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HomeMy WebLinkAboutRequired AttachmentsREQUIRRED ATTACHMENTS THE SCHOOL BOARD OF MIAMI-DADE COUNTY, FLORIDA PROCUREMENT MANAGEMENT SERVICES 1450 N.E. 2ND AVENUE, MIAMI, FLORIDA 33132 REQUEST FOR PROPOSALS NO. 056-G G 10 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be accepted in Procurement Management, at the above location, until 2:00 P.M. (Local Time) May 3, 2007, and may not be withdrawn for one hundred- twen ty (120) days from that date.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 PAR T OF THE PUBLIC DOMAIN AS DEFINED BY THE STATE OF FLORIDA SUNSHINE LAW. CERTIFICATION AND DENTIFICATION FOR PROPOSERS SUBMITTING PROPOSALS. 1 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. 1 agree to abide by all conditions of these proposal specifications and 1 certify that I am authorized to sign this proposal. (Please Type or Print Below) LEGAL. NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: Easter Seals South Florida, Inc. MAILING ADDRESS: 1475 NW 14th Avenue CITY STATE, ZIP CODE: Miami, FL 33125 TELEPHONE NUMBER: 305.325.0470 BY: SIGNATURE BY: TYPED Wayne Morgan TITLE: Vice President/CFO SUPPORTED..EMMPLO.YMENT SERVICES;FOR...T.FIREDUCATION::: OF STUDENTS. WITH DISABILIT ES' r ATTACHMENT B PROPOSER'S FEE AND CERTIFICATION OF HOURS OF SERVICES PROPOSER'S FEE Hourly Fee . 35 _ Qfl LEGAL NAME OF AGENCY OR CONTRACTOR SUBMITTING PROPOSAL: Easter Seals South Florida Ino AUTHORIZED SIGNATURE: NAME.TYFEI}:, Wayne Morgan Pier: N:: Vice President/CFO Evelys Miura,.Coordinator.. ProjectACCEPr`:'' Miami Dade College InteaMmerican. Campus,. Room.1112. 627 SIN 27.Avenue, Miami, FL 33135 (305) 237-6649 Phone: (305)237-6651 Fax Email: Projectaccept@a aolcom April 24, 2007 Re: Easter Seals Supported Employment Services To whom it may concern, This is a letter of supporton behalf of Easter Seals Supported Employment Program's cooperative agreement with Miami Dade County Public Schools. I have been involved with Easter Seals for the past 10 years through their job coach services. My students have gained a wealth of information and have benefited trememdously by their efforts to make employment a part of their daily lives. I am a belkverthatalkindi4idualwith,andiwithoutudisabilities,needsuppc0 i uthei ; j;obs, antiwithoutthe•heI . of seer Segill v env'.. r :-pc sr1 s.. ,Ms T :.; •P fk, oh ' j ani a true pa ck of p seh s eess and rn stude to $ : e+c a as; possibIe;. i° .t t my students have received ,adequate and, satisfactory. services.from Easter Seals.an& therefore• is support them: in their quest to- continue serving. our students°;. As always it will be be my pleasure to answer any questions in support of Easter Seals Supported Employment program. Sincerely, Evelys P. Ubiera PthjectAGt FT' Teacher- Apri124, 2007. To. Whom It May Concern: The Job Coach Program provided through Eastern Seals is of great benefit to our students. The staff is wonderful to work with. They are always willing to provide the best assistance to our students. It is important that this program continue as it benefits the students at Miami Senior High School. Sincerely, KiW Keila L. Morales SPED Departrnent.Chairperson Miami Senior High School 2450 SW 1st Street Miami, FL 33135 Ms. Coglin 1200 NW 6* ave Miami, F1.33136 April 25, 2007 Dear Sir: It is with great pleasure that I write a letter of acknowledgement for Easter Seals Supported Employment Program's cooperative agreement with Booker T. Washington High School. Ms. Sanchez has always displayed a high degree of integrity, responsibility, and ambition. She is definitely a leader; I have worked very close with her assisting my studentsin job placement She is: also, a me st:dep ndable teanrplayer: Her good judgment- and mature outlook ensure a Logical and practical approach to her endeavors. Ms. Sanchez works diligently in placing students with various employers. For further questions regarding Ms. Sanchez, feel free to contact me @ 305 324-8900 ext2276. ially, Ms. Coglin April 24, 2007 t To. Whom It May Concern.: The Job Coach Program provided through Eastern Seals is of great benefit to our students. The staff is wonderful to work with. They are always willing to provide the best assistance to our students. It is important that this program continue as it benefits the students at Miami Senior High School. oana Alvarez SPED Department. Data Input Specialist Miami Senior High School 2450 SW lst Street Miami, FL 33135 April 24, 2007 r To Whom It May Concern:. The Job Coach Program provided through Eastern Seals is of great benefit to our students. The staff is wonderful to work with. They are always willing to provide the best assistance to our students. It is important that this program continue as it benefits the students at Miami Senior High School. Sincerely, ZH ika A. Santos -Gonzalez SPED Program. Specialist; Miami Senior High School 2450 SW 1s` Street Miami, FL 33135 April 27,.20.07. To Whom It May Concern: This letter is to confirm that Mr. Reza Pourmashia visits our store at Pizza Hut on a regular basis trying to assist and secure the job opportunities for his clients. Furthermore he has been extremely generous with his time staying with his clients that are currently employed in our establishment for long hours. Making certain to the best of his abilities that his clients as well as store management team are mutually satisfied with their employee/employer relationship. It is my honor and extreme pleasure to assist Mr. Pourmashia in his humanitarian and professional efforts towards helping otheryoung men and womerr who are in need'of assistance. It has been a wonderful experience during the past year that I have had the pleasure of associating with Mr. Pourmashia and I must say that he is a rare example of tremendous work ethic, sacrificing, compassion and kindness towards others. Please feel free to contact me for any questions that you may have at (305) 247-6100. incerely Yours, ) Anr Maiat:; General' Manager Pi77a Hut Homesteadr_Fl. u Y. ♦. + . • ...... 14h iri-aide Cr.J itity Public Sc;i,00ls S osrinlendent ottchoois: Pido4ldh ff Crow, EdD. Assl+ednK Superintendent birds Adrnlntsbadw Director V !IY Gonfilto Instructional Supervisor J, Y B+rookner April 27, 2007 To Whom This May Concern, Mieml-o ds Cour t sahooI $os d Agustin J. Bar►et% Chair Dr. Mvbn Karp, Vice Char Reeder Diu der is PordMa Evelyn Lsootieb Gager, Perm Tabsroe Hentrnen Dr. Robert E. Ingram Ane Rivas Logan Dr. Mans Perez Dr. Salomon C. Stinson t am'writing° an beha of Mr: Reza Pot rrneeins Employment Speciai for E wasuSeelal Sabin > Serxiaes. t.fie., had the pleasure of waiting with Mr. Pourinasiha over the past live months in his position as a job coach for students with significant cognitive disabilities as South Ridge Senior High School and Homestead Senior High School. During this time, Mr. Pounnasiha has attended W,d vidual Educational Program (IEP) meetings for supported employment candidates and provided an explanation of the Program b parents/guardians. In addition, Mr. Pourmaelha has C• x �ji =-,arts.:: sxe i tine, a:: jpb:�;; .:.and: ,/t��ee�n supp�orti(v�e _ is .them due � ..atfe>-: in y��prvvws f {dr yy .; 10R':i' �yji� is :1 jam, `amploy� rt Ot ' :R�k;>`r4i.a . ,y - Yft 11418"t.�e`;.` suozessin As a Transeba SUpportreactier +4igt Mist der COuntylkitielditiokthavistackthalopportixdpidkleirtic Pounnaeitteinteract-with oYX` tudertts-artd'.IE:bthngs,-ms'gr+set=pleats,aas Atiehappineasatld,; :Ot,, our students invchtteti rt: the .Suppot Empk ymar t..Ptt grams ,t to pleasurst tohaveW-pourrnaalhassamernber; of our team ded{cated bwarda the education and success of our student LatootwErocinkiZEOK Transition Support Teacher, Miami Dade County Pubic School DMs on.at Sperm -Ede.. Y. t.' wi " E7t' :r r •r-tiaffrk_ '. 131!. !it.. 305'915.1796 • Fix 3059115:1FStYy-eses c erst NOV-3-2004 10:26P FROM: TO:3055474731 P.2/ Carlos S. Contreras, M.D. 1344 S.W.150 Avenue Miami, Florida 33194 May 2, 2007 RE: Mrs. Azam Farzaneh Employment spedalist r To whom it may concern, We are writing this letter to commend Mrs. Farzaneh for the magnificent Job she has done in her position as an employment specialist particularly with respect to our son Joshua. Mrs. Farzaneh allayed our fears about allowing our son to work for an hourly wage as a tax paying citizen. She has greatly helped our Down's Syndrome son, Joshua E. Contreras from Braddock High School, by having assisted him in obtaining a job at Pubkx Supermarket located on Miller Drive and 157t Avenue. He has been happily working there for almost three years now. Mrs. Farzaneh was a very sweet, kind, and loving influence on our son. Joshua loves his job, and he always looks forward to going to work. It is remarkable the smooth, and professional way in which Mrs. Farzaneh performs her job. She has always been on time in response to any of our queries, smiling and cooperative. Imagine, we shall never forget her. Joshua always speaks about her. We are very happy we met her. She has been a very special, and positive influence In our family, but particularly so in Joshua's life. We highly recommend Mrs. Farzaneh. Thank you. God bless you. Have a pleasant day. 0/, 7147 1/�r1� rhos and at ��'-� Miami -Dada County Public Schools Prirfcipal Miami -Dade Col/my School Board James R Haj .gus'trn J Barrera. Chair Peria 7-abates Hantrnan Vice Chair April 26.2007 To Whom It May Concern: Frank „I. Bohai{os Evelyn Langlieb Greer Or Robert B Ingram Cyr Martin Karp Ana Rivas Logan Dr. Marta Perez Dr. Solomon C. Stinson Superintendent of Schools Rudolph F. Crew_ Ed D I would like to express to you my appreciation of the work done by the Employment Specialist for our school, Azam Farzaneh. She has worked hard to place our students in supported employment throughout the year. When managers have stacks of applications to consider, she gets our student's applications on top. It's not easy to persuade employers to hire the handicapped, but she is able to do it. She was able to explain our program and type of clients to gain empathy and acceptance from them. She has gone out of her way to get our students the hours they prefer and the best job locations to please both parents and employers. She works well with parents also. She sets up interviews, trains new workers and smooths out any trouble areas that may arise between employers, employees and parents. We have parents waiting for their child to turn eighteen so that she can place their child in a job, too. She has attended I.G. P. meetings to discuss future. job placements. She has been there to answer questions from parents regarding how supported employment works. We are happy to have Ms. Azam as part of our team and look fomard to working with her next year. Sincerely, Celeste C. Sadler ESE Teacher, Southwest Miami Sr. SOUTHWEST MIAMI SENIOR HIGH SCHOOL RRW .5fth TPrrar:A. • Miami Florida 33165 .: , tirf a(,f/(i Principal Miami -Dade County School 8o3rd lames R. Ha) Agustin J. Barrera. Chair Pena i abares Hantrnan. Vice Chair Frank. l Bolar os Evelyn Lariglieb Greer Dr Robert B ingrain Dr. Martin Karp Ana Rivas Logan Dr. Marta Perez Dr Solomon C Stinson Superintendent of Schools Rudolph F Crew Ed C° April 27. 2007 To whom it may concern, l am writing this letter on behalf of Ms. Azam-Farzaneh for her role in training and finding employment for our mentally handicapped students. Ms. Azam has had success in matching students with an appropriate job. As a result of these jobs, our students have good self esteem, improve their employment skills, and are able to make money. Sincerely, Lourdes Luis ESE Teacher SOUTHWEST MIAMI SENIOR HIGH SCHOOL ocgt; c IA.' Gntl. - AR:.,..,: Ct:..:, !-. 0424i:G Principal James R Ha] April 26, 2007 To Whom It May Concern: - Miami -Dade County School Board Agustin J. Barrera, Char. Peria Tabares Hantman Vice Char Frank J. Botatio.s Evelyn Langtieb Greer Dr Robert B. Moran? Dr. Martin Karp Ana Rivas Logan Dr. Marta Perez Dr SolOnOn C Stinson Superintendent of Schools Rudolph F Crew. Ed D Please allow this letter to serve as a formal commendation for Azam Farzaneh. Here at Southwest Miami Senior High, Ms. Farzaneh has shown great dedication in obtaining employment for students with disabilities. Her efforts have lead to the successful placement of a number of students in the Special Education department at our school. She goes beyond the normal call of duty by establishing and maintaining contact with clients and their parents, in addition to the constant solicitation of employers to provide job opportunities to those often left out of the job maket. Ms. Farzaneh's personal compassion and love for those with disabilities is a key factor in her successes and without her our program wouldn't be as successful as it is today. Please let it be known that Ms. Azam Fa.rzaneh's services are greatly appreciated and well needed here at our school. Respectfully yours. I Molina Paraskeva Perez. Special .Education Program Specialist Southwest Miami Senior High Principal • Miami -Dade County School Board James R Haj Agustin J Barrera. Charr Perla TabaresHantman. Vice Chair Frank J Bolarios Evelyn Langlieb Greer Dr Robert B Irngra.m? Dr. Martin Karp Ana Rivas Logan Dr Marta Perez Dr. Solomon C Strnson Superintendent of Schools Rudolph F Grey}, Ed 0 April 26. 2007 T'o Whom It May Concern: I have had the opportunity to work with Mrs. Azam Farzaneh for four years. She has worked hard to find jobs for our students and give them on -the _job training. The students are happy at their_ jobs and are learning social skills and independent Ii8ving skills. We see a growth in their maturity and a high level of self-esteem. The parents appreciate the job she does because now they know what their child will do when they complete their education. This is a great service to the community and an essential element in our students all around development. Sincerely, r Agustin Grana S'i'El) "I.eachcr r. A.I * ''I IN•/r OR RP. .<[ a ..e /fi r•. e. .... • .... —. ..— —. Principal James R Haj April 26.2007 To Whom It May Concern: Miami -Dade County Public Miami -Dade County School Board Agustin J Barrera. Chair Perla Tabares Hantman. Vice Char Frank J Balerlos Evelyn Langtieb Greer Dr Robert 8 Ingram Dr Martin Karp Ana Rivas Logan Dr. Marta Perez Dr Solomon C Stinson Superintendent of Schools Rudolph F Crew Ed C Azam Farzaneh has been instrumental to Southwest Miami Senior special diploma students. Through her endless efforts,.she has obtained entry level jobs for our students and provides a liaison between employer, parents, student and school. Her determination and persistence has assisted many of students finding employment. We are extremely grateful for commitment and efforts. Sincerely. /' Marlene Espin } Cf)I Fri-11AI= T MI 1! API CCitties In LJSP'LI ts" e et A April 27, 2007 To Whom It May Concern: This is to inform that I know Mrs. Azam Farzaneh about three years. Mrs. Farzaneh is Employment Specialist at H. G. Braddock Senior High School and her duties are to work with kids that belongs to TMH Program "Trainable Mentally Handicap" - ESE Students (Exceptional Students Education). Mrs. Farzaneh, helps these special students to get jobs and follow up with students to give them support in the different activities that they may have. When these ESE students have a job they joint and interact with their community and the same job helps them to be more independent and grow up themselves. Mrs. Farzaneh is a very responsible, cooperative and professional, I think she will be an asset for any person who requires her services. Sincerely, La7aro . Buchillon ESE T acher April 25, 2007 'Po whom it may concern: I woad like to thank our employment specialist, Azam Farzaneh, for her work with our ESE students. She is continuously helping our students find employment in the community and making sure they are successful. It is not an easy task to find jobs for our students but Ms. Azam gets the job done. She is there with our students every step of the way until they are placed at a work site. She is always in communication with the parents, teachers, and managers in order to provide our students with a smooth transition into the work world. She makes sure to meet with the parents and explain how supported employment works and how it benefits their young adult. She is also present at I.E.P. meetings to discuss future job placements. Thanks to her efforts and dedication, our students acquire the work skills needed to maintain a job and gain a sense of independence and self-worth. Sincerely, asmina Rios ESE Teacher Braddock Senior High April 25, 2007 To Whom It May Concern: Ms. Azam Farzaneh and I have worked together for the past 17 years. She is a person who has always been patient and she has worked patiently with the students and their parents. She has worked very hard to make sure that the Moderately Mentally Handicapped young adults at Braddock, Killian and Southwest Senior High Schools are placed into the community for employment. Ms. Farzaneh is a person who always follows through and she makes an effort to make sure that the young adults are trained properly for employment. Throughout the years she has been a great asset to these programs. Should you require further information, please feel free to contact me. Sincerely, N 1_ Rua Ingram Transition Support Teacher r To Whom it May Concern: Miami 04/26/2007 Publix Supermarkets 7805 SW 40 ST Miami Florida Mrs Azam Farzaneh, an employment specialist, for the Supported Employment Program has been directly working with me for the last four years. In the years that I have worked with her, Mrs. Farzaneh has brought to my store excellent associates. She has been able to adapt each associates strengths with the needs of the store by placing them in the proper job classes. Throughout the time that the associates have been working with us she has consistently checked up and made sure that each associate is doing what Publix stresses, mainly providing premier Customer Service. Mrs. Farzaneh is always available for any questions or concerns and deals with any situation in a very professional and correct manner. Mrs Farzaneh is not only an asset to the company, but she cares a lot about her students/associates, always willing to go the extra mile for her company and for Publix. Any questions or concerns you may contact me at (305)266-1950. SirfberelyZ Store Manager Store # 44 t, 305.27 ;-82G2 litiogdo awe 7/(4414 Z. Roor.guep 9103.Soadaaeae 7Q ,7 iayu, e0 da -33r73 May 1, 2007 Re: Mrs. Azam Employment Coordinator -To WHOM IT MAY CONCERN: Our twin boys, Keith and Kenny entered Southwest High School as freshmen. They AI be graduating this year. Before meeting Mrs. Azam, and entering the program, both goys had fears, worries and insecurities about working. After speaking to Mrs. Azam, she was able to provide accurate and necessary information regarding the current job market, and other information regarding' the program. Mrs. Azam was successful in placing our boys in the right job for them with Publix. Since they have been employed at Publix the boys have become responsible, they now have a sense of duty and have demonstrated a desire to continue working. This could not have been possible without Mrs. Azam's guidance, expertise and help. Mrs. Azam is a skillful professional. She provides the children with step-by-step advice from the point of filling out an application, -through the interview process. She counsels the children as to what is precisely expected of them at their jobs, and the manner in which they are to conduct themselves. . I believe that Mrs. Azam is responsible for having prepared my boys for the real world by placng them with a job that they are able to do. She has contributed to building the foundation to assist in making the children feel productive and confident. The job interview process and getting a job for the first time is a very difficult process for anyone, but especially so for children with disabilities. Mrs. Azam possesses the skill, knowledge and dedication to carry out her responsibilities which produces successful results. As parents of twins with disabilities, we urge that this program continues for purposes of assisting other students and other families. Mrs. Azam's expertise and dedication makes this program a success. Our family is an example of such success and we are very grateful to the program, and especially to Mrs. Azam. Sincerely, Maria E. Rodriguez 04/30/2007 13:52 305-643-7618 ST FL VOC REHAB PAGE 02 FLORIDA DEPARTMENT OF EDUCATION STATE BOARD OTmUCAT1O11 T.WeZt.ARQTAIR,Oralry w Aar DQTYA CILCALLAWAY t1LAZIWYDUIM AO11O1MAR71,EZ flBC*IAu mor KA7appr1lli1KAMIK LIMA Llanelli May I, 2007 To Whom it May Concern: Jambe lamikat Coorialiihoper •rr The Division of Vocational Rehabilitation has fired with Taster Seals South Florida for many years to deliver supported employment services to developmentally disabled students and recent graduates. This relationship has resulted in the successful placement of may developmentally disabled individuals and will, hopefully, be responsible for many more in the years to come. Sincerely, Vocational Rehabilitation Consultant 1nArrALOPR Director. rad ion R habrampon .. 2002 Okl Said Augustine Road, Building A • Tallahassee, PL. 32301.48e62 Toll Free: 1-800- 451-4327 (Vos a or TTY) • In TNhhassee: 8504245.3398 (Voice or TrY) • FAX 850-245-3302 Florida Relay Service: 1-804-055-8771 (TTY) • 1-800-955-8770 (Vote) • www.rehebwori s,org April 26, 2007 Easter Seals To whom it may concern: By this means, I would like to recommend Reza Pourmasiha for any future professional opportunities. During the 2006-2007 school year, he was our job coach at Homestead Senior High. He has assisted over six students in the initial employment process. He also trained many of our students at the job site. We currently have two students that are holding paying jobs in the community. Reza closely monitors their progress and is in touch with the managers. He informs me of any difficulties or progress of the student at their employment site. He is very dedicated to the acquisition of jobs within our community for our mentally handicapped population. If you should have any questions, please contact me at 305-245-7000 ext. 2279. Sincerely, 00-111.L Ms. Elaine Abreu Homestead Senior High TMH Teacher Principal Miami -Dade County School Board James R. Haj Agustin J Barrera. Chair Perla Tabares Hantman. Vice Chair Frank J Botanos Evelyn Langl,eb Greer Dr Robert B. ingrarn Dr Martin Karp Ana Rivas Looan Dr. Marta Pere. Jr Solomon C Stinson Superintendent of Schools Rudolp?? F EC April 25. 2007 To Whom It May Concern: The Southwest Miami High School TMH Program is happy with the work that Mrs. Azam Farzaneh is doing for us. Mrs. Farzaneh always finds employment for our students and makes sure there is a link between the employer. the home and the school. She is always asking about new students to find employment for and is concerned about their well being. Mrs. Farzaneh is a great asset to our program and the students it serves. Sincerely. John P, Woodward Special Education Teacher (SPED) SOUTHWEST MMIAMI SENIOR HIGH SCHOOL OOS t, C SA, j:rlth ?'2144 Dr. A. Cielesz TMH Teacher Braddock Senior High 3601 S. W. 147t Avenue Miami, FL 33185 April 25, 2007 To Whom It May Concern: r Re: Mrs. Azam Farzaneh—Employment Specialist I have known Ms. Farzaneh and worked with her these past three years at Braddock Senior High. She has successfully placed Trainable Mentally Handicapped students in part-time jobs at Publix. If there are any questions, or if I can provide any further information, please call me at Braddock Senior High 305-225-9729. Sincerely, IYZ�. Dr. A. Cielesz TMH Program Van CIA. 590722783 419 4 nformaatio r . ee ,. . Federal Employer Identification Number Or Owner's Social Security Number Easter Seals South Florida, Inc. Name of Firm, Individual(s), Partners or Corporation 1475 NW 14th Avenue Street Address Miami, FL 33125 City State Zip Code 3. Ownership Disclosure ATTACHMENT C 2. Telephone/Fax/Contact Person 305.325.0470 Telephone number 305.325.0578 Fax number Wayne Morgan Contact Person wmorgan@sfl.easterseals.com 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 --r- Address Gender Race, • ethnicity', :Steck 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 arty new business with M-DCPS. Vendor applications can be downloaded at hilp:/fprocur•ement. dadeschoots.rLet Occupational Category President/CEO President Asst Human Resources AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN ATTACHMENT D Race/Ancestry Non- Non- Am. Ind.] Gender Hispanic Hispanic Alaska Male Female White Black Hispanic Asian Native Biller 3 1 2 Receptionist Controller Vice Pres Finance HR Aide 1 Acct Payable 1 Acct Receivable FM-4859 Rev_ (02-01) Occupational Cate jory ADC Director ADC Prog Coord ADC Activities Dir ADC Activities Aide AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN Race/Ancestry Non- Non - Gender Hispanic Hispanic Male Female White Black Hispanic 1 1 ADC Clerk 1 ADC Clerical Aide 2 2 1 ADC Companion 6 1 5 ADC Driver 1 3 4 ADC LPN 2 1 1 ADC Nursing Asst 1 28 4 25 ADC Respite Wker 12 2 10 ADC Secretary 1 1 2 ADC Social Worker 2 1 1 ATTACHMENT D Asian Am. Ind./ Alaska Native FM-4869 Rev. (02-01) v.rdy;Ow Occupational Category Development Dir AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN ATTACHMENT D Race/Ancestry Non- Non- Any. ind.J Gender Hispanic Hispanic Alaska Male Female White Black Hispanic Asian Native Development Rec 1 1 Event Coordinator Out of Sch Dir Tutor 2 2 Tutoring Coord 2 1 1 Greeter 1 1 1 1 Operations Dir Operations Maint OMR Director 1 OMR Off Mgr OMR Reauth Coord 2 1 1 Speech Therapist 2 1 1 Occupational Therapist 1 FM-4869 Rev. 102-01) ���a� �auay�i3�;i sw'xerc Occupational Category OMR Receptionist Voc Svs Dir Voc Svs Asst Dir Voc Case Manager Voc Program Asst AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN ATTACHMENT D Race/Ancestry Non- Non- Am. Ind./ Gender Hispanic Hispanic Alaska Male Female White Black Hispanic Asian Native 2 1 1 Voc Evaluator 1 2 2 1 Employment Spec Living Coach 2 5 1 1 3 2 SIS Counselor 2 2 4 Voc Technician 1 Voc Admin Asst 1 1 2 1 ,11 FM-4859 Rev. (02-09 ) mkilf erData Co rrf y,t4714'.r'.;^ous Occurmtionat Category MEPS Lunch Worker School Chef AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN Race/Ancestry ATTACHMENT D Non- Non- Am.Ind./ Gender Hispanic Hispanic Alaska Mate Female White Black Hispanic Asian Native 2 2 1 3 1- 1 School Drivers 7 School Teachers 3 4 6 1 1 4 Sch Teacher Asst 6 2 4 School Asst 4 2 2 School Aide 4 School Secretary 2 School LPN Sch Social Wker Sch Maintenance Med Rec Secretary Sch Principal 4 2 1 2 2 1 FM-4859 Rev. (O2-011 OccuDationni Category President/CEO President Asst Human Resources AFFIRMATIVE ACTION EMPLOYMENT BREAKDOWN ATTACHMENT D Race(Ancesuy Non- Non- Am. Ind./ Gender Hispanic Hispanic Alaska Male Female White Black Hispanic Asian Native 1 1 Biller 3 1 2 Receptionist Controller 1 Vice Pres Finance HR Aide Acct Payable Acct Receivable . ..«.0,. eIrroNirliWowilEVIPAP 1 Mow�,sr«��1 FM-4859 Rev. (02-01) Miami -Dade County. Public. Schools WORN 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 1I1E 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 Wayne Morgan Vice President/CFO (Print individual's name and title) for Easter Seals South Florida, Inc. (Print.Tarr : entity:subi g.swont..stat enti) whasnbasimmsaddiessig 1475 NW 14th Avenue Miami, FL 33125 and its Federal Employer Identification Number (FEIN) is 590222783 . If the entity has no FEIN, include the Social Security Number (SSN) of the individual signing this.. sworn.. statementand..so. indicate.. Wayne Morgan, Vice President/CFO it. L .... d i£I`ikai..?�ii✓e'?l:k' `ir �!w`rSL"i rI: (Print individual's name and title) sworn statement on behalf of Easter Seals :South Florida, Inc. (Print Name of entity submitting sworn statement) 3. I tuiderstandihatdMingthe2005 Legishtive.S sign ; libudeBINI877, TheiessicaLunsford, Act fitereinafter"The Act'` or ":: -17y was; passeland?:a vo .by Go erimaF Phsh.onMay.. 2, 2005, with: an, effective date• of September I,. 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 furtherI 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 Non Profit (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 Mann- :. Cc unty, Fliorirla W.: 7. I understanctiv&olewelt'` st-zeetiiiig.reepinMsPsot,277 as. + r i a >a& I.012 3-2..':°a . 435:04; FictridaStanttesmeansthat.friagerprintzrofatlznntraetaakperscsuaekmttstbeohtainetk, and submitted.tottte-F-1.orrdaDepartmentafLawEnfacementotstate.processingand to :the Federal Bureau ofliiuest gation.-for federalproeess g: , 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. I ur erat :i; i. s .arr *i /W ', > � x aZ • 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 groulids.or.a lease&ses wh school- ti activities are tal g•pll ~e.whemstudents are preserrk shalinotbe p tt tdi ct cr r ctwit steden and shall not be permitted to have access. to school district -fiends° kJ Initials Page 2 of 3 FM-6910 (08-05)