FY23 Statement of Work and Terms of Agreement

Section C

Description/Statement of Work (pdf)

C.1

Local Needs for Treatment Services and Urinalysis Collection (pdf)

Section D

Packing and Marking (pdf)

Section E

Inspection and Acceptance (pdf)

Section F

Deliveries or Performance (pdf)

Section G

Agreement Administration Data (pdf)

Section H

Special Agreement Requirements (pdf)

Section I

Required Clauses (pdf)

Section J

Attachments:

J.1

Program Discharge Summary Profile (pdf)

J.2

Sample Program Plan (Probation Form 45) (pdf)

J.3

For Future Use

J.4

Monthly Treatment Log (pdf)

J.5

Authorization to Release Confidential Information (PROB FORMS 11B, 11E, and 11I; PSA FORMS 6B and 6D) (pdf)

J.6

For Future Use

J.7

Daily Travel Record (Probation Form 17) (pdf)

J.8

Invoice Part A (pdf) Part B (pdf)

J.9

Urinalysis Log (pdf)

J.10

Department of Labor Wage Determination (as Required by the Service Contract Act - See Above.) (Please print the SF98, Department of Labor Wage Determination, for the County where your clinic is located.)

J.10A

Boone, Winnebago

J.10B

Cook, DuPage, McHenry

J.10C

Grundy, Will, Kendall

J.10D

Kane, DeKalb

J.10E

Lake

J.10F

LaSalle

J.10G

Stephenson, Ogle

Section K

Representations, certifications, and Other Statements of Offerors (pdf)

Section L

Instructions, Conditions, and Notices to Offerors (pdf)

Section M

Evaluation Factors for Award (pdf)