Request for Proposals (RFP) for RFP Information and Guidelines RFP No. 13-002-ADR Issue Date: Closing Date: April 19, 2013 Contact Brian Guthrie, Program Specialist 2 1305 Tacoma Ave S. STE 104 Tacoma, WA 98402 Phone: (253) 798-4378 Email: bguthri@co.pierce.wa.us Applicant Information Must Be Completed and Submitted by All Applicants Organization Name: Contact Name: Address: City: State: Zip: Phone: Fax: E-Mail: Return by 12:00 noon, Friday, April 19, 2013 to: Attn: Brian Guthrie 1305 Tacoma Ave S. STE 104 Tacoma, WA 98402 Phone: (253) 798-4378
TABLE OF CONTENTS Requests For Reasonable Accommodation... 3 Access To Referenced Documents... 3 Notice Of Solicitation... 3 Availability Of Funds... 3 Description Of Solicited Services... 3 Anticipated Timelines... 4 Eligible Applicants... 5 Application Evaluation Procedure And Criteria... 5 Unacceptable Applications... 6 Contact... 6 Questions From Applicants And Responses By Pierce County Community Conections... 6 Submittal Due Date And Instructions For Submittal... 6 Ownership Of Material... 7 Application Costs And Contingent Fees... 7 Acceptance Of Terms And Conditions... 7 Right To Reject Or Negotiate... 7 Contract Award And Notification To Selected Applicants... 8 Right To Appeal... 8 Required Assurances... 8 Application... 10 Acknowledgement Of Required Assurances... 14 Attachment A- Proposed Budget And Revenue Summary... 15 Attachment B- Salary And Wage Detail... 17 Attachment C- Unit Rate Calculation Form... 19 Attachment D- Senior Citizens Services Act Sliding Scale... 21 Attachment E- DSHS Senior Citizens Services Application... 23 Request for Proposals No. 13-002-ADR 2
REQUESTS FOR REASONABLE ACCOMMODATION (PCCC) will provide reasonable accommodation to allow for equal participation in the Request for Proposals (RFP) application process. To request a reasonable accommodation, please contact Brian Guthrie at (253) 798-4378 or 711 (Telecommunications Relay Service - TRS), or via e-mail at Bguthri@co.pierce.wa.us. ACCESS TO REFERENCED DOCUMENTS This document contains active hyperlinks. Prospective applicants who are unable to access the Internet may request copies of the documents referenced in this RFP by contacting Brian Guthrie at (253) 798-4378 or 711 (TRS), or via email at Bguthri@co.pierce.wa.us. All documents will be available on PCCC website: http://www.piercecountywa.org/cc or available upon request. NOTICE OF SOLICITATION Failure of the County to notify any interested party or parties directly regarding the availability of this RFP shall not void or otherwise invalidate the RFP process. In addition to providing required notification via the County s publication of record, The Puyallup Herald, the County will provide notification to all known interested parties, and to other organizations and individuals currently on the Department s e-mail distribution list. Any individual or organization wishing to be added to the Department s e-mail distribution list in order to receive future notices of funding opportunities can make such a request by contacting Sue George at sgeorge@co.pierce.wa.us. A copy of this Request for Proposal (RFP) will be posted to the Community Connections website at www.piercecountywa.org/cc AVAILABILITY OF FUNDS PCCC has made available from State Senior Citizens Service Act (SCSA) funding, $60,674 annually for foot care services. The initial contract period shall be for two (2) years, pending satisfactory performance. Contracts will be renewed (without advertisement or solicitation) for an additional two-year period contingent upon available funding, continued need for the service(s), and contractor performance. PCCC contracts may be extended annually up to four (4) years, pending satisfactory performance. DESCRIPTION OF SOLICITED SERVICES Caring for one s feet is an important part of a person s overall health. Feet are subject to substantial wear and tear throughout day to day life, and as people age this damage becomes more prevalent and needs attention. Other physical issues associated with aging, including vision impairment and limited flexibility and dexterity, can make it difficult for an older adult to safely care for their feet. Lack of regular preventative foot care can impact mobility which is vital for maintaining the independence of the older population and their participation in regular activities of daily living. is seeking proposals from eligible, qualified, and interested organizations to provide pedicure-level foot care services for eligible seniors sixty (60) years of age or older. PCCC shall contract with one (1) provider to administer foot care services at the sixteen (16) existing service sites located throughout Pierce County. Foot care services are to be provided to person s age sixty (60) years or older who reside in Pierce County. Foot care is funded by the State Senior Citizens Services Act (SCSA) and is provided on a sliding scale (Attachment D) based upon the client s household size and income. Community Connections requires that preference be given to older individuals living in the community who have the greatest Request for Proposals No. 13-002-ADR 3
economic need with particular attention to low-income minorities. Seniors living in residential care facilities or in supervised housing are not eligible for this service. The successful applicant must administer foot care services at the sixteen (16) existing service sites which include: Tahoma Family Center Lakewood Senior Center Buckley Senior Center Orting Meal site Tacoma Holy Church of Christ Parkland Meal site Eatonville Eagle's Hall Portland Ave. Community Center Fife Senior Center Point Defiance/Ruston Senior Center Gig Harbor Senior Center Puyallup Meal site Key Peninsula Health Center Spana-Park Senior Center Korean Women s Association Meal site Sumner Senior Center Foot care services for seniors includes the following activities: Obtaining physician authorization for the provision of services to each client; Assessing and documenting the condition of every client s feet; Soaking the feet, cutting and filing nails, and applying lotion to the feet; Providing general education to clients regarding care of the feet; and Referral to a podiatrist or physician when appropriate. Providers must be prepared to assess all new or returning clients for metabolic, neurological, or peripheral vascular disease that could make routine foot care procedures hazardous for the client. In these instances, clients should be referred back to their primary physician to assess their need for services from a podiatrist. Providers must be able to provide supervision and oversight of foot care services by conducting one (1) to two (2) clinic site visits per month, and by auditing client charts on an ongoing basis. Foot Care Service Projections Approximately 2,000 service units shall be provided during each twelve (12) month period to a projected 500 unduplicated clients. A unit is defined as a foot care session. ANTICIPATED TIMELINES The following anticipated timeline is subject to change, at the discretion of the County: March 27, 2013: : April 5, 2013: April 12, 2013: April 19, 2013: April 22-May 3, 2013: July 1, 2013: Notification of RFP is published in the Puyallup Herald, the County's newspaper of record. RFP issued to known interested applicants, and posted on the PCCC website. Questions from prospective applicants are due no later than 4:00 pm; please see page 6 for additional information. The County s written response to each question submitted will be sent to all known prospective applicants from whom the County has a valid email and/or postal address. The responses will also be posted on PCCC website. Application submission deadline; applications are due to the County no later than 12:00 noon. Final decisions on funding for services; awards announced. Effective date of contract. Request for Proposals No. 13-002-ADR 4
ELIGIBLE APPLICANTS Interested applicants must be legally constituted entities that meet the following criteria in order to be eligible to submit a full application/proposal for any of the services listed in this RFP: 1. The agency is a private non-profit or for-profit entity, public agency, corporation, commission, or authority. Contracting with for-profit entities is contingent upon approval obtained from the Washington State Department of Social and Health Services, Aging and Disability Services Administration. 2. The lead agency must demonstrate at least three (3) years successful experience in providing the identified service or collaborate with an agency with three (3) years experience. 3. If the proposal is submitted on behalf of a collaborative/partnership a lead agency must be identified. The lead agency must be the one providing the majority of the administrative and program services. The agency must meet all program and agency requirements outlined in this RFP. 4. The agency has a demonstrated capacity to ensure adequate administrative and accounting procedures and controls necessary to safeguard all funds that may be awarded, determined through evaluation of the agency s most recent audit report. 5. The agency can demonstrate a capability to meet program expenses in advance of reimbursement, determined through evaluation of the agency s most recent audit report. 6. The agency has the ability to perform Washington State Patrol criminal background inquiries and disclosure statements under RCW 43.43.830 through 43.43.845 for personnel, contractors, volunteers, students, and any other individual associated with the agency who will have direct unsupervised contact with program participants. 7. The agency must be able to comply with all applicable federal and state laws. 8. Applicants must: Currently have, or intend to obtain, an office located in Pierce County (which can be owned, leased, rented, or donated space); and Obtain, or have a telephone number with a local area code (253) and/or a toll free number. APPLICATION EVALUATION PROCEDURE AND CRITERIA Applications will be evaluated and scored according to, but not limited to, the demonstration of need for the identified target population; experience in providing foot care services to the targeted population; and, demonstrated ability of the applicant to implement and administer the program. When evaluating applications, the County also reserves the right to consider the applicant s performance related to previous contracts that the applicant may have held with the County. PCCC staff will conduct an initial review to ensure that applications meet eligibility and submittal requirements outlined in the RFP. Those that are determined to be acceptable will then be evaluated by an Evaluation Committee (EC) made up of individuals who are knowledgeable of the services and/or target population. The EC will meet to score the applications and may choose to interview applicants to request additional clarification and/or information from applicants. The EC will make funding recommendations to the Director or designee of. In the event that the applicant organization is awarded funding as a result of this RFP, Pierce County Community Connections staff will meet with the successful applicant(s) to review the terms and conditions that are associated with the receipt of funds. Request for Proposals No. 13-002-ADR 5
UNACCEPTABLE APPLICATIONS staff and the Department Director or designee will determine which applications are not responsive to the requirements of this solicitation. Unacceptable applications are those which meet at least one of the following shortcomings: 1. Does not address the essential requirements of the RFP. 2. Clearly demonstrates that the applicant does not understand the requirements of the RFP. 3. Does not meet eligibility requirements. 4. Does not meet the deadline for submittal. 5. Does not contain the original and prescribed number of copies. 6. Does not include the required signed assurance document. 7. Does not include all the information and documents required as part of the application. CONTACT Brian Guthrie, Program Specialist 2 1305 Tacoma Ave S. STE 104 Tacoma, Washington 98402 (253) 798-4378 (253) 798-3812 FAX bguthri@co.pierce.wa.us QUESTIONS FROM APPLICANTS AND RESPONSES BY PIERCE COUNTY COMMUNITY CONECTIONS Inquiries regarding the content of this RFP must be submitted to PCCC in writing, no later than 4:00 PM on April 5, 2013. Questions received after this date and time will not be answered. Questions may be submitted electronically, or via U.S. mail to the contact person identified above. The County will timeand date-stamp all questions received via U.S. mail. The County claims no responsibility for questions transmitted using electronic media, such as facsimile or e-mail, and not received by the County by the specified due date. The method of delivery shall be at the discretion and at the sole risk of the applicant. No later than April 12, 2013, the County will provide a written response to each question received, and, as applicable, will issue any resulting amendments to this RFP. A response will be provided directly to the applicant, and, simultaneously, to any other interested party who has obtained a copy of the RFP, provided that the County has a valid e-mail or postal address on record. Responses will also be posted on the PCCC website. SUBMITTAL DUE DATE AND INSTRUCTIONS FOR SUBMITTAL To be eligible for consideration, applications must be received by Pierce County Community Connections, 1305 Tacoma Ave South STE 104, Tacoma, Washington 98402 no later than 12:00 noon on Friday, April 19 2013. Applicants are strongly encouraged to carefully review the anticipated timelines associated with this solicitation, as identified on page 4. Applicants must submit their application in hard copy, and provide one (1) original and five (5) copies of their complete application, inclusive of the Acknowledgement of Required Assurances. Applications which do not contain an original and the prescribed number of copies will be deemed unresponsive and receive no further consideration. Covers are not necessary and three-ring binders must not be used. When mailed, applicants are strongly encouraged to send information to the County using Request for Proposals No. 13-002-ADR 6
certified mail, return receipt requested. All applications must be received by the deadline. Applications postmarked prior to the deadline but not received by the County will be considered unresponsive and are ineligible for consideration. Applications must be typewritten using 8-1/2 inch by 11-inch paper (double-sided printing in keeping with Pierce County s sustainability program), without artwork or photographs. Each page of the application must be numbered. Document footers must contain the name of the applicant organization, and the Request for Proposal number. All applicants must complete and submit the required Applicant Information, as identified on the Request for Proposal cover sheet. OWNERSHIP OF MATERIAL Applications and other materials submitted in response to this RFP become the property of the County, are documents of public record, and will not be returned. By submitting an application, applicants acknowledge and agree that they and/or their organization claim no proprietary rights to the ideas or approaches contained in their applications. APPLICATION COSTS AND CONTINGENT FEES The County is not liable for any costs incurred by an applicant prior to the issuance of a contract. All costs incurred in response to this solicitation, including travel costs to attend pre-application conference, meetings of the evaluation committee, and/or contract negotiation sessions, are the responsibility of the applicant. In the event that the application was developed with the assistance of other individuals (i.e., nonemployees) and/or organizations, the applicant understands and agrees that no contingent fees will be paid under any resulting contract. ACCEPTANCE OF TERMS AND CONDITIONS By submitting an application, the applicant acknowledges and accepts all terms and conditions of this request and all County and State regulations and requirements related to the delivery of the solicited services. If the applicant is awarded a contract, the application will become part of the contract agreement. The applicant is bound by the terms of the application, unless the County agrees that specific parts of the application are not part of the agreement. The County reserves the right to introduce different or additional terms and/or conditions during final contract negotiations. Applicants are strongly encouraged to review the County s current Basic Agreement prior to submitting an application. A copy of the County s current Basic Agreement is available upon request. RIGHT TO REJECT OR NEGOTIATE The County reserves the right to reject any or all applications, if such a rejection is in the County's best interest. This RFP is a solicitation for offers and shall not be construed as an offer, a guarantee or a promise that the solicited services will be purchased by the County. The County may withdraw this RFP at any time and for any reason without liability to applicants for damages, including, but not limited to, bid preparation costs. Additionally, the County reserves the right to negotiate with selected applicants and may request Request for Proposals No. 13-002-ADR 7
additional information or modification from an applicant. When deemed advisable, and before a contract is issued, the County reserves the right to arrange an on-site visit/review to determine the applicant's ability to meet the terms and conditions of the RFP. The County reserves the right, with or without cause, to cancel any contract resulting from this RFP. CONTRACT AWARD AND NOTIFICATION TO SELECTED APPLICANTS Decisions regarding contract awards for services solicited by this request will be made no later than May 3, 2013. Contracts become effective on the date signed by the County Executive or representative. RIGHT TO APPEAL Applicants whose applications are not selected have the right to appeal the decision of the County, limited to procedural errors in the selection process. In the event that no such procedural errors are found to have occurred, the decision of the County shall be final. An aggrieved applicant may, within two (2) business days after the selection of the prospective contractors, appeal in writing to the Director of or the Director s designee. The appeal must state all facts and arguments upon which the appeal is based. The Director or designee will review the content of the County s solicitation document, the application, and the facts which form the basis for the appeal. The Department Director or the Director s designee will render a written decision within thirty (30) business days of the receipt of the appeal. REQUIRED ASSURANCES Applicants who are awarded a contract agree to provide services in accordance with the requirements of the contract, and with the statutes, regulations, requirements, and policies identified below, including but not limited to: Terms of Pierce County s standard contract, and any specific requirements resulting from the contract associated with this RFP; Compliance with the policies of Pierce County; Compliance with federal and state laws requiring the safeguarding and disclosure of confidential information; Purchase of comprehensive liability insurance and bonding, as required by the County; Provide a copy of most recent financial audit, and/or audited financial statements; Completion and subsequent renewal of background checks for all employees, volunteers, or interns who will or may have unsupervised contact with children or vulnerable adults; Verification of a new employee s eligibility to work legally in the United States. The County requires that all businesses which contract with the County in excess of $25,000 and of duration longer than one hundred twenty (120) days, and are not specifically exempted by PCC 2.106.022, be enrolled in the Federal E-verify Program. The requirement extends to every subcontractor meeting the same criteria; Certification that the firm, association or corporation or any person in a controlling capacity or any position involving the administration of federal, state or local funds is not currently under suspension, debarment, voluntary exclusion, or a determination of ineligibility by any agency; has not been suspended, debarred, voluntarily excluded or determined ineligible by any agency within the past three (3) years; does have a proposed debarment pending; has not been indicted, convicted or has not had a civil judgment rendered against said person, firm, association or corporation by a court of competent jurisdiction in any matter involving fraud or misconduct with the past three (3) years; Maintaining program and financial records for audit review, and providing access to Request for Proposals No. 13-002-ADR 8
documentation upon request by the County; Submission of program and financial reports, as required by the County; and Certification that the firm, association or corporation or any person in a controlling capacity or any position involving the administration of federal, state or local funds is not currently under suspension, debarment, voluntary exclusion, or a determination of ineligibility by any agency; has not been suspended, debarred, voluntarily excluded or determined ineligible by any agency within the past three (3) years; does have a proposed debarment pending; has not been indicted, convicted or has not had a civil judgment rendered against said person, firm, association or corporation by a court of competent jurisdiction in any matter involving fraud or misconduct with the past three (3) years. Request for Proposals No. 13-002-ADR 9
APPLICATION FOOT CARE SERVICES Applicants must answer the following questions and/or provide the requested information in their applications: A. ORGANIZATIONAL INFORMATION 1. Organization Legal Name: 2. Street Address: 3. Mailing Address: 4. Website Address (if applicable): 5. Other Office Locations (state and nationwide): 6. Business Office Hours: 7. Executive Officer: Phone: Title: 8. Primary Contact Person: E-Mail: Phone: Title: 9. Type Of Organization: Sole Proprietor Partnership Other (specify) 10. Experience: Limited Liability Company (LLC) Corporation, Non-Profit E-Mail: a) Date of Incorporation: b) Number of years providing services: 11. Taxpayer Identification Number: 12. Washington State Unified Business Identifier (UBI) Number: 13. Litigation: Provide the caption, cause number, Court, Counsel, and general summary of any litigation pending or judgment rendered within the past three (3) years against the applicant, as applicable. Request for Proposals No. 13-002-ADR 10
14. Suspension & Debarment: Indicate the extent, if any, to which the firm, association or corporation or any person in a controlling capacity or any position involving the administration of federal, state or local funds is currently under suspension, debarment, voluntary exclusion, or determination of eligibility by any agency; has been suspended, debarred, voluntarily excluded or determined ineligible by any agency within the past three (3) years; does have a proposed debarment pending; has been indicted, convicted or has a civil judgment rendered against said person, firm, association or corporation by a court of competent jurisdiction in any matter involving fraud or misconduct with the past three (3) years. 15. Provide a copy of the following documents, as applicable: a. Internal Revenue Service (IRS) tax-exempt determination letter or business license if for profit. b. Organization chart c. Provide any recent (within the last twenty-four (24) months) site visit or program review reports received from monitoring entities (i.e. United Way, local or state government) other than Pierce County Community Connections Aging and Disability Resources. d. Management letter of the organization s most recent financial audit or audited financial statements. If there are findings please include the entire audit. e. Current resumes and job descriptions of individuals who will be performing services on behalf of PCCC clients. 16. Language Capacity: Indicate languages spoken by staff. 17. Program Staffing: 18. Professional References: List three (3) professional references. Request for Proposals No. 13-002-ADR 11
B. Program Qualification Requirements 1. Priority consideration will be given to applicants with demonstrated experience providing services to the target population as specified in the Description of Solicited Services. Describe the agency / organization history, mission and qualifications to provide Foot Care services for older adults. 2. PCCC requires the potential contractor to administer services at the sixteen (16) existing service sites. Describe the agency s plan for ensuring continued operation of services, including a plan for transition of program administration if agency is a new applicant. 3. PCCC requires the potential contractor to develop a formal oversight plan that ensures periodic supervision and Program Coordinator oversight occurs on a regular basis, including on-site clinic observations and chart audits. Please provide organization chart and describe how Program Coordinator will conduct program oversight. 4. Describe proposed methods for evaluating client satisfaction and program quality. 5. PCCC requires the potential contractor to develop Memorandums of Agreement (MOA s) for those host agencies, which require intervention and clarification of responsibilities. Issues to be addressed and formally clarified include: Purpose of Agreement Interagency Coordination Staff Responsibilities Authority/Lines of Communication Facility and equipment utilization including: building access times, assigned room(s); use of kitchen and bathrooms; available phone(s) for receipt of cancellations, delays, or reservations, and Other topics, as appropriate. Please provide examples of Memorandums of Agreement (MOA s) with potential host agencies. 6. The potential contractor will ensure coverage for each scheduled monthly site as stipulated in the program s formal substitute policy and procedures. Please provide policy and procedures surrounding program / staffing coverage. 7. The potential contractor shall develop procedures to ensure services to eligible clients are provided according to PCCC requirements. Please provide policies and procedures for: Client screening / eligibility determination Obtaining physician authorization Assessment of feet Providing foot care Client education (including educational materials) Follow-up to and documentation of physician referrals. 8. The potential contractor shall maintain written policies and procedures regarding scheduling of client appointments and maintaining a waiting list as needed. Please provide policy and procedures for appointment scheduling and waiting list criteria. 9. The potential contractor shall maintain written policies and procedures for the compilation and submission of data to the ADR information system in sufficient detail such that, operations can continue should staffing changes or absences occur. Request for Proposals No. 13-002-ADR 12
Please provide policy and procedures surrounding the compilation and submission of data in sufficient detail such that, operations can continue should staffing changes or absences occur. C. Fiscal Management 1. Complete a proposed one year budget using the Proposed Budget and Revenue Summary Form (Attachment A). This is a linked object in this document. To enter the data on the spreadsheet, double click any cell in the worksheet to open the worksheet in Excel. 2. Complete the Salary and Wage Detail Form (Attachment B) for all personnel/volunteers who will provide direct or indirect support of the applicant s proposed foot care services. 3. The potential contractor will receive a unit rate reimbursement per foot care session for person s age sixty (60) and over who reside in Pierce County. A client s percentage of co-payment, determined by income and assets after completion of the DSHS SCSA Application (Attachment E), will be based on the negotiated unit rate. The projected service levels are based on the current rate of $28.00 per unit. A unit is defined as a foot care session. Complete the Unit Rate Calculation Form (Attachment C). 4. The potential contractor is responsible for collecting and reporting client co-payments. Provide policy and procedures for ensuring collection and reporting of client co-payments. 5. The potential contractor shall maintain written policies and procedures for accounting and finance operations related to the submission of program billings reimbursed under this contract. 6. Describe your organization s current financial condition and outlook for sustainability. Provide sufficient detail to illustrate your organization s financial viability to carry out the services proposed in this RFP. If the organization is facing financial challenges, describe what steps are being taken to strengthen the organization s financial condition. 7. Please describe how the applicant will assure the proper use and safeguarding of public funds. Please include policies and procedures regarding financial operations of the organization and recent reviews or audits of the organization by a certified public accountant or other financial professional noting any weaknesses in the organization s financial internal controls and provide written report identifying the weaknesses and describe how the organization has responded to the report. 8. If the program award were increased or decreased by 10%, what would the impact be on the foot care services? 9. Have any bankruptcy proceedings been initiated by or against the organization (whether or not closed) or is any bankruptcy proceeding pending by or against the organization regardless of the date of filing? Request for Proposals No. 13-002-ADR 13
ACKNOWLEDGEMENT OF REQUIRED ASSURANCES This page must be signed and submitted with the application. Applicants who do not contain a signed Acknowledgement of Required Assurances are ineligible for consideration. By submitting the accompanying application, and by my signature on this document, I understand and agree that any contract resulting from this solicitation will require compliance with the requirements of the contract, and with the statutes, regulations, requirements, and policies identified below, including but not limited to: Compliance with the policies of Pierce County. Compliance with federal and state laws requiring the safeguarding and disclosure of confidential information. Purchase of comprehensive liability insurance and bonding, as required by the County. Completion of an annual financial audit, and/or as applicable, providing the County with a copy of the organizations audited financial statement. Completion and subsequent renewal of background checks for all employees, volunteers, or interns who will or may have unsupervised contact with children or vulnerable adults. Verification of a new employee s eligibility to work legally in the United States. Pierce County requires that all businesses which contract with the County for contracts in excess of $25,000 and of duration longer than one hundred twenty (120) days, and are not specifically exempted by PCC 2.106.022, be enrolled in the Federal E-verify Program. The requirement extends to every subcontractor meeting the same criteria. Maintaining program and financial records for audit review, and providing access to documentation upon request by the County. Submission of program and financial reports, as required by the County. Certification that the firm, association or corporation or any person in a controlling capacity or any position involving the administration of federal, state or local funds is not currently under suspension, debarment, voluntary exclusion, or a determination of ineligibility by any agency; has not been suspended, debarred, voluntarily excluded or determined ineligible by any agency within the past three (3) years; does have a proposed debarment pending; has not been indicted, convicted or has not had a civil judgment rendered against said person, firm, association or corporation by a court of competent jurisdiction in any matter involving fraud or misconduct with the past three (3) years. Organization Printed Name and Title of Person Authorized to Sign Contracts Signature Date Request for Proposals No. 13-002-ADR 14
ATTACHMENT A- PROPOSED BUDGET AND REVENUE SUMMARY Request for Proposals No. 13-002-ADR 15
PIERCE COUNTY COMMUNITY CONNECTIONS PROPOSED BUDGET AND REVENUE SUMMARY July 1, 2013 to June 30, 2014 Object Description COUNTY FUNDS OTHER FUNDS Program Income In-Kind Donations (Identify Source) (Identify Source) TOTAL ALL FUNDS 11 Salaries & Wages 20 Personnel Benefits 31 Office & Operating Supplies Small Tools & Minor 35 Equipment 41 Professional Services 42 Communications 43 Travel & Training 44 Advertising 45 Rentals 46 Insurance 47 Public Utilities 48 Repairs & Maintenance 64 Machinery & Equipment 90 Other Indirect (Admin.) GRAND TOTAL *Please provide details on Salary and Wage Detail form Request for Proposals No. 13-002-ADR 16
ATTACHMENT B- SALARY AND WAGE DETAIL Request for Proposals No. 13-002-ADR 17
PIERCE COUNTY COMMUNITY CONNECTIONS SALARY AND WAGE* DETAIL FORM July 1, 2013 to June 30, 2014 POSITION TITLE # OF POSITIONS RATE PER HOUR HOURS PER WEEK COUNTY GENERAL FUNDS OTHER FUNDS TOTAL S AL AR Y Request for Proposals No. 13-002-ADR 18
ATTACHMENT C- UNIT RATE CALCULATION FORM Request for Proposals No. 13-001-ADR 19
PIERCE COUNTY COMMUNITY CONNECTIONS UNIT RATE CALCULATION FORM 1. Total Cost of Program $ 2. Total Units of Service (include all units of service provided by this program, regardless of funding.) 3. Cost per unit of Service $ (Calculation: Total cost Total Units of service = Cost Per unit) 4. Unit Rate Requested: $ If different from #3, you must explain below Unit Rate Justification: Request for Proposals No. 13-001-ADR 20
ATTACHMENT D- SENIOR CITIZENS SERVICES ACT SLIDING SCALE Request for Proposals No. 13-001-ADR 21
Request for Proposals No. 13-001-ADR 22
ATTACHMENT E- DSHS SENIOR CITIZENS SERVICES APPLICATION Request for Proposals No. 13-001-ADR 23
Request for Proposals No. 13-001-ADR 24
Request for Proposals No. 13-001-ADR 25