtD[E^E`EaEEEFF5HHHHHHHHHII#I9I:I³teWF hhBn\CJOJQJ^JaJhhBn\>*OJQJ^JhhBn\@OJQJ^J&hhBn\5CJOJQJ\^JaJ"hhBn\5CJ OJQJ\^J hhBn\"hhBn\6CJOJQJ]^JhhBn\CJOJQJ^J"hhBn\6CJOJQJ]^JhhBn\5OJQJ^JhhBn\OJQJ^J hhBn\CJ OJQJ^JaJ HHHHvv $Ifgd kd%+$$Ifl0'FQF+ t0644 lBa yt HHHIII#Im\KK<$ (# a$gdBn\$ h! ]a$gdBn\$ pxxa$gdBn\$ p t"a$gdBn\kd+$$Ifl0'FQF+ t0644 lBa yt #I9I:I;IKNKKKKKKKK׺אqqq\q\)jh{N<hBn\CJOJQJU^JaJ h{N<hBn\CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJ hLhBn\CJOJQJ^JaJhBn\jh Uh  hhBn\hhBn\OJPJQJaJhhBn\OJQJ\^J JJJJJJJJJJJJJJJJJJJJJJJJJJJ$ $Ifa$gd JJJJJJJJJJJJJJJ| .$ !a$gd .gdBn\nkd,$$Ifl$0* t0644 lap yt JJJ>KKKKKKKKKZLMMMxM%N3N4NYNcNdNN.$a$gd  0Z]^Zgd .gd 0>]>gd 0$L]^La$gd 0KKKKKKKKKKYLZLiLlLmLLLLLMMMϹqqq\K\8%h'+CJOJQJ^JaJmHnHu hKhBn\CJOJQJ^JaJ)jhKhBn\CJOJQJU^JaJ h{N<hBn\CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJhBn\h %hBn\CJOJQJ^JaJmHnHu+h{N<h CJOJQJ^JaJmHnHu7jh{N<hBn\CJOJQJU^JaJmHnHu*(h'+CJOJQJ^JaJmHnHu*MMMMMwMxMMMMMMMNNNNN N#N$N%N2N4NϼvvcHϼ4jh{N<hBn\CJOJQJU^JaJmHnHu%h'+CJOJQJ^JaJmHnHu)jh{N<hBn\CJOJQJU^JaJ h{N<hBn\CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJh %hBn\CJOJQJ^JaJmHnHu+h{N<h CJOJQJ^JaJmHnHu4jhKhBn\CJOJQJU^JaJmHnHu4N=NXNYNbNcNdNmNNNNNNNNO O O^OsOuOOOOOOOOO¾¾||iN4jh{N<hBn\CJOJQJU^JaJmHnHu%h'+CJOJQJ^JaJmHnHu)jh{N<hBn\CJOJQJU^JaJ h{N<hBn\CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJh  hLh CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJ hLhBn\CJOJQJ^JaJNNNNOOOOOO z+ 9 : ^ h i    0gd 0]gd  0L]^Lgd  0Z]^Zgd 0$L]^La$gd .$a$gd OOOOOOOOOOOO  yz    % & ҄veeeeePeP)jh{N<hBn\CJOJQJU^JaJ h{N<hBn\CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJU hLh CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJ hLhBn\CJOJQJ^JaJh %hBn\CJOJQJ^JaJmHnHu+h{N<h CJOJQJ^JaJmHnHuION PART II EXHIBIT D _________________________________________________________________________________________________ DVSS RFSQ Page  PAGE \* MERGEFORMAT 174 December 2015 APPENDIX E SOQ APPLICATION PART II EXHIBIT E APPENDIX E SOQ APPLICATION PART II EXHIBIT F APPENDIX E SOQ APPLICATION PART II EXHIBIT G APPENDIX E SOQ APPLICATION PART II EXHIBIT H APPENDIX E SOQ APPLICATION PART II EXHIBIT H & ) * + 8 : C ] ^ g h i r                   # $ % ' ( ѻwfwfwfwf_ hFh  hLh CJOJQJ^JaJh CJOJQJ^JaJhBn\CJOJQJ^JaJ hLhBn\CJOJQJ^JaJh %hBn\CJOJQJ^JaJmHnHu+h{N<h CJOJQJ^JaJmHnHu4jh{N<hBn\CJOJQJU^JaJmHnHu%h'+CJOJQJ^JaJmHnHu#        $ % & ' ( .gd .$a$gd  ?0P1h:pBn\/ =!"#$% Dp21h:p / =!"*#$% 21h:p / =!"*#$% 21h:p / =!"#$% 21h:p / =!"#$% 21h:p / =!"`#$% 21h:p / =!`"#$% 21h:p / =!"#@$ % 21h:p / =!"#@$ % 6&P1h:p / =!"#$% 6&P1h:p / =!"#$% ,1h/ =!"#$% e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt e$$If!vh#v!#v:V l t65!5pyt `$$If!vh#v#v#v:V l t*6555yt TR$$If!vh#v$#v:V l t*65$5yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt Td$$If!vh#v#v#v:V l t*6555yt Td$$If!vh#v#v#v:V l t*6555yt Td$$If!vh#v#v#v:V l t*6555yt Td$$If!vh#v#v#v:V l t*6555yt Td$$If!vh#v#v#v:V lW t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt Td$$If!vh#v#v#v:V l  t*6555yt Td$$If!vh#v#v#v:V l  t*6555yt Td$$If!vh#v#v#v:V l  t*6555yt Td$$If!vh#v#v#v:V l  t*6555yt Td$$If!vh#v#v#v:V l  t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T`$$If!vh#v#v#v:V l t*6555yt T$$If!vh#vc:V l t 6P806,5cyt $$Ifl!vh#v~ #vl:V l  t 0,5~ 5l/ / alpyt $$Ifl!vh#v~ #vl:V l   t 0,5~ 5l/  / alpyt $$Ifl!vh#v$:V l  t 0,5$/ alp yt $$Ifl!vh#v~ #vl:V lM  t 0,5~ 5l/ / alpyt $$Ifl!vh#v$:V l  t 0,5$/ alp yt J$$Ifl!vh#v~ #v\ #v#v :V l^  t0,,5~ 5\ 55 / / / / / alp(yt f$$Ifl!vh#v~ #v\ #v#v :V l^  t0,,5~ 5\ 55 /  / /  / / / / alp(yt $$Ifl!vh#vn#v#v<:V l  t06,5n55</ alpyt O$$Ifl!vh#vn#v#v :V l  tF06,5n55 /  alpFyt Xkdl$$Ifl֞n@LX d#p&|)n       tF0644 lalpFyt $$Ifl!vh#vn#v#v :V l^ t06,5n55 alpFyt kd$$Ifl^֞n@LX d#p&|)n      t0644 lalpFyt $$Ifl!vh#vn#v#v :V l^ t06,5n55 alpFyt kd$$Ifl^֞n@LX d#p&|)n      t0644 lalpFyt $$Ifl!vh#vn#v#v :V l^ t06,5n55 alpFyt kd$$Ifl^֞n@LX d#p&|)n      t0644 lalpFyt $$Ifl!vh#vn#v#v :V l^ t06,5n55 / alpFyt kd!$$Ifl^֞n@LX d#p&|)n      t0644 lalpFyt v$$Ifl!vh#v':V l:065'alyt v$$Ifl!vh#v':V lg065'alyt v$$Ifl!vh#v':V l^065'alyt v$$Ifl!vh#v':V lU065'alyt v$$Ifl!vh#v':V l^065'alyt $$Ifl!vh#v#v%:V l0655%alyt $$Ifl!vh#v#v%:V l0655%alyt $$Ifl!vh#v~':V lQ t06,5~'/ Balyt $$Ifl!vh#v~':V l t06,5~'/ Balyt $$Ifl!vh#v~':V lw t06,5~'/ Balyt $$Ifl!vh#v~':V ln t06,5~'/ Balyt $$Ifl!vh#v~':V lw t06,5~'/ Balyt $$If !vh#v$#v:V l t06,5Q5+/ Ba yt $$If !vh#v$#v:V l t06,5Q5+/ Ba yt $$If!vh#vh%:V l t0650*p yt $$If!vh#vh%:V l t0650*p yt ^2 666666666~~~vvvvvv666666666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ Bn\NormalCJ_HaJmH sH tH R@R ` Heading 1 $@&a$5>*CJOJQJ\^JJ@J ` Heading 2$@&5CJOJQJ\^JR@R ` Heading 3$@&^8`5CJOJQJ\^JV@V ` Heading 4$@&a$5CJOJQJ\^JN@N ` Heading 5 $@&a$5CJ OJQJ\^JN@N ` Heading 6 $@&a$5CJOJQJ\^J@ ` Heading 7/$xx0*$@&M ^a$&6@OJQJ\]^Jq ~@~ ` Heading 82$xx0 *$@&M ^a$ 5@OJQJ^Jq @ ` Heading 9/ $xx0*$@&M ^Ta$&6@OJQJ\]^Jq DA D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List RoR `Heading 1 Char5>*CJOJQJ\^JaJNoN `Heading 2 Char5CJOJQJ\^JaJNoN `Heading 3 Char5CJOJQJ\^JaJNo!N `Heading 4 Char5CJOJQJ\^JaJNo1N `Heading 5 Char5CJ OJQJ\^JaJNoAN `Heading 6 Char5CJOJQJ\^JaJboQb `Heading 7 Char.6@CJOJQJ\]^JaJq \oa\ `Heading 8 Char(5@CJOJQJ^JaJq boqb `Heading 9 Char.6@CJOJQJ\]^JaJq B@B`pTOC 1OJQJ^JmHnHuFF `pTOC 2"dd T$ [$\$^88 `pTOC 3 ~$ $ ^>"@> `Caption1$OJQJ_H aJ@>@@ `Titlea$5CJOJQJ\^JFoF ` Title Char5CJOJQJ\^JaJBJ@B `Subtitle <@&a$ OJQJ_H FoF ` Subtitle CharCJOJQJ_H aJ*W`* ``Strong5\:X`: `@Emphasis56OJQJ]@@"@ ` No Spacing"OJQJ_H aJ <2< `List Paragraph#^6@6 %`Quote$6OJQJ_H DoQD $` Quote Char6CJOJQJ_H aJT@T '` Intense Quote &]^56OJQJ_H aJVoqV &`Intense Quote Char56CJOJQJ_H aJBaB `0Subtle Emphasis 6B*phZZZJaJ `PIntense Emphasis56>*CJaJDaD `Subtle Reference >*CJaJDaD `Intense Reference 5>*CJFaF ` Book Title56CJOJPJQJaJr Ar `p TOC Heading-$d@& a$,>*B*CJOJPJQJ^JaJnHph6_tH4@4 /Bn\Header .!6o6 .Bn\ Header CharCJaJ4 @4 1Bn\0Footer 0!6o6 0Bn\0 Footer CharCJaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] ! Q"/N7<3FAuEyQ  46LNPPPPnnnnnn@@@@@@ppNNN~~  0-59C:IKM4NO& ( (3?GQ\ahmpw{S[z- { / " ? e  d  | -!<p awy| v!"$~(*.]//4s99W:k@AAB^CHH#IJJJN ( )*+,-./012456789:;<=>@ABCDEFHIJKLMNOPRSTUVWXYZ[]^_`bcdefgijklnoqrstuvxyz|}~6:AY]`x|e}!!!!!8@0(  B S  ? OLE_LINK224F24F>>>>>>>>>1F4FKY/8df""..p6v6==>>>>>>>>>1F4F333333333>>??@AB0BCCE5E4FXq<.`%"*/A(\r0c`_6Ndo b]~P^`Po(.pp^p`CJOJQJo(q @ @ ^@ `OJQJo(o ^`OJQJo( ^`OJQJo( ^`OJQJo(o ^`OJQJo( PP^P`OJQJo(   ^ `OJQJo(o ^`OJQJo(88^8`CJOJQJo(q ^`OJQJo(o   ^ `OJQJo(   ^ `OJQJo( xx^x`OJQJo(o HH^H`OJQJo( ^`OJQJo( ^`OJQJo(o ^`OJQJo(hh^h`.tt^t`)DD^D`. L ^ `L.  ^ `.^`.L^`L.TT^T`.$$^$`.L^`L.^`o(.^`.' ^' `o(()C C ^C `.^`.L^`L.^`.^`.SLS^S`L.o b\r0X.`%*/`_6                             q|       Bn\Tg'+RR`}>>@d  89 ; < D3F@,@B@F@@Unknown G*Ax Times New Roman5Symbol3. *Cx Arial7.@Calibri;WingdingsY CG TimesTimes New Roman7@CambriaK1   MS Gothic-3 0000?= *Cx Courier NewACambria Math"1h<<[ X5 q[ X5 q0>>JHP  $PBn\2! xx  Pham, Thu P. techsupport$      Oh+'0( px   Pham, Thu P. Normal.dotm techsupport2Microsoft Office Word@Ik@&g.@&g. [ X5՜.+,0 hp  LADPSSq >  Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry F.Data u-1Table9WordDocumentSummaryInformation(DocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q