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Home My WebLink AboutAttachment EAttachment E - Jessica Lunsford Act Miami -Dade County Public Schools SWORN STATEMENT - NEW CONTRACTS ATTACHMENT E SWORN STATEMENT PURSUANT TO SECTION 1012.465, FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to The School BoaI?21, d of Mia County, Fl (Hereinafter`Board"or"SchoolBoard")by Y/ Y -1 ere-0Ti( 0 2. Fxectychve_ )177_J'-(A7 p (Pnnt�individual's /p�name and title) n/�.. for fr the Cf/ r 1 b YM ea1q oe tM o,i (Print Name of entity submitting sworn statement) (9 ny) whose business address is k-f-ut 33 an,d its Federal Employer Identification Number (FEIN) is q—O(e 3 7g 0-2- . If the entity has no FEIN, include the Social Security Number (SSN) of the individual signing this sworn statement and so indicate. 1 rxeD (Print individual's name and titl-) n�w r A.G �w/'��1 sworn statement on behalf of it bit (�YJ Y ,(? U( (Print Name of entity submitting sworn s e0}ment) 3. I understand that during the 2005 Legislative Session, House Bill 1877, The Jessica Lunsford Act (hereinafter "The Act" or "Act") was passed and approved by Governor Bush on May 2005, with an effective date of September 1, 2005. , am duly authorized to make this Initials Page 1 of 3 FM-6910 (08-05) 4. I understand that the Act amends the background screening requirements of section 1012.465, Florida Statutes (2004) for all non -instructional school district employees or "contractual personnel" by requiring all non -instructional school district employees or contractual personnel who are permitted access on school grounds when students are present to undergo and pass "level 2 background screening," and further I understand the Act defines "contractual personnel" to include any vendor, individual, or entity under contract with the Board. 5. I understand that pursuant to section 1012.465, Florida Statutes as amended by the Act, non - instructional school district employees or contractual personnel who are permitted access on school grounds when students are present. who have direct contact with students or who have access to or control of school funds must meet level 2 screening requirements as described in sections 1012.32 and 435.04. Florida Statutes. 6. I understand that as a PWed- 1. /,J€/tj (eg. a private bus Type of en *ty service contractor) all contractual personnel, as defined in section 1012.465, Florida Statutes, must meet level 2 screening requirements as outlined in sections 1012.32 and 435.04, Florida Statutes in order to do business with The School Board of Miami -Dade County, Florida. 7. I understand that "level 2 screening requirements," as defined in sections 1012.32 and 435.04, Florida Statutes means that fingerprints ofall contractual personnel must be obtained and submitted to the Florida Department of Law Enforcement for state processing and to the Federal Bureau of Investigation for federal processing. 8. I understand that the School Board will implement local procedures to comply with level 2 screening requirements, as defined in sections 1012.32 and 435.04. I understand that my company must comply with these local procedures as they are developed. 9. I understand that any costs and fees associated with the required background screening will be borne by my company. 10. I understand that any personnel of the contractor found through fingerprint processing and subsequent level 2 background screening to have been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to any offense outlined in Section 435.04, Florida Statutes (or any similar statute of another jurisdiction), shall not be permitted to come onto school grounds or any leased premises where school -sponsored activities are king place when students are present, shall not be permitted direct contact with students, and shall not be permitted to have access to school district funds. Initials Page 2 of 3 FM-6910 (08-05) 11. I understand that the failure of my of the company's or my affected personnel to meet level 2 screening standards as required by section 1012.465, Florida Statutes, may disqualify my company from doing business with The School Board of Miami -Dade County, Florida. 12. I hereby certify that the foregoing statement is true and correct in relation to the company for which I am submitting this sworn statement. I further certify that this statement is being given knowingly and voluntarily by me on behalf of my company. The company submitting this sworn statement agrees to be bound by the provisions of SECTIONS 1012.32,1012.465, AND 435.04 OF THE FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT 2005. I CERTIFY THAT THE SUBMISSION OF THIS FORM TO THE SCHOOL BOARD OF MAMI- DADE COUNTY, FLORIDA ON BEHALF OF THE COMPANY IDENTIFIED 1N PARAGRAPH ONE (1) ABOVE BINDS THE COMPANY TO FULLY COMPLY WITH THE BACKGROUND SCREENING REQUIREMENTS OF SECTIONS 1012.32, 1012.465, AND 435.04, FLORIDA STATUTES. (Signature) Sworn to and subscribed before me this JO day orp/2e, 20 p7. Personally known J OR Produced Identification Notary Public -State of F`j,e(/)/,L n TYuoe of Identification) My commission expires ff7 '_ 1 C9 D/ 0 l 06,0, 4 , hwillia"KATRINA L. PERRY s� °4'4 Notary Pubic - State of Florida I. � • EMy Commission Expires Feb 27, 2010 +� �� V Commission it DD 522624 f '•. se •° ... Bonded By National Notary Assn. t Initials 'nted typed or stam'ssioned name of notary public P Page 3 of 3 FM-6910 (08-05) CHC,. Committed to 1elping individuals learn Community and work skills 11450 S W 79'h Street, Miami, Florida 33173. ph. 305/279.7999. Fax 305.279.6627. info(a.chcmiami.orq RFP # 056-GG10 RFP Title: Supported Employment Services for the Education of Students withiglities RFP Opening Date: 5/3/07 TOFU L M AS MAY 3 ` 2007 PURPOSE: L Provide supported employment services for students with moderate to bilities currently being enrolled in (SPED) programs in Miami -Dade County Public Schools (M- Our agency is qualified to provide supported employment services to serve the needs of this population. We have been working with individuals with developmental disabilities since 1972 and offered Supported Employment services for the past four years. PROPOSAL AGENCY :LIAISON: Director of Education (Silvia Atlas) has many years experience in the field of Special Education. She work;Md with M-DCPS for ten years in the areas of Profound Mentally Handicapped (PMH), Trainable Mentally Handicapped (TMH), and Educable Mentally Handicapped (EMH). She is familiar with the Individual Educational Plan (IEP) process and would be responsible for. maintaining effective coordination between the school district and the agency. JOB COACHES: CHC currently has 3 qualified job coaches to work with this program (Natalia Viera, Angela Gomez, Luis Rolon) All our coaches have at least two years experience working with the Supported Employment Program. They have completed the appropriate certification and training and are also bilingual in English/Spanish. (SEE ATTACHED DOCUMENTATION) DESCRIPTION OF PROGRAM: Job Development: Our job coaches work with the business community to provide a variety of jobs and competitive pay for those individuals. Job Matching: Our coaches work to assess and match the vocational skills of individuals with disabilities with the jobs available in the community. On -the -Job Training: Our coaches provide training while individuals are employed. Follow-up: Our coaches work with employers to ensure the placement and training of individuals is beneficial to all parties involved. Documentation: Our coaches are proficient documenting all phases of the program. They keep logs of services and write monthly updates regarding status of individuals. THE SCHOOL BOARD OF MIAMI-DADE COUNTY, FLORIDA PROCUREMENT MANAGEMENT SERVICES 1450 N.E. 2ND AVENUE, MIAMI, FLORIDA 33132 REQUEST FOR PROPOSALS NO. 056-GG10 SUPPORTED EMPLOYMENT SERVICES FOR THE EDUCATION OF STUDENTS WITH DISABILITIES Sealed proposals will be accepted in Procurement Management, at the above location, until 2:00 P.M. (Local Time) May 3, 2007, and may not be withdrawn for one hundred - twenty (120) days from that date. ANTI -COLLUSION STATEMENT THE UNDERSIGNED PROPOSER HAS NOT DIVULGED TO, DISCUSSED, OR COMPARED HIS PROPOSAL WITH OTHER PROPOSERS AND HAS NOT COLLUDED WITH ANY OTHER PROPOSER OR PARTIES TO THE PROPOSAL WHATSOEVER. PROPOSER ACKNOWLEDGES THAT ALL INFORMATION CONTAINED HEREIN IS PART OF THE PUBLIC DOMAIN AS DEFINED BY THE STATE OF FLORIDA SUNSHINE LAW. CERTIFICATION AND DENTIFICATION FOR PROPOSERS SUBMITTING PROPOSALS. I certify that this proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a proposal for the same service, and is in all respects fair and without collusion or fraud. I agree to abide by all conditions of these proposal specifications and I certify that I am authorized to sign this proposal. (Please Type or Print Below) LEGAL NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: Cj0-,Me., • MAILING ADDRESS: CITY STATE, ZIP CODE: TELEPHONE NUMBER: BY: SIGNATURE BY: TYPED TITLE: U.601( ,'FL 33 /i3 SUPPORTED EMPLOYMENT SERVICES FOR THE EDUCATION OF STUDENTS WITH DISABILITIES ATTACHMENT B PROPOSER'S FEE AND CERTIFICATION OF HOURS OF SERVICES PROPOSER'S FEE Hourly Fee eP LEGAL NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: 01*-Lvac, AUTHORIZED SIGNATURE: NAME TYPED: POSITION: f ec6C-- Vendor Information Sheet ATTACHMENT 1A. n I Irb W'I Federal Employer Identification Number Or Owner's Social Security Number 1B. 0, l I YN. Name of irm, Individual(s), Partner r rpion 5D Ste) '1 o le Street Address Zia P % L 31r13 City State Zip Code 3. Ownership Disclosure 2. (3Tele 0S-on� � Coin a t�erson Telephone number C c) 2'1-(oL2`1 Fax numb^ eA t Vb\n � .-k-G� 7 l c Contact Person OnnACocholikankt .orj E-mail address If the contract or business transaction is with a corporation, partnership, sole proprietorship,or joint venture, the full legal name and business address shall be provided for the chief officer, director, or owner who holds, directly or indirectly the majority of the stock or ownership. If the contract or business transaction is with a trust, the full legal name and address shall be provided for each trustee and each beneficiary. Post Office addresses are not acceptable. I Name Title Address Gender Race - ethnicity Stock Ownership NOTE: The information provided by the vendor on this form should be consistent with that provided on the "Vendor's Application". All vendors must have a current vendor's application on file with M-DCPS, and have provided information and/or be familiar with M-DCPS' policy regarding the following: (a) Employment Disclosure, (b) Drug Free Workplace, (c) Family Leave Policy, (d) Code of Business Ethics, (e) Conflict of Interest, (f) Perception, (g) Gratuities, and (h) Business Meals. Failure to provide M-DCPS a current vendor application may cause the vendor not to be awarded anv new business with M-DCPS. Vendor applications can be downloaded at: http://procurement_dadeschools.net !ritemai Revenue Service Date: March 30, 2001 Community Habilitation Center inc 11450 Southwest 79th Street Miami FL 33173-3640 Dear Sir or Madam, Department of the Treasury P, O. Box 2508 Cincinnati, OH 45201 Person to Contact: Shawndea Krebs 31-02330 Customer Service Representative Toil Free Telephone Number: 11:00 ant to 9:30 p.m EST 877-829-5500 Fax Number: 513-263-3756 Federal Identification Number: 23-7171039 This letter Is In response to your request for a copy of your organization's determination letter. This letter will take the place of the copy you requested. Our records indicate that a determination letter issued in September 1972 granted your organization exemption from federal income tax under section 501(c)(3) of the Internal Revenue Code. That letter is still in effect Based on information subsequently submitted, we classified your organization as one that is not a private foundation within the meaning of section 509(a) of the Code because it is an organization described in sections 509(a)(1) and 170(b)(1)(A)(rI). This classification was based on the assumption that your organization's operations would continue as stated In the application, if your organization's sources of support, or itscharacter, method of operations, or purposes have changed, please let us know so we can consider the effect of the change on the exempt status and foundation status of your organization. Your organization Is required to file Form 990, Return of Organization Exempt from income Tax, only if its gross receipts each year are normally more than $25,000. If a return is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period. The law Imposes a penalty of $20 a day, up to a maximum of $10,000, when a return is filed late, unless there is reasonable cause for the delay. All exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more paid to each employee during a calendar year. Your organization is not liable for the tax Imposed under the Federal Unemployment Tax Act (FUTA). Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code, However, these organizations are not automatically exempt from other federal excise taxes_ Donors may deduct contributions to your organization as provided in section 170 of the Code, Bequests, legacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and glft tax purposes if they meet the appiicable provisions of sections 2055, 2106, and 2522 of the Code. 00043 DEPARTMENT OF REVENUE Consumer's Certificate of Exemption issued Pursuant to Chapter 212, Florida Statutes 85-8012627216C-0 11/02/2003 Certificate Number Effective Date This certifies that COMMUNITY HABIILITATION CENTER 11450 SW 79TH ST MIAMi FL 33173-3640 11/30/2008 Expiration Date DR-14 R. 01/02 • is exempt from the payment of Florida sales and use tax on real property rented, transient angible personal property purchased or rented, or services purchased. DEPARTMENT OE REVENUE Important information for Exempt Organizations DR-14 R. 01/02 1. You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases. See Rule 12A-1.039, Florida Administrative Code (FAC). 2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's customary nonprofit activities: 3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be reimbursed by the organization. 4. This exemption applies only to purchases your organization makes. The sale or lease to others by your organization of tangible personal property, sleeping accommodations or other real property is taxable. Your organization must register, and collect and remit sales and use tax on such taxable transactions. Mote: Churches are exempt from this requirement except when they are the lessor of real property (Rule 12A-1.070, FAC). 5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no circumstances should this certificate -be used for the personal benefit of any individual. Violators will be liable for payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third degree felony. Any violation will necessitate the revocation of this certificate. 4 6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Central Registration at 850-487-4130. The mailing address is 5050 West Tennessee Street, Tallahassee, FL -32399-0100. Miami -Dade County Public Schools SWORN STATEMENT - NEW CONTRACTS ATTACHMENT E SWORN STATEMENT PURSUANT TO SECTION 1012.465, FLORIDA STATUTES AS AMENDED BY KB 1877, THE JESSICA LUNSFORD ACT THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to The School Board of Miami -Dade County, Fl (Hereinafter"Board" or "School Board") by Pta- zck.rao - E__)(iJA-tvc 'pre_dor (Print individual's name and title) for C,VVQ., 1n C , (Print Name of entity submitting sworn statement) SiTed- 4-ticky\kk,L- 3 113 2. whose business address is and its Federal Employer Identification Number (FEIN) is 039 . If the entity has no FEIN, include the Social Security Number (SSN) of the individual signing this sworn statement and so indicate. I-R--olAp tIa77groo. , am duly authorized to make this (Print individual's name and title) n sworn statement on behalf of �� j f (Print Name of entity submitting sworn statement) 3. I understand that during the 2005 Legislative Session, House Bill 1877, The Jessica Lunsford Act (hereinafter "The Act" or "Act") was passed and approved by Governor Bush on May 2, 2005, with an effective date of September 1, 2005. 616itailks" Page 1 of 3 FM-6910 (08-05) 4. I understand that the Act amends the background screening requirements of section 1012.465, Florida Statutes (2004) for all non -instructional school district employees or "contractual personnel" by requiring all non -instructional school district employees or contractual personnel who are permitted access on school grounds when students are present to undergo and pass "level 2 background screening," and further I understand the Act defines "contractual personnel" to include any vendor, individual, or entity under contract with the Board. 5. I understand that pursuant to section 1012.465, Florida Statutes as amended by the Act, non - instructional school district employees or contractual personnel who are permitted access on school grounds when students are present, who have direct contact with students or who have access to or control of school funds must meet level 2 screening requirements as described in sections 1012.32 and 435.04, Florida Statutes. 6. I understand that as a rl� U T O I J�) T e of entity-) OV f (a (eg. a private bus (J service contractor) all contractual personnel, as defined in section 1012.465, Florida Statutes, must meet level 2 screening requirements as outlined in sections 1012.32 and 435.04, Florida Statutes in order to do business with The School Board of Miami -Dade County, Florida. 7. I understand that "level 2 screening requirements," as defined in sections 1012.32 and 435.04, Florida Statutes means that fingerprints of all contractual personnel must be obtained and submitted to the Florida Department of Law Enforcement for state processing and to the Federal Bureau of Investigation for federal processing. 8. I understand that the School Board will implement local procedures to comply with level 2 screening requirements, as defined in sections 1012.32 and 435.04. I understand that my company must comply with these local procedures as they are developed. 9. I understand that any costs and fees associated with the required background screening will be borne by my company. 10. I understand that any personnel of the contractor found through fingerprint processing and subsequent level 2 background screening to have been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to any offense outlined in Section 435.04, Florida Statutes (or any similar statute of another jurisdiction), shall not be permitted to come onto school grounds or any leased premises where school -sponsored activities are taking place when students are present, shall not be permitted direct contact with students, and shall not be permitted to have access to school district funds. Page 2 of 3 FM-6910 (08-05) 11. I understand that the failure of as of the company's or my affected personnel to meet level 2 screening standards as required by section 1012.465, Florida Statutes, may disqualify my company from doing business with The School Board of Miami -Dade County, Florida. 12. I hereby certify that the foregoing statement is true and correct in relation to the company for which I am submitting this sworn statement. I further certify that this statement is being given knowingly and voluntarily by me on behalf of my company. The company submitting this sworn statement agrees to be bound by the provisions of SECTIONS 1012.32, 1012.465, AND 435.04 OF THE FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT 2005. I CERTIFY THAT THE SUBMISSION OF THIS FORM TO THE SCHOOL BOARD OF MIAMI- DADE COUNTY, FLORIDA ON BEHALF OF THE COMPANY IDENTIFIED IN PARAGRAPH ONE (1) ABOVE BINDS THE COMPANY TO FULLY COMPLY WITH THE BACKGROUND SCREENING REQUIREMENTS OF SECTIONS 1012.32, 1012.465, AND 435.04, FLORIDA STATUTES. Sworn to and subscribed before me this '`-' day or 20 Z. Personally known v OR Produced Identification Notary Public -State of My commission expires itials (Ty e of Identification Lc:Af 2OO 7 Notary Public State of Florida Irma Resnic My Commission DDE20772 Expires ti4115/2010 _.. �........ (Printed typed or statfiped commissioned name of notary public) Page 3 of 3 FM-6910 (08-05) AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN ATTACHMENT D Race/Ancestry Non- Non- Am. Ind./ Gender Hispanic sPanic Alaska Occupational Category Male Female Whiter Black Hispanic Asian Native. :---_-)t-taYill.I€ D ref-lt, r D i f ecA-t) c_S / cQ... en.* \Dor eexs V V 04i Le, CAC din oAus \Z 0--- 17 z y V V V 3 RV1-4869 Rev. (02-01) CORPORATE OFFICE: 125 S.W. 107th Av. • Miami, FL 33174 (305) 229-7002 • Fax (305) 229-7006 To Whom It May Concern: .1,os aaxdw,r R F61'AIIRANi RFS Ai.IRANT April 30, 2007 We are happy to support agencies like Community Habilitation Center (CHC inc) by providing jobs for individuals with developmental disabilities in the community. CHC, Inc and Los Ranchos have had a successful business partnership for many years. We are proud to work together to provide individuals with meaningful and competitive employment. Should you need more information or need to contact us personally feel free to do so at the following number: 305-229-7002. Sincerely, ()(sar:—. Marjorie Arias Los Ranchos Corporate Office General Manager BAYSIDE MARKET PLACE (305) 375-8188 / 375-0666 SWEETWATER HOLIDAY PLAZA COCO WALK (305) 552-6767 / 221-9367 (305) 461-8222 / 447-3077 CORAL GABLES (305) 446-0050 / 446-4976 THE FALLS SHOPPING CENTER (305) 238-6867 / 251-6016 Charcoals Latin Grill, Inc. "Dolphin Mall" 11401 NW 12t' Street Miami, FL 33172 April 25, 2007 To Whom It May Concern: This letter is written as a reference letter for Community Habilitation Center. We've had a business partnership with them for the past few years. We employ some of the individuals that attend the Adult Day Training Program. They work with adults with developmental disabilities and we help them by providing jobs for those individuals ready to enter competitive employment. This agency is a great example of people dedicated to making the lives of those that need help in becoming more independent and productive members of society. Should you need additional information please free to contact us personally at the above numbers. Ismael General LA FOGATA BBQ SPECIALTIES, INC. 1401 S.W. 126 Place Miami, FL 33184 May 2, 2007 To Whom It May Concern: La Fogata and Community Habilitation Center (CHC inc) have been partners since 2005. We have employed some of the individuals that attend the Adult Day Training Program at CHC and have had a positive and rewarding experience working with them. The administration and educational staff at the center have been helpful in working with us to provide the individuals with employment. They supervise and communicate with our staff any concerns and work with the individuals to improve their job performance. We are proud to support and work with CHC inc. and recommend them for future endeavors in the business community. Sincerely, C. WWxg President Natalia Vieira 8335 S.W 152 Av Apt 111 Miami, FI 33196 Phone: 305-380-7135 / CeII: 305-527-1221 Email: Nati055@hotmail.com Objective To use my skills, experience and education to succeed in my career and to be of benefit to my employer. Work Experience July 1, 2004 — Present Supported Employment Coach, Community Habilitation Center • Work with individuals with disabilities to develop job searching skills such as proper behavior in interviews, filling out applications and creating a resume. • Assess individuals with disabilities to provide appropriate job placement • Assist individuals with disabilities obtain jobs in their community. • Provide on going specialized on -site training to assist the employee in learning and performing job duties. • Assist individuals with disabilities in creating natural supports at the work place. • Works with the employer to develop job accommodations needed by a person because of his or her disability as well as maintain a relationship with employer to maximize success. December 2003 — July 2004 Reading Instructor, Kumon Reading Center • Plan and implement reading activities • Assist children with reading homework • Help children with learning disabilities develop phonemic awareness Education • 1999-2003 - Miami Sunset Senior High • 2003-2005 - Miami Dade College — Associates of the Arts 2005-Present Florida International University - Seeking Bachelors in Exceptional Student Education Computer Skills • Microsoft Office 2000 • Microsoft Excel • PowerPoint • Microsoft Office Publisher Volunteer work • 2002-2003 Kendal Lakes Elementary, Future Educators of America Organize activities for students wanting to be future teachers to gain experience in this field. Read books to children • Summer of 2002 Community Habilitation Center Help individuals with disabilities with art activities • May, 2004 - present First Baptist church of Perrine Teach Sunday School for children ages 3-5 Counsel Middle school students. Qualifications • First Aid certified • CPR certified • AED ESSENTIALS • Supported Living/Supported Employment certified • Bilingual — English - Spanish skills • fri**„10•011.w"."""r", • • -..`•‘• VdraalfjP,'• •, "m4:41ji.....\„;•:•.. so • • 44. ••••• •;41"01...,11 14:•,.‘..44. • • • M....%744:&::: - 00°.°01"-:.t or° • : •- • 10 ••;4;;:f.„-=1:1; ilitr.,,v4,44y41 o'••:•!•;:zr,atr.11 ra:::./4474";: "sv‘•""-P../4;$::% %sr:, #14,:s* ".4://•:,1;•-"4-111:11:1141:1-.1•414,44" 1 larA:;:.10;s:4111LArrea.;,e4e,",;AI WN#11;s:r403:111; '37"*"t"//4"v"":".41 1;k:'•%1","%ilr"; C./ ,..,.4,4,.- linah—iiim ...E.-. 11 111111111+00141\141 iiikill\\\TV:t="fillitt '.--.. Vi'll ..2....'. */ .44 titil: t! ir!....: ....—'1:78N1$: • . - ' ' .....:"•••••• ; SX NSUFischler School of Education and Human Services Ebiss Certificate of fpucceogfut Coniptetion of 18 jboUto of fire-tierbite Valuing for Supporteb Cmplopment ippettattot 4rebp granteb to: iaatatta laber 11-51 LESLIE WILSON, M.(( JANUARY 23, 2005 MICHELE MCGUIRE, PH.D. JANUARY 23, 2005 A.6 -;,.•••••Alies\-A. our ••• •••• •.• ler 11::::;;;;••::;• la • :0•$•::::,‘2. ''SN • Angela M. Gomez 3452 SW 23rd Terr. Miami, FI 33145 (305)586-8587 OBJECTIVE: To obtain a challenging position where I may demonstrate my skills, experience and education and be an asset to the company. WORK EXPERIENCE: Supportive Employment Coach Project: Retum To Work September 2006 - April 2007 • Working with individuals to develop job seeking skills such as writing resumes, filling out applications, dressing for interviews and answering questions. • Assist individuals to obtain desired positions where they can be productive and interact with their community. • Provide on going specialized on site training to individuals in order to master job duties. • Work with employers as well as co-workers to make the transition easier for the individual with the disability and to obtain a relationship were they can become natural supports at the work site. • Work with employers to accommodate individuals with special needs. Supportive Employment Coach February 2004 — August 2006 Community Habilitation Center, Inc. • Teaching individuals to fill out applications on the computer and by paper. • Preparing individuals for job interviews, showing proper dress code and how to answer questions. • Providing on going specialized on site training to provide mastering of job duties. • Assisting the employer and co-workers with special accommodation For individuals with certain needs. EDUCATION: NSU Fischler School of Education and Human Services Weehawken High School Computer Skills: Microsoft Office 2000 Microsoft Excel Qualifications: First Aid and CPR certified Supported Employment/Supported Living certified *A. &6A4M44AM Fischand Hler School.uman ofSeEducationrvicesSU 1 1 � 'CGIJt$ (ICQTtIfICAtQ of igtULCogYt[C Completion of• , is 3our of re-erbtte Xvaintng for 4 : � upporteb Qemplopment fte, i� berebp granteb to: 444 Rneta orne;0114A. /8', • A-c5.AA, e/SA.IS MIc IIELE McG , PILD. LESLIE WILSON .S. INSTRUCTOR JULY 14, 2005 JULY 14, 2005 III/ Luis Rolon 6901 SW 129 AV #8 Miami, Fl 33183 786-260-7736 Email: Luis@CHCMiami.org Objective To obtain a position where my education and work experience will have valuable application Work Experience 2001 - Present Supported Employment Coach, Community Habilitation Center • Work with individuals with disabilities to develop job searching skills. • Assist individuals with disabilities obtain jobs in their community. • Assess individuals with disabilities to provide appropriate job placement • Assist individuals with disabilities obtain jobs in their community. • Provide on going specialized on -site training to support the employee in learning and completing job duties. • Assist individuals with disabilities in creating natural supports at the work place. • Works with the employer to develop job accommodations needed by a person because of his or her disability as well as maintain a relationship with employer to maximize success. Education • 1996-1999 Marist College, Poughkeepsie, NY Psychology Major • 1998-2000 New York state Department of Labor Certification in Counseling Computer Skills • Microsoft Office 2000 • Microsoft Excel Qualifications • First Aid certified • CPR certified • Supported Living/Supported Employment certified • Bilingual — English - Spanish skills 0% 0% ,N e, FA 0 = 0 0 0 0 )) .... ^ • • • ' f - ' - , • This training meets the 12 hours of pre -service and 8 hours of continuing education training requirements by the Developmental Disabilities Program, Dept. of Children and Families for Florida supported eMployment providers in the Developmental Services Program. Certi tcat mpletion Orientation to Stip orted Employrnent AUO:OSTIITE, FL 32085-0439. • tic.com - ititic;..//wfmint',com '6)) (4')/ ..)•••• - = „ , r , --r . , T • 7 - T , • • • 4 4 t •• 7 ' ' : '1.1 . : ; . ; - - - • . „ . 41, Pie c�c T CERTIFICATE OF COMPLETION Supported Competitive Integrated Employment Training Project 18 hours Held On January 17, 18 & 19, 2006 West Palm Beach., FL Presented. to: Luis Rolon For completion of : Supported Employment & Natural Supports: A Florida Training Curriculum 13301 Bruce B Downs Blvd. Tampa, FL 33612.3899 SOUTH FLORIDA, • 1,7z1::rw„-.A`i p"r ti• e a 3 rr it T'• xY' ["'n„y' alr,.Y.�rrx'k i'' i.. v� ' �•:�''t1� d.Ji:"rs'�' i r AL:14s,a kiii• ate .� j Kj z r � .te, a:. ,c.-� y, .' j r �ti.{, � .:=" 1992-1995 Silvia E. Atlas 3934 S.W. 107th Avenue Miami, Florida 33165 (305) 223-5618 sanc3696@bellsouth.net OBJECTIVE To promote the field of exceptional student education through excellence in academic instruction, cooperative teaching practices and participation in professional activities. EDUCATION Florida International University Bachelors of Science in Special Education. During studies served as vice president of CEC student chapter, was a member in good standing of Kappa Delta Pi, Golden Key National Honors Society and Future Educators of America. Internship working with TMH students grades 9th-12th at Southwest Senior High School. Graduated Cum Laude. 1988-1994 Miami -Dade Community College Associate of Arts. Concentration in Psychology. 1998- 2014 1995-1998 WORK EXPERIENCE Miami -Dade County Public Schools M. A. Milam K-8 Center Presently working with TMH students grades 2nd-5th using Functional Skills Curriculum. Worked with EMH students grades 3td-5th using Functional Academics Curriculum. Worked with TMH students grades K-2"d during summer school. Serving as Team Teacher and Head Coach of Special Olympics. Hialeah Middle School Worked with TMH students grades 5th-8th in OTC using Community Based Curriculum. Worked with PMH students grades 9th-12th using Life Skills Curriculum. Served as Team Leader and Team Teacher AWARDS 2003-2004 Francisco R. Walker, Teacher of the Year M.A. Milani K-8 Center 1996-1997 Exceptional Student Education, Teacher of the Year Hialeah Middle School AFFILIATIONS AND ACTIVITIES Special Olympics Council for Exceptional Children Social and Hispanic Committees REFERENCES Upon Request The parents who established the Community Habilitation Center (CHO in 1972 set a goal to have a safe, pleasant, and comfortable place where their sons and; daugh- ters would be able to' meet their goals: having a more independent and productive life. They formed a partnership between Miami -Dade County ndg thei w not -for -profit corporation,,: After 'any hours cir4tiArd,e4ork, planning and negotiation, the county leased a plot of land down a dirt road on 117th Avenue. That dirt road is now 79th Street. There were several small buildings on the property and with some renovation they became CHC. A place for their family members to come learn and grow. plant In 20r'� completed and moved into new state-of-the-art facility. The New Learning "Center, opened a new world for everyone. Today more than one hundred individuals work and learn at CHC` Each person is given the opportunity to participate inalwide array,:,"of work groups a0 set individual goals. Plans are now underway for a complete renovation of the original building. New ADA restroom acilities, expansion of Supported mployment;'and Supported Living programs along with new class- rooms..are only a few of the projects to further enhance our program. CHC has grown into something that the founding parents would be proud of and never would have imagined tints continue to be the key- o its, success. They are mem- ers ofthe- Board of Trustees and run the CHC Auxiliary Action Corps. Its main function is to support the organization in every way possible. COMMUNITY HABILITATION CENTER 1 2006 Health & Fitness Good health is a key , o t independence. The goal in Health Fitness is to give the individual t tools to stay healthy and phys ca fit , Through fund raising efforts of"t CHC's Auxiliary Action Corps, we now have treadmills, exercise bikes, roWi machines, and other equipment that. individuals use on a, weekly basis::: They learn good health practicep which include developing good eating habits, weight control, and exercise routines. Sports & Fitness Several times a week individuals can participate in an outdoor Sports and Fitness program at CHC. The connection between taking part in sports activities and staying fit is always stressed when individuals are learning a new sporting activity. The skills needed to be successful in each activity are eagerly taught, practiced, and learned using a team approach. Our coaches as well as athletes participate in Special Olympics. They. practice and prepare for competitions at the local'and state level in a variety of sports_., . 4.. rus... . Tec; an .s e Thro • offers m ` : vi computers eq Epp software. orne g we do. orts our lab access to functional At first, everyone learned about computers and how to perform basic tasks. Many of the goals; set by individuals could Abe enhanced through use of computer programs. Our next step is to use the computers to accomplish specific tasks such as scanning photos. As they become more efficient and become able to successfully scan and' save photos, we will be able to offer this service as a small business. The Technology Lab offers individuals the opportunity to gain knowledge and prepare for a work setting environment. Human Resources (HR) Teambuilding Social Workers at CHC share the responsibility of conducting group Imeetings Thes Human Resources OR) Teambui® gsessions are used 'to discuss art explain issues and concerns. s°c Thesemeeetings' are the place where the people are able to''voice op D%Rp talk in a group setting :ommon problems. Usually a e range of topics is introduced and discussed. It is a timewhen peo- ple are able to open ups and voice challenges- that may need to be addressed. i> is alsaa time when the Social Workers can introduce new ideas and air concerns that may help all the individuals that attend CHC. t.rlt nas a full-time Music Therapist :on staff. Researched - based Music Therapy has a proven track record of helping individuals gain or improve skills that are need- ed to achieve personal success in life and work. Activities used in Music Therapy can help to increase social skills, improve receptive and expressive communication, improve cognitive functioning and improve motor ability. COMMUNITY HABILITATION CENTER 3 2006 M4Ctowfii. "Furthering the Independence ofAdults with Developmental Disabilities" Request for Proposals RFP No. 056-GG10 May 3, 2007 BY REGULAR AS TO FORM MAY 3 2007 17 J 1 Supported Employment Services for the Education of Students with Disabilities To: The School Board of Miami -Dade County From: MACtown, Inc. 151 NE 62nd Street Miami, Florida 33138 ORIGINAL THE SCHOOL BOARD OF MIAMI-DADE COUNTY, FLORIDA PROCUREMENT MANAGEMENT SERVICES 1450 N.E. 2ND AVENUE, MIAMI, FLORIDA 33132 REQUEST FOR PROPOSALS NO. 056-GG10 SUPPORTED EMPLOYMENT SERVICES FOR THE EDUCATION OF STUDENTS WITH DISABILITIES Sealed proposals will be accepted in Procurement Management, at the above location, until 2:00 P.M. (Local Time) May 3, 2007, and may not be withdrawn for one hundred - twenty (120) days from that date. ANTI -COLLUSION STATEMENT THE UNDERSIGNED PROPOSER HAS NOT DIVULGED TO, DISCUSSED, OR COMPARED HIS PROPOSAL WITH OTHER PROPOSERS AND HAS NOT COLLUDED WITH ANY OTHER PROPOSER OR PARTIES TO THE PROPOSAL WHATSOEVER. PROPOSER ACKNOWLEDGES THAT ALL INFORMATION CONTAINED HEREIN IS PART OF THE PUBLIC DOMAIN AS DEFINED BY THE STATE OF FLORIDA SUNSHINE LAW. CERTIFICATION AND DENTIFICATION FOR PROPOSERS SUBMITTING PROPOSALS. I certify that this proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a proposal for the same service, and is in all respects fair and without collusion or fraud. I agree to abide by all conditions of these proposal specifications and I certify that I am authorized to sign this proposal. (Please Type or Print Below) LEGAL NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: MACtown, Inc. MAILING ADDRESS: 151 NE 62nd Street CITY STATE, ZIP CODE: Miami, Florida 33138 TELEPHONE NUMBER: p5-758-4485 BY: SIGNATURE BY: TYPED Clinton Bower TITLE: Chief Executive Officer ii M4C towfi Inc. "Furthering the Independence ofAdults with Developmental Disabilities" MACtown, Inc. was originally founded in 1962 as the Miami Adult Center for the Retarded by family members and friends of the disabled. MACtown, Inc. has been at its location in the neighborhood of Little Haiti since its inception. Historically, the organization has had a strong presence in the Haitian community both in the people they serve and the caring and dedicated employees. MACtown, Inc.'s ICF (Intermediate Care Facility) provides care to 56 residents. Typically these individuals need a level of care than higher than can be provided in other settings in the community due to either behavioral or health concerns. At our main campus, we provide Adult Day Training services to over 120 adults at 3 different locations. The training focuses on academic and social skills as well as Activities of Daily Living. This Adult Day Training Center has had an on -going relationship with Edison Middle School in allowing those students to experience an Adult Day Training program and allowed the educational professionals that have come with them the opportunity to observe the students in this setting. Supported Employment services are currently being provided to 15 developmentally disabled adults in a variety of paid competitive positions. In the 20 plus years MACtown has been providing this service over 100 people have been successfully placed, and Supported Employment services have been gradually faded. Most of them still remain on their respective jobs. MACtown, Inc. also provides services in 4 community -based group homes with 6 adults in each home. MACtown, Inc. also operates a restaurant located on NE 2"d Ave called Cafe MAC which is staffed completely by disabled persons, along with the services of 2 Supported Employment Specialists. The Cafe is open to the general public 6 days per week. 4 of the employees are Supported Employment clients who will work there are minimum of 6 months to receive the training necessary to be placed in similar work in other community based settings. The other 10 employees work as trainees for 3 hours per day so they can eventually be placed in full time positions at the Cafe. The Cafe is funded partially by the Able Trust, which awarded MACtown, Inc. a grant, and is operated solely as a venue for training disabled persons in the area of restaurant operations, an area of great need in the service industry oriented economy of the greater Miami area. On the main campus of the facility is a full size swimming pool, exercise room, full kitchen, and ample and lush green spaces. The City of Miami is in the midst of developing a new park Tess than 200 yards from the campus. This park will have numerous athletic fields including: soccer fields, baseball diamonds and tennis courts. MACtown, Inc. employs 3 full time Board Certified Behavior Analysts, 1 full time Registered Nurses, and 4 full time Licensed Practical Nurses. A registered dietitian works 25 hours per week for dietary consultation. We also have a management staff of 3 full time QMRP's (Qualified Mental Retardation Professional) and numerous other staff with extensive experience working with both adults and children with disabilities. MACtown, Inc. is licensed by the AHCA (Agency for Health Care Administration) to provide ICF services to 56 residents. The organization is reviewed annually by AHCA to ensure compliance with all state and federal regulations. All programs are monitored and reviewed at least annually by the various governmental entities (i.e. AHCA, APD, Delmarva and MAXIMUS). MACtown, Inc. has received exemplary reviews by the aforementioned entities. The mission of MACtown Inc. is to foster a community in which disabled people have the opportunity to participate fully in a creative and challenging environment that values their culture and uniqueness and provides opportunities to reach their greatest potential and independence. MACtown, Inc. has a long and valued history within the "Little Haiti" Community of Miami and based upon this history believes that it is the responsibility of the organization to return something to the community by providing this service to the children of the community which will enrich and improve their lives through the provision of quality Supported Employment Services to children transitioning out of the public school system. Required Information: A. Documented completion of appropriate coursework/training in the area of Supported Employment. Attached are the certificates for employees currently working in the Supported Employment Department of MACtown, Inc... These certifications come as result of contract MACtown, Inc. has to provide Supported Employment Services through the Home and Community Based Waiver and the Division of Vocational Rehabilitation. TRN computer based training modules were utilized to achieve the required 40 hours of training. All of the existing employees have been working in the area of Supported Employment in excess of 3 years, and all have extensive experience n the field of developmental disabilities. Any additional Supported Employment Specialists will complete certification prior to work under the MDCPS Contract. B. The agency must identify a liaison to coordinate service delivery. Kevin Edwards is Director of External Services, which encompasses the area of Supported Employment. Mr. Edwards has over 20 years experience in serving the disabled. He has worked in Residential, Pre -vocational and vocational settings. Prior to coming to MACtown, Inc., he was the contract Liaison between United Cerebral Palsy Association of Miami, Inc. and Miami -Dade County Public Schools for Supported Employment Services to SPED students. In his position as Liaison for MACtown, Inc. he will establish and maintain an effective rapport with Contract Administrator (Jill Brookner) and her staff, along with the Transition Specialists at each assigned Educational Center. He will assure contract compliance at all times and oversee the job performance of all Supported Employment Specialists (Coaches). He will work closely with each Transition Specialist, Transition Teachers, TMH, EMH, and Autistic Program Teachers and paraprofessionals listed in the contracted service areas to ensure each student has his or her needs met and that all referrals are handled in a timely manner. Mr. Edwards will also be responsible to schedule meetings with school principals, assistant principals, department heads to insure coordination of services meets the needs of each individual school. Currently Mr. Edwards has an established relationship with both Edison Middle and Edison High School in serving some of the TMH students in those two educational centers. C. Provision of Supported Employment Services Services will be provided to students from any Miami -Dade County Public School who has disabilities classified from moderate to severe. These students can come from programs designed to serve students who are PMH, TMH, EMH or Autistic and are in the transitional phase of their educational experience. The Director (Liaison) and Supported Employment Specialists (Coaches) will review all referrals and current Supported Employment students at each school. They will arrange interdisciplinary team meetings (teachers, paraprofessionals, families, students and other support system members) to assess current vocational skill level and level of support/training required for each student. The Director will attend IEP Meetings to review the Supported Employment Program and how it will affect the student's transition out of school. At that time, if the referral is deemed to be beneficial to the student by the family member/guardian, teacher and school transition team members the Supported Employment Specialist will collect all the needed data to begin Job Development for the student. A Supported Employment Specialist (Job Coach) will be assigned to each school and to each student specifically. A "back-up" Job Coach will also be involved at each school to ensure continuity of services in the event the assigned Job Coach is unavailable. One Supported Employment Specialist (Job Coach) will be assigned to each school until the caseload at that school exceeds 5 students (students who are considered Phase I by VR, defined as a student who is seeking employment or getting needed skills/training to begin working in the competitive employment market), at which time a second Specialist will be assigned, or until 15 referrals for Phase II (Phase II is defined as students placed in established, competitive employment longer than 180 days according to VR). A Supported Employment Specialist may be assigned to more than one school if the student to coach ratio does not exceed those listed above in order to maintain a full caseload. Each student will receive one to one coaching as needed in order to obtain and maintain employment. Depending on the severity of the disability, the level of intervention will vary from student to student based upon their individual needs. This level of support will be provided on -going, year round as needed, and will faded out as natural supports in the workplace are developed. After graduation, students who are eligible for services under the Home and Community Based Waiver will be referred for Supported Employment Services at a level and intensity necessary to maintain competitive employment. For those students not eligible for services under the waiver, or who may be on a waiting list for services, paid supports will be provided through other means, i.e. Vocational Rehabilitation, Alliance for Human Services Grants, or natural (unpaid) supports. All support services will continue to be coordinated through MACtown, Inc.. On -going communication will be facilitated by Supported Employment Specialist between family/guardian and other supported systems in the student's life. D. Evidence of licensure/certification. Certificates attached E. Documentation of experience Resumes attached F. Appropriate SE coursework Certificates attached G. Documentation of Bi-lingual capability Samilla Quintana -Supported Employment Specialist TBA-one Creole speaking Job Coach H. Documentation of type and frequency of supervision including the positions and qualifications of staff members who will provide supervision. The Program Director, Mr. Edwards will be responsible for the supervision of all Supported Employment Specialists, once the caseload supports 5 SE Specialists (Coaches) a Program Coordinator will be hired to assist in supervision, the Program Coordinator will be certified in Supported Employment and have a minimum of a Bachelors Degree in Special Education or a related field or a minimum of 5 years experience in DD or related field, with a minimum of 2 years supervisory experience. The Program Director will meet weekly with Supported Employment Specialists to review caseload and individual progress for each student assigned. Staff will be monitored in the field at least every two weeks, either at job site or in the school. The Director will assess level of training being provided and amend/revise as needed. He will maintain an on -going rapport with students, job site supervisors, school faculty and family members to monitor effectiveness and quality of training being provided by each Supported Employment Specialist for each student. Each student and Supported Employment Specialist will be monitored regarding goal progress and timelines for employment benchmarks. Once a referral is received and the student is ready to work, the Supported Employment Specialist will strive to fmd job placement within 30 days. The Supported Employment Specialists will be required to provide proof of Job Development each week for the student assigned to his/her caseload. The Director, along with other team members will coordinate the job development, job matching, on-the-job training and follow-up services necessary to ensure the successful transition of the student from school to paid competitive employment and ensure their on -going success through follow-up and re-training as necessary. I. Liaison information See Question "B" above J. See attachment B K. See attached "Anti -Collusion" Statement L. See attached letters of reference M. See attachment C N. See attachment D O. See attachment 0 SUPPORTED EMPLOYMENT SERVICES FOR THE EDUCATION OF STUDENTS WITH DISABILITIES ATTACHMENT 6 PROPOSER'S FEE AND CERTIFICATION OF HOURS OF SERVICES PROPOSER'S FEE Hourly Fee $32 •00/$8.00 per 4 hour LEGAL NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: MACtown, Inc. AUTHORIZED SIGNATURE: NAME TYPED: POSITION: Clinton Bower Chief Executive Officer Vendor Information Sheet 1A. 59-6135600 Federal Employer Identification Number Or Owner's Social Security Number 1B. MACtown, Inc. Name of Firm, Individual(s), Partners or Corporation 151 NE 62nd Street Street Address Miami, Florida 33138 City State Zip Code 3. Ownership Disclosure ATTACHMENT C 2. Telephone/Fax/Contact Person 305-758-4485 Telephone member 305-756-9990 Fax number Clinton Bower Contact Person clintb@mactown.org E-mail address If the contract or business transaction is with a corporation, partnership, sole proprietorship,or joint venture, the full legal name and business address shall be provided for the chief officer, director, or owner who holds, directly or indirectly the majority of the stock or ownership. If the contract or business transaction is with a trust, the full legal name and address shall be provided for each trustee and each beneficiary. Post Office addresses are not acceptable. Name Title Address Gender Race - ethnicity Stock Ownership Clint Bower CEO 1464 NE 133rd Road M C N/A N. Miami, F1 33161 NOTE: The information provided by the vendor on this form should be consistent with that provided on the "Vendor's Application". All vendors must have a current vendor's application on file with M-DCPS, and have provided information and/or be familiar with M-DCPS' policy regarding the following: (a) Employment Disclosure, (b) Drug Free Workplace, (c) Family Leave Policy, (d) Code of Business Ethics, (e) Conflict of Interest, (f) Perception, (g) Gratuities, and (h) Business Meals. Failure to provide M-DCPS a current vendor application may cause the vendor not to be awarded any new business with M-DCPS. Vendor applications can be downloaded at: http://procurement.dadeschools.net AFFIRMATIVEACTION EMPLOYMENT BREAKDOWN. ATTACHMENT D Race/Ancestry Non- Non- Am. Incl./ Gender Hispanic Hispanic Alaska Occupational Category Male Female White Black Hispanic Asian Native DI r-e A, / ' / / FM-4859 Rev. 102-01) Miami -Dade County Public Schools SWORN STATEMENT - NEW CONTRACTS ATTACHMENT E SWORN STATEMENT PURSUANT TO SECTION 1012.465, FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to The School Board of Miami -Dade County, Fl (Hereinafter `Board" or "School Board") by Clinton Bower, CEO for (Print individual's name and title) MACtown, Inc. (Print Name of entity submitting sworn statement) whose business address is 151 NE 62nd Street MIami, Florida 33138 and9its -6135600 Federal Employer Identification Number (FEIN) is 5If the entity has no FEIN, include the Social Security Number (SSN) of the individual signing this sworn statement and so indicate. 2. I Clinton Bower , am duly authorized to make this (Print individual's name and title) sworn statement on behalf of MA C t o w n , Inc . (Print Name of entity submitting sworn statement) 3. I understand that during the 2005 Legislative Session, House Bill 1 877, The Jessica Lunsford Act (hereinafter "The Act" or "Act") was passed and approved by Governor Bush on May 2, 2005, with an effective date of September 1, 2005. Initials Page 1 of 3 FM-6910 (08-05) 4. I understand that the Act amends the background screening requirements of section 1012.465, Florida Statutes (2004) for all non -instructional school district employees or "contractual personnel" by requiring all non -instructional school district employees or contractual personnel who are permitted access on school grounds when students are present to undergo and pass "level 2 background screening," and further' understand the Act defines "contractual personnel" to include any vendor, individual, or entity under contract with the Board. 5. I understand that pursuant to section 1012.465, Florida Statutes as amended by the Act, non - instructional school district employees or contractual personnel who are permitted access on school grounds when students are present, who have direct contact with students or who have access to or control of school funds must meet level 2 screening requirements as described in sections 1012.32 and 435.04, Florida Statutes. 6. I understand that as aPrivate Business Contractor (eg. aprivatebus Type of entity service contractor) all contractual personnel, as defined in section 1012.465, Florida Statutes, must meet level 2 screening requirements as outlined in sections 1012.32 and 435.04, Florida Statutes in order to do business with The School Board of Miami -Dade County, Florida. 7. I understand that "level 2 screening requirements," as defined in sections 1012.32 and 435.04, Florida Statutes means that fingerprints of all contractual personnel must be obtained and submitted to the Florida Department of Law Enforcement for state processing and to the Federal Bureau of Investigation for federal processing. 8. I understand that the School Board will implement local procedures to comply with level 2 screening requirements, as defined in sections 1012.32 and 435.04. I understand that my company must comply with these local procedures as they are developed. 9. I understand that any costs and fees associated with the required background screening will be borne by my company. 10. I understand that any personnel of the contractor found through fingerprint processing and subsequent level 2 background screening to have been found guilty of, regardless of adjudication, or entered a plea of nolo contendere or guilty to any offense outlined in Section 435.04, Florida Statutes (or any similar statute of another jurisdiction), shall not be permitted to come onto school grounds or any leased premises where school -sponsored activities are taking place when students are present, shall not be permitted direct contact with students, and shall not be permitted to have access to school district funds. Initials Page 2 of 3 FM-6910 (08-05) 11. I understand that the failure of any of the company's or my affected personnel to meet level 2 screening standards as required by section 1012.465, Florida Statutes, may disqualify my company from doing business with The School Board of Miami -Dade County, Florida. 12. I hereby certify that the foregoing statement is true and correct in relation to the company for which I am submitting this sworn statement. I further certify that this statement is being given knowingly and voluntarily by me on behalf of my company. The company submitting this sworn statement agrees to be bound by the provisions of SECTIONS 1012.32, 1012.465, AND 435.04 OF THE FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT 2005. I CERTIFY THAT THE SUBMISSION OF THIS FORM TO THE SCHOOL BOARD OF MIAMI- DADE COUNTY, FLORIDA ON BEHALF OF THE COMPANY IDENTIFIED IN PARAGRAPH ONE (1) ABOVE BINDS THE COMPANY TO FULLY COMPLY WITH THE BACKGROUND SCREENING REQUIREMENTS OF SECTIONS 1012.32, 1012.465, AND 435.04, FLORIDA STATUTES. (Signature) Sworn to and subscribed before me this 07 day or , 20 Vt. Personally known r/ OR Produced Identification Notary Public -State of jAfteetk My commission expires Initials (Type of Identification) 4/4)/a 00 g . Violet Anne Gonzalez Commission #DD307305 Expires: naed Apr7 06, 2008 �p niu „`. PoAtlantic l�gnding Co., Inc. (Pnn'led typed or srfiped commiss name of notary p lic) Page 3 of 3 FM-6910 (08-05) cog�o¢�C eoozciinakuz9 & C'onsut.9, .ina. Phone: (305) 595-4787 Fax: (305) 595-4226 10050 S.W. 123 Avenue Miami, FL 33186 January 17, 2007 TO; Division of uocatiQnal.:Rehabilitation Re MATtowri, Inc: Su —pp- orted Employment Services Contract It is my privilege to inform you that have placed numerous Developmental Services consumers in MACtown, Inc.'s Supported Employment Program. These consumers have been placed in jobs in the community and have been quite successful. The job placement and follow -along services provided by MACtown, Inc. have been excellent. I support their application to become a Vocational Rehabilitation Contractor. Feel free to contact me personally if you have any questions. Sincerel odriguez, Waiver Support Coordinator To: Vocational Rehabilitation I have worked with MACtown, Inc. over the past couple of years as they have been providing Supported employment to one of our employees. I support their application to become a Vocational Rehabilitation Contractor. Please contact me if you have any questions. Sincerely Michael -Reis 305-935-2969 ke To: Vocational Rehabilitation I have worked with MACtown, Inc. over the past couple of years as they have been providing Supported employment to one of our employees. I support their application to become a Vocational Rehabilitation Contractor. Please contact me if you have any questions. Sincere Santiago Int r - - tment otel 30- 372-4406 ke 943 NE 120 ST. • :'''ii_a:''.ii FL • P-1OX = $97-; 3$ 86; 251-8'54 OBJECTIVE EXPERIEN CE KKVIN F;'.D\ ARI)S To continue to grow- and learn fiona..consumers-of social services and to be a part of a productive team that reflects my dedication to individual growth for all consumers. 2002-Present United Cerebral Pals`- Miami, FL Assistant Director of Residential Services m Supervise Program Coordinators and monitor the overall operation of the group homes • Supervise the Department of Maintenance for 14 facilities • Insure that APD, DCF, HUD, fire and health codes are in compliance ■ Responsible for hiring committee; reviewing applications, interviewing and assisting in training new staff • Coordinate licensing for the group homes 1999 - 2002 United Cerebral Palsy • Pro<ram Coordinator ■ Supervised overall operations of two group homes • Responsible for hiring, training and supervising 15 staff ■ Assisted in moving a group home to a new location Miami, FL 1998 - 1999 Project Home Philadelphia, PA Program Coordinator • Supervised thirty single room occupancy apartments, housing formally homeless mentally ill adults • Provided case management for e,.cl. resident to ensure the cycle homelessness 7,7as broken ▪ Supervised Residential Counselors e Assist in advoca - program to educatt landlords and to assist- others in providing housing to the homeless EDUCATION TihiTabelphi..1 _ fiL C27e 2 PICrCiCkil Case .-1-1a112,,zcmerri: for HIV-- rnentally ill COI uircr in HOP \):',A funded housing, 'program Monitored residents for possible drug use and insured that druL prevention programs were followed E Assisted in the partial hospital program for HIV drug addicted consumers a Led group discussions to combat depression and drug addiction 1991 -1995 SERV Centers ,Inc Trenton, NT , Residential C01/11.re 101" ig Provided case management services in a HUD funded housing -program for twenty two mentally ill consumers recently reintroduced into the community. 1980 - 1981 • Religion Trevecca College Nashville, TN • • • • Certificate of Completion This training provides 18 hours of on-line pre -service or continuing education training in the following topic: Job Coaching and Consulting ,t This is to document that: Kevin Edwards United Cerebral Palsy of Miami Miami FL has completed a web -based training curriculum and passed a post-test on: Oct 2006 Presented by: Dale DiLeo, Lead Trainer TRAINING RESOURCE NETWORK • PO BOX 439 • ST. AUGUSTINE, FL 32085-0439 904-824-7121 • FAX: 904-823-3554 • info@trninc.com • http://www.trninc.com Sharon Higgs 1060 NW 66th St. Miami FI Miami FI 33150 786-537-5288 SKILLS Cosmetology Medium Typist Electronic Calculator Direct Care Multi -phone Lines Community Specialist General Office Duties Data Entry General Maintenance Sales/ Cashier Supportive Employment coordinator English EDUCATION 75-78 Miami North Weston Senior High 7100 NW 12ave Miami FI 33150 EMPLOYMENT Mac Town Inc. 10102 - still 151 NE. 62nd St. Miami FI 33138 11199-10102 Various options while here which include But not limited to the care of residential Clients, transportation, and group home Care and SE coordinator. Braids by the bay (Own Business) 401 Biscayne blvd. Suite 104 Hair braiding and designs 2198 -10199 Parrot Bay &Garden South Sheraton Balhabor Hotel Collins Ave. Reference Patricia Newkirk 940 Nw 43St Miami . FI 33147 Elousie Sheffield 9065 NW 32nd Ct. RD Miami Fi Assistant Mang. Sales, purchasing, QA. Customer satisfaction Betty Oliver 775 NW 51st St. Miami Fl. This training provides 12 hours of on-line pre -service or continuing education training in the following topic: Orientation to Supported Employment This is to document that: Sharon Higgs MACtown, Incorporated Miami FL has completed the web -based training curriculum: Mar 2006 TRAINING RESOUROE NETWORK • PO BOX 439 • ST. AUGISTINE, FL 32085-0439 904-824--7121 • FAX: 904-823-3554 • info@trninc.com •'httpJ/www.trninc.com F F�i 4 i^i•,01.� >: `skis as �w- This training provides 12 hours of on-line pre -service or continuing education training in the following topic: Tools of Supported Employment t This is to document that: Sharon Higgs MACtown, Incorporated Miami FL has completed the web -based training curriculum: Presented by: Dale DiLeo, Lead Trainer TRAINING RESOURCE NETWORK • PO BOX 439 • ST. AUGU TINE, FL 32085-0439 904-824-7121 • FA ,: 904-823-3554 • info@trninc.com • hp'://www.trninc.com SKILLS Medium Typist Electronic Calculator Multi -phone Lines General Office Duties Machine Operator Industrial Cleaner Bilingual: English -Spanish EDUCATION 09/90.06/92 EMPLOYMENT Samila Quintana 803 SW 8th Street Hallandale Beach, FL 33009 954-793-6831 Word Processing Direct Care Community Specialist Data Entry General Maintenance Restaurant Management J.R. McCaskey HIGH SCHOOL 445 N. Reservoir St., Lancaster, PA 17602 Diploma Mac Town Inc. 11105 - still 151 NE. 62nd St. Miami FI 33138 07105 —11105 08/04 — 06105 Various options while here which include But not limited to the care of residential Clients, records specialist, Kitchen cook, Portion control, and cafe coordinator, And supportive employment coordinator Gulf stream park/ Horse Track 901 S Federal Hwy Hallandale Beach, FL 33020 Maintenance personal Duties include but not limited to The cleaning of offices and grounds, Stables, and track, parking lots and General repairs as needed. Anna house keeping 3500 N State Road 7 Fort Lauderdale, FL 33319 Receive house calls for daily jobs Assure satisfaction in the cleanliness Of my client's homes 01103 -02104 04/99.11101 02/94-11/01 Reference Wanda Santiago 5929 Pier St. Hollywood FL. 33001 Terry Perez 2740 NE 214 Terr. Aventura FL 33109 Taco Bell 1340 Columbia Ave Lancaster Pa 17603 Duties included but are not limited to Taking order, making of orders, and quality Q.A., the sanitation of food surfaces and Cleanliness, stocking product, and Assist in inventory at the end of the month. Business Staffing 1525 Oregon Pike Lancaster, PA 17602 Executive asst. Duties included but are not limited to daily Processing of appeals, processing of incoming and outgoing mail, filing, translation of documents, typing, Scheduling, drug screening, and locating and assisting in training of new hires Assisting in the training of new hires Keystone residence of Lancaster 104 Tracy Ct Willow Street, PA 17584 Community care specialist Duties included but not limited to the daily Care of client in there own home setting To empower them to achieve there goals Get them as involved in the community as possible Monthly, quarterly and yearly report on Medical, physical, and financial Information. Wanda Torres 835NE8thST Hallandale FL 33009 puacnta to: cvmi,Ga. 04,t,i4vticina ascanA413, g>.4xe2: 91,► 2006 imj 2730Somerset Drive V301 Lauderdale Lakes, FI. 33311 Objective Expsnence 954-446.4319 e-mail bis57570.hotmail.com Beverly Jones -Seymour To obtain a challenging and responsible position in a group home setting, (organization) providing hands-on experience with individuals with Developmental Disabilities. 1999-August 2004 United Cerebral Palsy of Miami Program Coordinator • Direct supervision of two -behavior group homes • Evaluate and assess staff job duties • Staff scheduling and supervision Miami, Fl. • Personal ar InStruGtor Su�eiafi5ton 3tad trainin 45._ _.-eonsumei finances • iPP implementation • Implementing/formulating Individual Habilitation Plans and Behavior Management Plans • Direct family contact • Familiar with DCF guidelines 1997-1999 United Cerebral Palsy of Miami Miami, FI. Coordinator of Supported Employment • Staff and consumer supervision • CARF accreditations • Job development/Follow-up • On the job training • Work Crew • S.E. Monthly Billing • IPP implementation • Case notes 1995-1997 United Cerebral Patsy of Miami Supported Employment Consultant • Job development • Follow-up • On the job training • iPP implementation • Case notes 1992-1995 Home Manager Miami, FI United Cerebral Palsy of Mid Coast Counties Education Jteler :: Current Pos ion • IPP implementation • Doctor appointment/scheduling • Consumer Finances • Staff scheduling/supervision 1991-1992 United Cerebral Palsy of Mid Coast Counties Direct Care Aide • Assist developmentally disabled consumers with all aspects of daily living skills 1970-1972 California University California PA pffssiQi .aRci p r Qn fumAikct u. rtgjest October 2004 — Present Archways Facility Manager Direct supervisor of a 26 co-ed dually diagnosed population Evaluate and assess staff job duties Staff scheduling and supervision Residential Staff Person supervision and training Daily client documentation Conduct weekly group sessions Implementing/formulating Individual Treatment Plans Attend client staffing Ft Lauderdale, FL Direct contact with Case Managers Mental Health Technician Certified CARF Accreditation Reference upon request. 1fjiO Certificate of fpucceoofuf Completion of .8jbourss of re-ethite 1raining for Oupporteb ntptopment = peciatit t5 berebp granteb to: V LESLIE WILSON, M.S. JANUARY 23, 2005 Supported Employment Services For The Educationsf S*udents With Disabilities Request For Proposal Response Name and Address of Requestor: Miami -Dade County Public Schools Office of Exceptional Student Education and Psychological Services 1500 Biscayne Blvd, Suite 409 Miami, FL 33132 Name and Address of Proposer: Work Opportunities Unlimited Contracts, Inc. 9000 Sheridan St., Suite 101 Pembroke Pines, FL 33024 Intent of Proposer: At this time, Work Opportunities Unlimited is submitting this proposal to provide 3 job coaches and provide 4500 hours of services within the contract year of July 1, 2007 to June 30, 2008. It is our intent to provide services within our capability and to produce outcomes that may provide us the opportunity to increase the number of job coaches and service hours with the approval of Miami -Dade Public Schools. A. Company Supported Employment Experience In 1982, Work Opportunities Unlimited was founded to assist individuals with barriers to employment to secure successful community -based competitive employment. The Mission and philosophy established and promoted at that time has turned a "one -person" operation into a company with a workforce of over 200, that serves over 2,000 adults and students annually throughout the states of Maine, New Hampshire, Massachusetts, Rhode Island, Maryland and Florida. In addition to private citizens Work Opportunities Unlimited provides services to individuals referred by school districts, welfare, Mental Health Agencies, Developmental Disability Agencies, Vocational Rehabilitation, the Department of Children Youth and Families, and the Social Security Administrations through the Ticket to Work program. Below are the employment results from 2005 and the Mission Statement and Core Values that have been adopted by the Governing Body and can be seen within the fabric of the office teams and ultimately in the outcomes for all customers: 2005 Employment Results Supported Employment Served-419 Working-289 Naturally Supported-147 Mental Health Served-46 Placed-37 Closed-17 Time To Secure Job Placements 16% 32% 16% 36% ■ 1-10 Days ■ 11-30 Days 031-90 Days ❑ More 90 Days Vocational Rehabilitation Served-620 Placed-402 Closed-274 Schools/DCYF Served-425 Mission Statement We create new opportunities for success in the workplace, every day! Core Values • We believe that all people can work. • It is our responsibility to change the world of work. • We believe in individual initiative and dignity. • We are a pioneering and creative organization. • We build successful, reciprocal relationships. • We are never satisfied. B. Agency Liaison: Ryan Mountain -Vice -President of Program Development (Resume Attached) 603-767-6948 C. Supported Employment Services Design The goal of our services is to create a seamless transition from school to work. Through community -based internships and long-term job placement we are able to give students the opportunity to experience work that will influence their course of study and assist them starting on a career path. Each student is very different therefore a menu of service (Appendix A) will be utilized to create the specific services needed for each student. Below is a list and brief description of the services that appear on the menu: • Program Registration- Select program components that will give each student the best work -based learning experience. The school will receive signed consents and information release forms. • Employment Preparation Assessment- Assess and teach job seeking skills that will assist the student in obtaining and retaining community -based employment. This can be done one on one or in a group setting. The school will receive an assessment report and a copy of the student's resume. • Transition/Career Planning- This planning process helps the student organize their goals and objectives related to school, vocational aspirations, and transition. Parents are encouraged to participate in this opportunity to have an impact on their son/daughter's transition services. The school will receive a copy of the student's plan. • Vocational Exploration and Assessment- Through the utilization of community -based internships, local Career Centers, and company tours, we will be able to assess the technical skills of the student and at the same time learn about the student's interests. The school will receive all documentation pertaining to a student's performance on the job including written employer feedback. • College Tours -Our transition services also include helping students and families identify and access post -secondary educations resources. • Transportation Training- In order to facilitate access to community employment and education, a student can be trained on the public transportation system in their community. The school will receive a Transportation Assessment that will outline the student's proficiency at navigating the public transportation system. • Student Portfolio- With the assistance of our staff, the student will produce a Student Portfolio that will include documentation of all services including employer assessments. The school can receive sample copies of portfolios or a copy of each student's portfolio. • Paid Job Placement- The goal here is to make a successful job match that results in successful employment in the community. The school will receive a Placement Notification and a Job Analysis. • Volunteer Placement- The goal is to make a successful job match that results in a successful unpaid volunteer experience. The school will receive a Placement Notification and a Job Analysis. • Training and Support- This service ensures that the student has the necessary skills and supports to remain positively connected to his/her work environment_ Progress reports will be submitted to the school for as long as the support is authorized. Services will be provided year-round, and at this time we are proposing to provide 3 job coaches to provide 4500 hours of service. It will be our responsibility to provide up to 4500 hours of service and will therefore utilize qualified substitute staff if we experience turnover. Ha request is made to provide more than 3 job coaches, then we will assess our ability to meet that request at the time it is made. If we are able to meet the request in a manner that will result in positive outcomes for the students then we will do so. As students prepare to leave high school and enter adult services, Work Opportunities Unlimited will assist in the transition process. As an adult supported employment provider we are able to, not only educate students and families about adult services, but we can provide the direct service as well. D-G. Staff Qualifications Ryan Mountain (Liaison) - 12 years experience in supported employment -Resume attached (Appendix B) Joseph Leddy (Management) - 40 years experience in the vocational rehabilitation field - Resume attached (Appendix B) David Dwyer (Management) - 17 years experience in supported employment - Resume attached (Appendix B) Alfredo Sanchez (Job Coach 1) -10 years experience in the vocational rehabilitation field - Resume, 18 hr. supported employment training certificate, evidence of being bi-lingual Job Coach 2- To be determined -The person will have a Bachelors Degree in a related field and will undergo the 18 hr. Supported Employment Pre -Service Training acknowledged by the Agency for Persons with Disabilities. Job Coach 3- To be determined -The person will have a Bachelors Degree in a related field and will undergo the 18 hr. Supported Employment Pre -Service Training acknowledged by the Agency for Persons with Disabilities. H. Supervision Mr. Sanchez will be our initial job coach who will provide job development and training services. Work Opportunities Unlimited will also recruit, hire, and train two additional job coaches. The principal supervision will be provided by Ryan Mountain in conjunction with support from David Dwyer and Joseph Leddy. Joseph Leddy will provide weekly supervision by observing Mr. Sanchez in the field providing services to students. In addition Ryan Mountain and David Dwyer will combine to provide monthly observations in the field in addition to quarterly quality control meetings with Miami -Dade Public School representatives. All student files and outcomes will be monitored using an on-line database. This database will store all monthly reports and employment related documents. The database will also track the performance of each staff person (job coach) through the completion of service outcomes, which are determined through the utilization of the service menu. Ultimately each staff person is evaluated at 90 days and then again at their anniversary date of hire. Satisfaction Surveys will also be disseminated to school representatives, students/families, and employers. I. Liaison Identification Ryan Mountain is the designated liaison due to his extensive experience with providing employment services to high schools throughout New England. Mr. Mountain began his employment at Work Opportunities Unlimited in 1994. At that time he provided supported employment services including job development and job coaching to adults. He went on to provide job placement services to adults referred from Vocational Rehabilitation as well as for youth from the Dept. of Children Youth and Families. From 1996-1999 he managed a supported employment program that served 100 individuals and employed up to 18 employees. In 2000, Mr. Mountain began providing employment services to students with significant disabilities. Mr. Mountain spearheaded the creation of the Career Links model of service that has been used to provide services to high school students since the year 2000. Since that time Work Opportunities Unlimited has provided services to over 50 school districts and 500 students throughout New England. Mr. Mountain has consulted with school districts throughout New England to create supported employment service models that are a best fit for the school district. The consultation includes: service delivery mechanisms, content of each service, staff training, and ongoing quality control. SUPPORTED EMPLOYMENT SERVICES FOR THE EDUCATION OF STUDENTS WITH DISABILITIES ATTACHMENT ES PROPOSER'S FEE AND CERTIFICATION OF HOURS OF SERVICES PROPOSER'S FEE Hourly Fee LEGAL NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: Ky g1%7 Cie" fc!✓r t 'Tge.S £° AUTHORIZED SIGNATURE: NAME TYPED: POSITION: Pre& cke r�1 l .ti+ k J c T S rt L+ f THE SCHOOL BOARD OF MIAMI-DADE COUNTY, FLORIDA PROCUREMENT MANAGEMENT SERVICES 1450 N.E. 2ND AVENUE, MIAMI, FLORIDA 33132 REQUEST FOR PROPOSALS NO. 056-GG10 SUPPORTED EMPLOYMENT SERVICES FOR THE EDUCATION OF STUDENTS WITH DISABILITIES Sealed proposals will be accepted in Procurement Management, at the above location, until 2:00 P.M. (Local Time) May 3, 2007, and may not be withdrawn for one hundred - twenty (120) days from that date. ANTI -COLLUSION STATEMENT THE UNDERSIGNED PROPOSER HAS NOT DIVULGED TO, DISCUSSED, OR COMPARED HIS PROPOSAL WITH OTHER PROPOSERS AND HAS NOT COLLUDED WITH ANY OTHER PROPOSER OR PARTIES TO THE PROPOSAL WHATSOEVER. PROPOSER ACKNOWLEDGES THAT ALL INFORMATION CONTAINED HEREIN IS PART OF THE PUBLIC DOMAIN AS DEFINED BY THE STATE OF FLORIDA SUNSHINE LAW. CERTIFICATION AND DENTIFICATION FOR PROPOSERS SUBMITTING PROPOSALS. I certify that this proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a proposal for the same service, and is in all respects fair and without collusion or fraud. I agree to abide by all conditions of these proposal specifications and I certify that I am authorized to sign this proposal. (Please Type or Print Below) LEGAL NAME OF AGENCY ORted CONTRACTOR SUBMITTING PROPOSAL: (JO / (� �(�; r vn� 1,e.5 (j (w C``A4-(4-`1- , c. MAILING ADDRESS: .72 OCO S e. Ski `k /0 / CITY STATE, ZIP CODE: / F'vn 6 , lle P<4e.5 1 FL 33 U TELEPHONE NUMBER: 9/ S /— 3 fir— 6 7' 749- 45°'/x7D9 ,� / �1 BY: SIGNATURE ( 14/ YrS, BY: TYPED Skoh.e,i 4, A1//oc, TITLE: Re s January 3, 2007 I write an endorsement for Work Opportunities Unlimited (WOU). The services this company provides to my students is excellent and second to none! WOU is and organization whose staff and employees understand students, their academic, social, pre - vocational and vocational needs. WOU works in strong partnership with my district in order to assist students in the development of the work skills within the "content" domain as well as within the affective domain. WOU staff cares for and about those people with whom they work --the administrators, teachers, students and each other. Their partnership and their ability to move forward even under the most difficult circumstances is unparalleled! If you are looking for an organization to assist you in increasing the success of your students, one that can work in partnership, develop new skills and understanding related to transitioning to the world of work, look no further. You have found the organization that can do it. Without reservation, I wholeheartedly encourage you to contract with WOU. Your students will be the beneficiaries of such a wise decision on your part. Sincerely, Carole Smith, Ed.D Special Services Director MSAD #35 180 Depot Rd. Eliot, ME January 8, 2007 Good Afternoon, Work Opportunities has provided everything from Career Plans and Work Readiness Assessments to on -site support, Transition Planning Trainings for parents, facilitation of transfer to adult services, college tours, mobility training for students, and comprehensive career/work assessments. 1 have found them to be thorough, knowledgeable, professional and very dedicated to the students they become involved with. The have proven to be a tremendous asset to the Team, the student, and the parent, and always cultivate the very information you are looking for when considering appropriate transitions from high school to post secondary settings. I have used them now in two different positions/districts and have been very pleased with the services I have received from them for the past 8 years. Ken Kramer, MA, MEd Assistant Director of Special Education, Belmont Public Schools, Belmont Massachusetts *Originally written as an email January 3, 2007 To Whom It May Concem: can only say positive comments about Work Opportunities. In my previous job as well as in my current job, I had terrible transition services for students with autism, emotional disabilities, and MR. I was able to restructure programs with the help of Work Opportunities, where they actually helped in some of the students transition planning, work experiences, some instructional skills such as budgeting, and above all on the job training based on the needs of the students. All programming was individualized. Please call me if you have any other questions, I would be happy to talk more about the great work that Work Opportunities does for our students. Dominic DePatsy Director of Instructional Support Cape Elizabeth 207-799-3987 ddepatsyacape.k12.me.us *Originally written in an email message MAINE SCHOOL ADMINISTRATIVE DISTRICT NO. 35 ELIOT AND SOUTH BERWICK 47 Dow Highway TEL (207) 439-2438 Eliot, Maine 03903 FAX (207) 439-2531 Carole A. Smith Director of Special Services Wesley E. Kennedy Gail M. Sullivan Superintendent Assistant Superintendent With the Individuals with Disabilities Education Act emphasis on school to work transitions, it is incumbent upon school districts to carefully plan for students' entries into the work force. For students with disabilities, learning job seeking and keeping skills in natural environments is essential. Such experiences increase learning by providing genuine and meaningful reasons for learning a given skill or set of skills, creating practice opportunities and offering immediate feedback regarding the students' application and generalization of skills. Work Opportunities works collaboratively with M.S.A.D. #3 5 to implement students' Individual Educational Programs (IEP) as related to prevocational and vocational training. Work Opportunities personnel work as part of the Pupil Evaluation Team from the initial stages. Completing student interest/aptitude inventories related to job training, setting up job trials and providing students with a variety of job experiences are activities in which Work Opportunities is involved. Every step of the way, students are guided by an employment consultant who models essential skills, working side by side with the student. The employment consultant also assists students in learning how to access the natural supports available within the work force, such as asking assistance from coworkers and/or job supervisors as well as socialization skills critical to success in the world of work. Employment consultants use fading assistance to support students in the development of their abilities to employ independent work skills. Work Opportunities provides the school personnel with detailed reports that assist the student's special education team in identifying areas needing further instruction as well as those aspects of a "job well done." There are many unique qualities of Work Opportunities that foster a complete educational experience. The organization's ability to choose an employment consultant who is a quality "match" for the student with whom s/he works provides successful and fulfilling experiences, for both the student and the employment consultant. Employment consultants attend student Pupil Evaluation Team meetings, integrate any academic and/or behavioral goals and objectives within the student's IEP to the rate and degree necessary to implement the pre -vocational and vocational components, and are immediately available to praise and troubleshoot. Work Opportunities staff meets with families regularly and maintains close contacts with parents. The quality of student programs is enhanced by frequent, meaningful and clear communication. These attributes distinguish Work Opportunities as an organization that compliments students' school experiences and closes the circle, making the cyclical nature of school - to -work transition seamless and a reality for students in M.S.A.D. #35. d›-u-r-1 Carole Smith Special ServicesDirector M.S.A.D.#35, Eliot -South Berwick, Maine August, 1999 REVERE PUBLIC SCHOOLS Vincent G. Cowhig Jr.,MEd. Administrator of Special Education Special Education Department 101 School Street Revere, MA 02151 December 4, 2003 Telephone 781-286-8240 Fax 781-485-8402 E-mail vcowhig@ revere.mec.edu As the Administrator of Special Education for the Revere Public Schools, I have had a long and rewarding relationship with Work Opportunities Unlimited. I first worked with the agency more than six years ago when a multi -handicapped student was approaching the age to terminate school -funded services. WOU was contracted to provide school to work transition and employment training The success I witnessed with this difficult student convinced me that this was an agency that I needed to collaborate with to provide services for our special education students. For the last four years we have contracted to have WOU prepare our students for the world of work. They have become an important part of our array of services offered to students. They have gained the trust and respect of parents, staff and students. They have worked with the special education staff at the high school to prepare students for life after school. They have helped handicapped students to explore a wide range of employment opportunities and have supported students in the work place. They have handled difficult families and situations with a high degree of sensitivity and professionalism. The staff of WOU is highly trained and competent. They have always worked to insure that the home, school and work place are all cooperating to insure success for students. The menu of services is impressive and individual plans can be designed to meet the unique needs of each student. As a school administrator, I have found that the services are appropriate, flexible and affordable. I have recommended Work Opportunities Unlimited to my fellow administrators in other districts and will continue to do so. Vi>Sdent G. Growhig Administrator of Special Education t#iluttt fuldir *cInnt� Methuen High School 1 Ranger Road, Methuen, MA 01844 Ken Kramer, M.Ed. Mid Department Chairperson / Ett. January 5, 2004 To Whom It May Concern: (976) 681-1375 E-mail: khkramer@methuen.k12.ma.us It is a pleasure to write a reference on behalf of the Work Opportunities Agency. As the Special Education Department Chair at Methuen High School, I have overseen our contract with this agency for the past three years. We had sought their expertise to serve the vocationalltransition needs of our students, and have been extremely pleased with the services they have provided. In practice, it is often difficult to provide the breadth of evaluation, support, site coordination, and inter -agency planning that needs to take place for each student. As a rule, schools traditionally struggle with this area of service. Work Opportunities has allowed us to meet these challenges thoroughly and successfully. The stafTis extremely well versed in the areas of job site cultivation, job coaching, and vocational evaluation and assessment. Accordingly, our students have benefited greatly from their expertise and have been very successful at moving from high school to appropriate adult vocational, educational, and/or supported living environments. In addition, the Work Opportunities staff has acted as liaison between our program and the many services and agencies available beyond the high school setting. This level of support and facilitation has afforded us the opportunity to comprehensively coordinate and plan for our students, providing them with a wide range of options and the safety and security of knowing a plan is in place for them once their high school years come to a close. Notable to our contract with Work Opportunities is the high level of ongoing communication that we require, and that the Work Opportunities staff has successfully provided. Methuen faculty is provided with weekly updates on each of the students, and parents are regularly involved and updated on the job site activities and ongoing progress as well. In addition to this, our need to provide individualized and tailored vocational and transition services has been thoroughly met by the flexibility of a menu approach to choosing the services that Work Opportunities provides. In accordance with the principles of an IEP, all students' needs are subsequently met in a completely targeted and personalized fashion. We have been very satisfied with the Work Opportunities Agency and the services we provide to or students through them. The staff always presents with a high degree of professionalism. Their follow through, attention to detail, and support and compassion for our students are hallmarks of all their efforts and accomplishments at our school. I believe the Work Opportunities Agency would be an excellent candidate for any school or program considering their services, and would be happy to discuss this further if warranted. enneth Kramer, M.Ed., M.A. MHS Special Education Department Chairperson {{i�AMMni�iee� fw Cvwwr{........{f Vendor Information Sheet Federal Employer Identification Number Or ATTACHMENT C 2. Telephone/Fax/Contact Person ‘:0 3-7; 7.-6 4f-k Telephone number Owner's Social Security Number • 7 %o y , _ i seS at Z- Fax number j Name of Firm, Individual(S�)/,artners or Corporation s gyet ,Z p c/ -t f 4 f -A 90.00 , 5 %e--i- < fvile /©7 Contact Person Street Address at.6„/le R.tes , 330;4' City State / Zip Code 3. Ownership Disclosure E-mail address If the contract or business transaction is with a corporation, partnership, sole proprietorship,or joint venture, the full legal name and business address shall be provided for the chief officer, director, or owner who holds, directly or indirectly the majority of the stock or ownership. If the contract or business transaction is with a trust, the full legal name and address shall be provided for each trustee and each beneficiary. Post Office addresses are not acceptable. Name Title Address Gender Race- ethnicity Stock Ownership SiCafr-4V A-Wo d Presidcis- lilt Lpr:415./ sh , M G 0 Dover, A 14 t ?Zo NOTE: The information provided by the vendor on this form should be consistent with that provided on the "Vendor's Application". All vendors must have a current vendor's application on fife with M-DCPS, and have provided information and/or be familiar with M-DCPS' policy regarding the following: (a) Employment Disclosure, (b) Drug Free Workplace, (c) Family Leave Policy, (d) Code of Business Ethics, (e) Conflict of Interest, (f) Perception, (g) Gratuities, and (h) Business Meals. Failure to provide M-DCPS a current vendor application may cause the vendor not to be awarded any new business with M-DCPS. Vendor applications can be downloaded at: http://procurement.dadeschools.net Attachment D Affirmative Action Employment Breakdown Form The data requested could not be compiled in time for this bid to be submitted. However, the data does exist and can be produced at a later time by request. Below is a copy of our Equal Employment Opportunity policy taken from our Employee Manual. 103 Equal Employment Opportunity Effective Date: 4/1/2004 Revision Date: In order to provide equal employment and advancement opportunities to all individuals, employment decisions at Work Opportunities Unlimited will be based on merit, qualifications, and abilities. The Company does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, or any other characteristic protected by law. Work Opportunities Unlimited will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship. This policy govems all aspects of employment, including selection, job assignment, compensation, discipline, termination, and access to benefits and training. Any employee with questions or concerns about any type of discrimination in the workplace are encouraged to bring these issues to the attention of their Director or the Vice President of Human Resources. Employees can raise concerns and make reports without fear of reprisal. Anyone found to be engaging in any type of unlawful discrimination will be subject to disciplinary action, up to and including termination of employment. Miami -Dade County Public Schools SWORN STATEMENT - NEW CONTRACTS ATTACHMENT E SWORN STATEMENT PURSUANT TO SECTION 1012.465, FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT THIS FORM MUST BE SIGNED AND SWORN TO IN 1HE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted to The School Board of Miami -Dade County, Fl (Hereinafter "Board" or "School Board") by �'- A _Wood (Print individual's name and title) for WO t") t'" (1f (rt f/ ( bl ! l rYT � �r's C 1'+ Y G Lt C s :o (Print Name of entiubmitting sworn statement) whose business address is /if C-UG(15/ S'i'r c-41- /)t)Vc v) f'ii/f- a and `/oov 9;e-v, c Gb 1 cfve ) S'ui e loin P br c1-e- Phis , FL 30Zz- and its Federal Employer Identification Number (FEIN) is 01.--o 1L1'1 . If the entity has no FEIN, include the Social Security Number (SSN) of the individual signing this sworn statement and so indicate. 2. I, f !� 7 t"I .� i d , am duly authorized to make this (Print individual's name and title) sworn statement on behalf of We Opp c V ivl .11 es U yl l ini t fd Cj ✓F Z 1-4.C, (Print Nanie of entity submitting sworn statement) 3. I understand that during the 2005 Legislative Session, House Bill 1877, The Jessica Lunsford Act (hereinafter "The Act" or "Act") was passed and approved by Governor Bush on May 2, 2005, with an effective date of September 1, 2005. Initials Page I of 3 FM-6910 (08-05) 4. I understand that the Act amends the background screening requirements of section 1012.465, Florida Statutes (2004) for all non -instructional school district employees or "contractual personnel" by requiring all non -instructional school district employees or contractual personnel who are permitted access on school grounds when students are present to undergo and pass "level 2 background screening," and further I understand the Act defines "contractual personnel" to include any vendor, individual, or entity under contractwith the Board. 5. I understand that pursuant to section 1012.465, Florida Statutes as amended by the Act, non - instructional school district employees or contractual personnel who are permitted access on school grounds when students are present. who have direct contact with students or who have access to or control of school funds must meet level 2 screening requirements as described in sections 1012.32 and 435.04, Florida Statutes. 6. I understand that as a pvate-- J // lsS (eg. a private bus Type of entity service contractor) all contractual personnel, as defined in section 1012.465, Florida Statutes, must meet level 2 screening requirements as outlined in sections 1012.32 and 435.04, Florida Statutes in order to do business with The School Board of Miami -Dade County, Florida. 7 I understand that "level 2 screening requirements," as defined in sections 1012.32 and 435.04, Florida Statutes means that fingerprints of all contractual personnel must be obtained and submitted to the Florida Department of Law Enforcement for state processing and to the Federal Bureau of Investigation for federal processing. 8. I understand that the School Board will implement local procedures to comply with level 2 screening requirements, as defined in sections 1012.32 and 435.04. I understand that my company must comply with these local procedures as they are developed. 9. I understand that any costs and fees associated with the required background screening will be borne by my company. 10. I understand that any personnel of the contractor found through fingerprint processing and subsequent level 2 background screening to have been found guilty of, regardless of adjudication, or entered aplea ofnolo contendere or guilty to any offense outlined in Section 435.04, Florida Statutes (or any similar statute of another jurisdiction), shall not be permitted to come onto school grounds or any leased premises where school -sponsored activities are taking place when students are present, shall not be permitted direct contact with students, and shall not be permitted to have access to school district funds. Initials Page 2 of 3 FM-6910 (08-05) 11. I understand that the failure of any of the company's or my affected personnel to meet level 2 screening standards as required by section 1012.465, Florida Statutes, may disqualify my company from doing business with The School Board of Miami -Dade County, Florida. 12. I hereby certify that the foregoing statement is true and correct in relation to the company for which I am submitting this sworn statement. I further certify that this statement is being given knowingly and voluntarily by me on behalf of my company. The company submitting this sworn statement agrees to be bound by the provisions of SECTIONS 1012.32, 1012.465, AND 435.04 OF THE FLORIDA STATUTES AS AMENDED BY HB 1877, THE JESSICA LUNSFORD ACT 2005. I CERTIFY THAT THE SUBMISSION OF THIS FORM TO THE SCHOOL BOARD OF MIAMI- DADE COUNTY, FLORIDA ON BEHALF OF THE COMPANY IDENTIFIED IN PARAGRAPH ONE (1) ABOVE BINDS THE COMPANY TO FULLY COMPLY WITH THE BACKGROUND SCREENING REQUIREMENTS OF SECTIONS 1012.32, 1012.465, AND 435.04, FLORIDA STATUTES. Sworn to and subscribed before me this Personally known h e� (Signature) day or f F' >/ , 20pi. i.' OR Produced Identification Notary Public -State of IV t' vv S fit r- e (Type of Identification) My commission expires u /�'laso7 WEAN E. BOUDREAU N$ry Public - New Ha:meting fORMi$1i1 0 Evives May i es 2007 v J B4.4 - j • J ucti -cam (Printed typed or stamped commissioned name of notary public) Initials Page 3 of 3 FM-6910 (08-05)