ࡱ>  VTbjbj hLT $   Ppd tp:N Z:<<<<<<$/`b::bb`4u^^^bL:^b:^^ElHCG*&08GJc<cTHcHAbb^bbbbb``jbbbbbbbcbbbbbbbbb : TWorkforce Solutions Brazos Valley On-Line Accredited High School Program Proposal Packet Vendor Information Vendors full legal name ___________________________________________________________________ Vendors mailing address and vendor identification number ___________________________________________________________________ Vendors street address (if different from above) ___________________________________________________________________ Name, title, telephone number, and e-mail address of vendors representative with signature authority for the proposal ___________________________________________________________________ Name, title, telephone number, and e-mail address of vendors contact person for the proposal ___________________________________________________________________ Names of entities submitting as a partnership if applicable ___________________________________________________________________ ___________________________________________________________________ Signature of vendors authorized representative Date signed Fiscal Agent Information (if different from Vendor Name) Full legal name of the fiscal agent __________________________________________________________________ Fiscal agents mailing address and vendor identification number ___________________________________________________________________ Fiscal agents street address (if different from above) ___________________________________________________________________ Name, title, telephone number, and e-mail address of fiscal agents representative with signature authority for the proposal ___________________________________________________________________ Name, title, telephone number, and e-mail address of fiscal agents contact person for the proposal ___________________________________________________________________ ___________________________________________________________________ Signature of fiscal agents authorized representative Date signed Certifications The Offeror certifies that: Type of Business Entity It is organized as one of the types of business entities listed below. Please check the appropriate type and enter the appropriate information requested.  FORMCHECKBOX  Public agency  FORMCHECKBOX  Private, non-profit corporation, incorporated in the State of _________________, Charter Number ____________________.  FORMCHECKBOX  Private, for-profit corporation, incorporated in the State of __________________, Charter Number _____________________.  FORMCHECKBOX  Partnership  FORMCHECKBOX  Sole Proprietorship  FORMCHECKBOX  Other, describe _____________________________________________________ Payee Identification Number It has a Texas Comptrollers Payee Identification Number (formerly Vendor Identification Number) or has attached a completed application for a Payee Identification Number to this proposal. If the offeror has a Payee Identification Number, enter the number in space below: _____________________________________________ Texas Corporate Franchise Tax Certification Pursuant to Article 2.45, Texas Business Corporation Act, state agencies may not contract with for profit corporations that are delinquent in making state franchise tax payments. The following certification that the corporation entering into this offer is current in its franchise taxes must be signed by the individual authorized on Form 2031, Corporate Board of Directors Resolution, to sign the contract for the corporation. The undersigned authorized representative of the corporation making the offer herein certifies that the following indicated statement is true and correct and that the undersigned understands that making a false statement is a material breach of contract and grounds for contract cancellation. Indicate the certification that applies to your corporation:  FORMCHECKBOX  The corporation is a for-profit corporation and certifies that it is not delinquent in its franchise tax payments to the State of Texas.  FORMCHECKBOX  The corporation is a non-profit corporation or is otherwise not subject to payment of franchise taxes to the State of Texas.  FORMCHECKBOX  Entity is not incorporated. Offerors Certification: I hereby certify that: all of the information in this proposal, including all assurances herein, is, to the best of my knowledge, complete, and accurate; the Offeror has authorized me as its representative to submit this proposal; the Offeror will comply with all terms of the proposed contract if one is awarded; and this offer is firm and good, and will remain so for 90 days. _____________________________________________________________________ Signature of Authorized Representative _____________________________________________________________________ Printed Name of Authorized Representative _____________________________________________________________________ Title of Authorized Representative _____________________________________________________________________Date Signed Reference Form: Provide three references for which you have provided a similar product or services. NAME  (1) REFERENCE #1 (CONTACT INFORMATION, DATES AND DESCRIPTION OF PROJECT/NATURE OF RELATIONSHIP)  (2) REFERENCE #2 (CONTACT INFORMATION, DATES AND DESCRIPTION OF PROJECT/NATURE OF RELATIONSHIP)  (3) REFERENCE #3 (CONTACT INFORMATION, DATES AND DESCRIPTION OF PROJECT/NATURE OF RELATIONSHIP)  Proposal Narrative Instructions Provide a detailed narrative and description of your proposed approach achieving the Boards objectives for an accredited on-line high school program. A. Demonstrated Effectiveness Describe your experience providing the requested services. List the entities for which services have been provided. Describe the outcomes achieved in terms of customer achievement/attainment for each contract ongoing or completed in the last three years. Qualifications and experience of lead personnel, teachers, academic coaches, mentors or other staff interacting with students. B. Program Design Describe the components of the proposed program and the intended outcome of each component. Describe your timeline for implementation of the program and each component Describe the process for on-boarding customers or students into the program Describe the automation requirements for implementing and operating the program to include the specifications of required equipment, and the number and type of computers and computer applications for customer use. Describe your security approach for equipment and customer information. Describe your ability to accommodate custom integration and data/report requests from the Board. Describe the step by step customer flow from recruitment to graduation/achievement of desired customer outcomes. Describe the curricula available for academic, soft skills and workplace skills. What is the service capacity of your program in terms of customer enrollment. Describe your programs accreditation in Texas and the ability. C. Cost Describe the total annual (fiscal year) cost for commencing and providing services (include any onetime initiation fees and deposits); Describe the total annual cost for system management, support, and training; Describe any other fees or assessed costs for providing requested services Describe the cost per customer served CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS This certification is required by the Federal Regulations Implementing Executive Order 12549, Debarment and Suspension, 45 CFR Part 93, Government-wide Debarment and Suspension, for the Department of Agriculture (7 CFR Part 3017), Department of Labor (29 CFR Part 98), Department of Education (34 CFR Parts 85, 668 and 682), Department of Health and Human Services (45 CFR Part 76). The undersigned certifies, to the best of his or her knowledge and belief, that both it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency; 2. Have not within a three-year period preceding this contract been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, State or local) transaction or contract under a public transaction, violation of federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a government entity with commission of any of the offenses enumerated in Paragraph (2) of this certification; and, 4. Have not within a three-year period preceding this contract had one or more public transactions terminated for cause or default. Where the prospective recipient of federal assistance funds is unable to certify to any of the statements in this certification, such prospective recipient shall attach an explanation to this certification form. _____________________________________________________ Name of Organization/Firm Signature of Authorized Representative Date ___________________________________________________________ Print Name and Title of Authorized Representative CERTIFICATION REGARDING LOBBYING This certification is required by the Federal Regulations Implementing Section 1352 of the Program Fraud and Civil Remedies Act, Title 31 U.S. Code, for the Department of Agriculture (7 CFR Part 3018), Department of Labor (29 CFR Part 93), Department of Education (34 CFR Part 82), Department of Health and Human Services (45 CFR Part 93). The undersigned certifies, to the best of his or her knowledge and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee or a Member of Congress in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a federal contract, grant, loan, or cooperative agreement. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, Disclosure Form to Report Lobbying, in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. ________________________________________________ Name of Organization Signature of Authorized Representative Date __________________________________________________ Print Name and Title of Authorized Representative CERTIFICATION REGARDING DRUG-FREE WORKPLACE This certification is required by the Federal Regulations Implementing Sections 5151-5160 of the Drug-Free Workplace Act, 41 U.S.C. 701, for the Department of Agriculture (7 CFR Part 3017), Department of Labor (29 CFR Part 98), Department of Education (34 CFR Parts 85, 668 and 682), Department of Health and Human Services (45 CFR Part 76). The undersigned subcontractor certifies it will provide a drug-free workplace by: 1. Publishing a policy statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the consequences of any such action by an employee; 2. Establishing an ongoing drug-free awareness program to inform employees of the dangers of drug abuse in the workplace, the subcontractors policy of maintaining a drug-free workplace, the availability of counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed on employees for drug abuse violations in the workplace; 3. Providing each employee with a copy of the subcontractors policy statement; 4. Notifying the employees in the subcontractors policy statement that as a condition of employment under this subcontract, employees shall abide by the terms of the policy statement and notifying the subcontractor in writing within five days after any conviction for a violation by the employee of a criminal drug abuse statute in the workplace; 5. Notifying the Board within ten (10) days of the subcontractors receipt of a notice of a conviction of any employee; and, 6. Taking appropriate personnel action against an employee convicted of violating a criminal drug statute or require such employee to participate in a drug abuse assistance or rehabilitation program. _____________________________________________________ Name of Organization _____________________________________________________ Signature of Authorized Representative Date _____________________________________________________ Print Name and Title of Authorized Representative CERTIFICATION REGARDING CONFLICT OF INTEREST By signature of this proposal, Proposer covenants and affirms that: 1. No manager, employee or paid consultant of the proposer is a member of the Workforce Solutions Brazos Valley Board; 2. No manager or paid consultant of the proposer is a spouse to a member of the policy board, the chairman or a manager of the Workforce Solutions Brazos Valley Board; 3. No member of the policy board, the president or an employee of the Brazos Valley Workforce Development Board owns or controls more than 10 percent in the proposer; 4. No spouse of a member of the policy board, president or employee of the Workforce Solutions Brazos Valley Board is a manager or paid consultant of the proposer; 5. No member of the policy board, president or employee of the Workforce Solutions Brazos Valley Board receives compensation from proposer for lobbying activities as defined in federal laws or Chapter 305 of the Texas Government Code; 6. Proposer has disclosed within the proposal any interest, fact or circumstance which does or may present a potential conflict of interest; 7. Should proposer fail to abide by the forgoing covenants and affirmations regarding conflict of interest, proposer shall not be entitles to recovery of any costs or expenses incurred in relation to any contract with the Workforce Solutions Brazos Valley Board and shall immediately refund to the Workforce Solutions Brazos Valley Board any fees or expenses that may have been paid under the contract and shall further be liable for any costs incurred or damages sustained by the Workforce Solutions Brazos Valley Board relating to that contract. Name of Organization Submitting Proposal: ____________________________________ Name and Title of Authorized Signatory: ______________________________________ Signature: ____________________________________________________ Date: __________________ ASSURANCES AND CERTIFICATIONS Each organization and any branch, division or department or individual that submits a proposal in response to a Request for Proposal warrants, assures and certifies: 1. The information contained in this proposal is true and correct. 2. The costs described in the proposal budget accurately reflect the proposers cost of providing services or goods. 3. No employee, member of a government board or board of directors, or any other individual associated with an organization or individual person offering a proposal under this Request for Proposals has offered or will offer any gratuities, favors, or anything of monetary value to any member of the Workforce Solutions - Brazos Valley Board or BVCOG any employee of the Board or BVCOG for the purpose of or having the effect of influencing the decisions of the with respect to the organization or individuals proposal or any other proposal. 4. No employee, member of a governing board or board of directors, or any other individual associated with an organization or individual person offering a proposal under this Request for Proposals has engaged or will engage in any activity which may be construed in restricting or eliminating competition for funds available under this Request for Proposals. 5. The organization or individual possesses the legal authority to offer this proposal. 6. If the proposer is an organization, a resolution, motion, or similar action has been duly adopted or passed as an official act of the proposers governing body authorizing the submission of this proposal. 7. No person will be excluded from participation in, be denied the benefits of, be subjected to discrimination under, or be denied employment in the administration of or in connection with any program operated with funds from this Request for Proposals because of race, color, religion, sex, national origin, age, disability, sexual orientation, or political affiliation or belief. 8. The organization or individual business does not and will not knowingly employ an undocumented worker as defined in Texas Government Code, 2264.001(4). If the Contractor knowingly employs an undocumented worker, they shall repay WSBVB/BVCOG the amount of the public subsidy with 15% interest no later than the 120th day after the business is notified of the violation. 9. If awarded this contract the organization or individual business will comply with the Buy American Act concerning these funds. Each organization or individual that submits a proposal also warrants and assures that they will abide by the rules of the following laws, acts, codes, etc. and all applicable rules and regulations promulgated hereunder, as a condition to award of financial assistance from WSBV with respect to operation of WSBV funded programs or activities and all agreements or arrangements to carry out WSBV funded programs or activities: WIA of 1998 Title Vi of the Personal Responsibility and Work Opportunity Act of 1996 PL 88-352 Civil Rights Act of 1964 42 USC12001 American with Disabilities Act of 1990 PL 93-112 Rehabilitation Act of 1973 40 TAC Texas Administrative Code, Article 40, Part I, Chapter 73 Subpart A Assurances required for the Child Care program, Chapter 809 Texas Workforce Commission Administrative Code Age Discrimination Act of 1975 Title IX of the Education Amendments of 1972 Texas Government Code 2264.051 By signing I acknowledge that I have read these assurances and certifications and that I am authorized to bind the organization I represent to these requirements should this proposal be accepted for funding by the Workforce Solutions Brazos Valley Board. __________________________________ __________________________________ Signature Proposing Organization _________________________________ __________________________________ Typed Name and Title Date     WSBV On-Line High School RFP June 2016  PAGE \* MERGEFORMAT 1 !"HYZ`mnx~T Z  ` m o[oJ h)h`"CJOJQJ^JaJ'h)hO*OJQJ^JaJmH nH u h)h*CJOJQJ^JaJ h)h6 CJOJQJ^JaJ h)hO*CJOJQJ^JaJh)hO*6CJaJh)h*6CJaJ hZ#0hO*h)hO*6CJ aJ h)h|:6CJ aJ &h)hO*56CJ OJQJ^JaJ #h)h)5CJ OJQJ^JaJ "IYZmn Q T hh^hgdO* h`gdO* hh`hgdO* `gdO* h^hgdO*h^hgdO*  & Fgd*$ gd)$a$gd)$a$gd) F G 1 2 n o  ^`gdO* h^h`gdO*h^hgdO*gdO*gdO* h`gdO* hh`hgdO*m n  > ? @ X x y nŴŠŎwgwXF5 hc hO*CJOJQJ^JaJ#hc hO*OJQJ^JmH nH uhc hO*CJOJQJ^Jhc hT5CJOJQJ^Jhc hO*5CJOJQJ^J hO*5CJ#h)hO*OJQJ^JmH nH u'h)h6 OJQJ^JaJmH nH u!hc OJQJ^JaJmH nH u'h)hO*OJQJ^JaJmH nH u h)hO*CJOJQJ^JaJ)h)hO*B*CJOJQJ^JaJph > ? y z % & ' m p hh^hgdO* h`gdO* hh`hgdO* `gdO* h^hgdO*h^hgdO* & Fgd*$  hh^hgdO* no_`agdO*  hh^hgdO* ^`gdO* h^h`gdO*h^hgdO*gdO*gdO* h`gdO* hh`hgdO*no|a $<°xl^Q^Q@!jh*$ hO*CJ OJQJUh*$ hO*CJOJQJh*$ hO*5CJOJQJh*$ hO*6OJQJh*$ hO*56OJQJhO* hO*5 hO*CJhO*mH nH u#hc hFm2OJQJ^JmH nH u#hc hO*OJQJ^JmH nH uhc hO*CJOJQJ^J hc hCJOJQJ^JaJ hc hO*CJOJQJ^JaJhc hO*OJQJ^J"$<= $^a$gdO* 0^`0gdO*^gdO*gdO*$ & F `a$gd*$ $ hh^ha$gdO* $h`ha$gdO* h@h^hgdO* $ & F gd*$  t^gdO*     !/0>?@VWefgq]W hO*CJ'jDh*$ hO*CJ OJQJU'jh*$ hO*CJ OJQJU'j\h*$ hO*CJ OJQJU'jh*$ hO*CJ OJQJU'jth*$ hO*CJ OJQJUh*$ hO*CJOJQJ!jh*$ hO*CJ OJQJU'jh*$ hO*CJ OJQJUh*$ hO*CJ OJQJ]./UV^gdO* & F `gd*$ h0^h`0gdO* ^gdO*$ ^a$gdO* $^a$gdO*$ ^a$gdO* ]^gdO* :;LMN\]^xyz佬佬w佬cVh*$ h`"CJOJQJ'jh*$ hO*CJ OJQJU'j h*$ hO*CJ OJQJU'jh*$ hO*CJ OJQJUh*$ hO*CJ OJQJ!jh*$ hO*CJ OJQJUh*$ hO*CJOJQJh*$ hO*5CJOJQJh*$ hO*5OJQJh*$ hO*CJOJQJh*$ hO*5CJOJQJ :;LMxy T^gdO* T^T`gdO*^gdO*gdO* & F `gd*$  tgdO* $^a$gdO* 0^`0gdO*^gdO*]^ABC{^gdO* & F hF^Fgd*$ ^`gdO* & F hDF^Fgd*$ ^`gdO* & F hF^Fgd*$ ^gdO*^gdO* & F `gd*$ h^hgd`"BD  EGHILPRSTUVWY{Ż{rlrc\UQUhxC h|:hZ h|:h[Yh|:h=RCJ h)CJh|:hCJ h[YCJh`" h=RCJ h=R5h""Th=ROJQJ^Jh2OJQJ^JhSQOJQJ^JhgOJQJ^Jh`"OJQJ^Jh=R hu5 h6 5 hO*CJhO*mH nH uh*$ hO*CJOJQJh*$ hO*OJQJmH nH uCD#$%kH $Ifgdm8gd)gdugd`" $^a$gd`" $ a$gd`"$ ^a$gd`"^gd`"^gdO*HIJQRtt <$Ifgd* $Ifgd*wkd$$IfTl4%R&   04 laf4p TRST $Ifgd*gkd$$IfTl4%R&04 laf4T  "#$%&()*+/0123457FY_`{役٩役٩͢͢͢ԓhuCJaJ h`">*CJ h[Y>*CJh=Rh`"hxChZhSbh[Y h)CJ hCJ h=R>*CJ h=R5 h[YCJ h`"CJ h=RCJ h|:h[Y h|:h`" h|:hSb8$%&'()*+,-.tt)$If^)`gd* $Ifgd[Y $Ifgd*gkd1$$IfTl4@%R&04 laf4T ./012t)$If^)`gd* $Ifgd[Ygkd$$IfTl4@%R&04 laf4T $Ifgd* Z[zyyy & Fgd*$ $a$gdxCgdugkd5$$IfTl4@%R&04 laf4T $Ifgd* YZz-8 f g !""""ֶxxixZJZxZiZiZh)h{}F5CJOJQJ^Jh)h{}FCJOJQJ^Jh)hiQpCJOJQJ^Jh)hTCJOJQJ^Jh)hxCCJOJQJ^Jh)hxC5CJOJQJ^Jh)hSQ5CJOJQJ^Jh)h,*v5CJOJQJ^Jh)hsm5CJOJQJ^Jh)hg5CJOJQJ^J#h)hxC5CJOJQJ^JaJ h`"6CJy g !!"""B######c$$$"%#%$%%%gdu & Fgd*$ gdiQp?^?gd* & Fgd*$ gd{}F & Fgd*$ "B#######"%#%$%%%&%'%(%)%w%x%%%&P,R,,,,,⼵zjZjzMzzh=5OJQJ\^JhIh26OJQJ]^JhIh{k6OJQJ]^JhIh{kOJQJ^JhIh{k5OJQJ\^JhIh{kCJaJh=h{khg h*6CJ hg6CJ hiQp5CJh)hiQp5CJOJQJ^Jh)h{}FCJOJQJ^Jh)hiQpCJOJQJ^Jh)h*CJOJQJ^J%%&%'%(%)%x%&e'!(1**z+{+P,Q,R,,,,,,,,, &d P gd{kgd{kgd{k$a$gd=gd{kgd=gd:@,,,,,--I-i-j-.2!4R4S4h4i4j4l4m444444505156><@<v<w<<<<<<<<*=+=پٮ٣斉rىپٮىjىh CJaJhIh OJQJ^Jh OJQJ^Jh 5OJQJ\^Jh{k5OJQJ\^JhIh{kCJaJhIh{k6OJQJ]^JhIh{k5CJ\aJh=5OJQJ\^JhIh{kOJQJ^JhIh{k5OJQJ\^Jh=OJQJ^J),,,-G-I-j-./124 4!4S4i4j4k4l4m44444455 &d P gd{k$a$gd gd{kgd{k515667D9E999::s;t;=<><?<@<w<<<<<<<<+=]=_=gd{kgd{k$a$gd +=_====CC9DK>>>??C@D@0A1AAACCCCC9D:D;D*B*TS@T O*Body Text Indent 3hx^hCJaJ8Z@8 :@ Plain TextOJQJfof {kDefault 7$8$H$1B*CJOJPJQJ^J_HaJmH phsH tH @@  List Paragraph ^./. 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