Common use of Agency Information Clause in Contracts

Agency Information. Agency [Insert Agency name] Agency File Reference [Insert Agency file reference number] RFQ Reference [Insert Agency RFQ reference number] Agency Representative Name: [Insert contact name] Position: [Insert title] Address: [Insert address, including postcode] Email: [Insert email address] Contact number: [Insert contact number, including area code] RFQ and Proposed Order Details RFQ Release Date [insert date the RFQ is released] RFQ Closing Date [insert date and time the RFQ closes] Proposed Order Commencement Date [insert date the Services will commence] Proposed Order Term and/or Completion Date [insert the order term and/or completion date] Request For Quotation for Services Options to extend The Agency may extend the Contract for [insert time period] by providing written notice to the Service Provider prior to the Order Completion Date. Milestones [Insert proposed milestones for the delivery of the Services] Statement of Work Service Area [Insert which Service Category within a Service Area the Services required relate to (Financial/Corporate/Commercial)] Service Category [Insert the relevant Service Category that the services relate to] Service Sub-category [Insert the relevant Service Subcategory that the services relate to] Detailed Statement of Work [Insert a detailed description of the Services required and any Associated Outputs, including relevant background material and whether any licences/authorisations are required to provide the services and any reporting that may be required. A separate Statement of Work may be referenced and attached] Deliverables [include details of any deliverables required under a resulting Contract] Subcontractors [Select one of the following statements: The Service Provider may nominate subcontractors to provide some or all of the Services; or The Service Provider may not nominate subcontractors to provide some or all of the Services.] Location [Insert the required work location/site, or insert ‘Not Applicable’] Fees [Insert details of fee structure e.g. hourly/daily rates, fixed fee] Payment Terms [Select the relevant payment terms] [For Non-corporate Commonwealth entities: (a) five calendar days where the Agency and the Service Provider both have the capability to deliver and receive e Invoices through the Pan-European Public Procurement On-Line Framework and have agreed to use this method of invoicing; or (b) 20 calendar days] [For Agencies other than Non-corporate Commonwealth entities: [insert payment terms]] Travel [Insert details of any travel that may be required and whether the Service Provider will be reimbursed for travel costs or if travel will be paid for by the Agency, or insert Not Applicable]. Agency Material [List any documents attached to the RFQ] Existing Material [Insert details of any Existing Material or insert ‘Not Applicable’] Contract Material [Unless specified in the Statement of Work, insert details of any Contract Material] Request For Quotation for Services Confidential Information [Include details in table below or insert Not Applicable] Key Personnel Requirements Required Qualifications and Experience [Include details of mandatory/desired qualifications, expertise, capacity and capability of Key Personnel, and whether or not they must have a security clearance]

Agency Information. Agency [Insert is applying for: (Please Check) Category 1 Status Category 2 Status Agency name] Name Agency File Reference [Insert Phone # Agency file reference number] RFQ Reference [Insert Address Email OCPE Agency RFQ reference number] Coordinator Phone # Cell # Email Signed on the date or dates below by authorized representatives of each party Agency Representative NameDate: [Insert contact name] PositionAgency Owner/Manager Date: [Insert title] AddressOCPE Agency Coordinator Aledo Independent School District Date: [Insert addressExecutive Director of Curriculum Date: Superintendent TO BE COMPLETED BY OCPE AGENCY COORDINATOR AND INSTRUCTOR The following schedule must be completed and signed by the OCPE Agency Coordinator and Instructor before the application will be considered. The instructor/facility should notify the OCPE Campus Coordinator if a change occurs in the number of hours the student is participating. OCPE INSTRUCTOR AGREEMENT AND STUDENT ACTIVITY SCHEDULE I understand that (name of student) _ is applying for an Off-campus Physical Education waiver and the student must participate in his/her activity, including postcode] Email: [Insert email address] Contact number: [Insert contact numberunder professional supervision, including area code] RFQ a minimum of 15 hours each week for CATEGORY I activities or a minimum of 10 hours each week for CATEGORY II activities. All activities must be completed at a single (one) approved agency, and Proposed Order Details RFQ Release Date [insert date the RFQ is released] RFQ Closing Date [insert date hours must be practice hours, and time the RFQ closes] Proposed Order Commencement Date [insert date the Services will commence] Proposed Order Term may not include competitions times and/or Completion Date [insert the order term and/or completion date] Request For Quotation for Services Options to extend meetings. The Agency may extend the Contract for [insert time period] by providing written notice records concerning daily attendance, grades, records of competitions, etc. must be completed and returned to the Service Provider prior District on dates specified by the district. The above-named student is scheduled to participate in a physical education program meeting this requirement as designated below: DAY BEGINNING TIME ENDING TIME ACTIVITY TOTAL HOURS OF PARTICIPATION MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY TOTAL HOURS OF PARTICIPATION PER WEEK As the instructor in the program, I support the following conditions of the OCPE Program: 1. I will provide copies of my credentials, certification, and/or documentation of instructor training and experience to the Order Completion DateOCPE District Liaison upon request. Milestones [Insert proposed milestones for 2. I will include the delivery agreed upon Physical Education TEKS during scheduled practices, and submit a written outline of program objectives and activities to the Services] Statement of Work Service Area [Insert which Service Category within a Service Area the Services required relate to (Financial/Corporate/Commercial)] Service Category [Insert the relevant Service Category that the services relate to] Service Sub-category [Insert the relevant Service Subcategory that the services relate to] Detailed Statement of Work [Insert a detailed description of the Services required and any Associated Outputs, including relevant background material and whether any licences/authorisations are required OCPE Campus Liaison upon request. 3. I agree to provide the services required documentation, including student’s hours of participation, an accurate record of student attendance, and any reporting that may be required. A separate Statement of Work may be referenced a marking period grade, on the form provided by the district, and attached] Deliverables [include details of any deliverables required under a resulting Contract] Subcontractors [Select one return this form to the OCPE Campus Liaison by mail, email, or fax within five (5) days of the following statementsend of each grading period. 4. I agree to contact the OCPE Campus Liaison if the student’s attendance becomes irregular, is not completing the required number of hours, or is no longer enrolled in the program. 5. I agree to contact the OCPE Campus Liaison if the student chooses to transfer into a general physical education class and/or does not meet the 90% attendance requirements. For the OCPE Program, one day of participation is equivalent to one day of attendance or absence. 6. I agree to release the student on designated Fitness Gram administration date. I understand that I am accountable to Aledo ISD for the participation of each student in Off-Campus Physical Education. I will make every effort to cooperate with the district. As a qualified instructor, my signature verifies the above schedule and recommends this student for participation in the program. Signature of OCPE Agency Instructor Date Signature of OCPE Agency Coordinator Date Aledo Independent School District Off‐Campus Physical Education Grade Reporting Form Student’s Name: The Service Provider may nominate subcontractors to provide some or all Student’s Activity: School Campus: OCPE Campus Liaison: Activity Site: Contact Person: Grade Reports will be due within (5) days of the Services; or The Service Provider may not nominate subcontractors last day of each grading period. Please submit the grade reports to provide some or all of the Services.] Location [Insert the required work location/site, or insert ‘Not Applicable’] Fees [Insert details of fee structure e.g. hourly/daily rates, fixed fee] Payment Terms [Select the relevant payment terms] [For Non-corporate Commonwealth entities: (a) five calendar days where the Agency and the Service Provider both have the capability to deliver and receive e Invoices through the Pan-European Public Procurement On-Line Framework and have agreed to use this method of invoicing; or (b) 20 calendar days] [For Agencies other than Non-corporate Commonwealth entities: [insert payment terms]] Travel [Insert details of any travel that may be required and whether the Service Provider OCPE Campus Coordinator. Each student will be reimbursed issued a grade of “pass” or “fail” for travel costs or if travel will be paid for their participation in the Off Campus PE program Citizenship grades are: E ‐ Excellent S ‐ Satisfactory N ‐ Needs improvement U ‐ Unsatisfactory 1st Marking Period: Citizenship: Due Date: October 5, 2018 2nd Marking Period: Citizenship: Due Date: November 9, 2018 3rd Marking Period: Citizenship: Due Date: December 21, 2018 4th Marking Period: Citizenship: Due Date: February 15, 2019 5th Marking Period: Citizenship: Due Date: April 12, 2019 Due 6th Marking Period: Citizenship: Date: May 30, 2019 Contact Person Signature: Attach the participation log and submit by the Agency, or insert Not Applicable]. Agency Material [List any documents attached to the RFQ] Existing Material [Insert details of any Existing Material or insert ‘Not Applicable’] Contract Material [Unless specified in the Statement of Work, insert details of any Contract Material] Request For Quotation for Services Confidential Information [Include details in table below or insert Not Applicable] Key Personnel Requirements Required Qualifications and Experience [Include details of mandatory/desired qualifications, expertise, capacity and capability of Key Personnel, and whether or not they must have a security clearance]due date to: Aledo High School Xxxxx Xxxxxx Off‐Campus PE Coordinator Xxxxxx 9th Grade Xxxxx Xxxxxx Off‐Campus PE Coordinator Aledo Middle School Xxxx Xxxx Off‐Campus PE Coordinator Aledo High School 0000 Xxxxxx Xxxxx Xx Xxxxxx 9th Grade Aledo Middle School 000 Xxxxxx Xxxxx Rd 000 XX 0000 Xxxxx Xxxxx XX 00000 Aledo TX 76008 Xxxxx XX 00000 Or fax to: Attn: Xxxxx Xxxxxx Off‐Campus PE Coordinator xxxxxxx@xxxxxxxx.xxx Attn: Xxxxx Xxxxxx Attn: Xxxx Xxxx Off‐Campus PE Coordinator Off Campus PE Coordinator xxxxxxx@xxxxxxxx.xxx xxxxx@xxxxxxxx.xxx 817‐441‐5136 817‐441‐2146 817‐441‐5133 Aledo Independent School District Off‐Campus PE Attendance Log Student Name: Activity: Activity Site: Contact Person:

Agency Information. Agency [Insert is applying for: (Please Check) Category 1 Status Category 2 Status Agency name] Name Agency File Reference [Insert Phone # Agency file reference number] RFQ Reference [Insert Address Email OCPE Agency RFQ reference number] Coordinator Phone # Cell # Email Signed on the date or dates below by authorized representatives of each party Agency Date: Agency Owner/Manager Date: OCPE Agency Coordinator Aledo Independent School District Date: AISD Representative NameDate: [Insert contact name] Position: [Insert title] Address: [Insert addressSuperintendent TO BE COMPLETED BY OCPE AGENCY COORDINATOR AND INSTRUCTOR The following schedule must be completed and signed by the OCPE Agency Coordinator and Instructor before the application will be considered. The instructor/facility should notify the OCPE Campus Coordinator if a change occurs in the number of hours the student is participating. OCPE INSTRUCTOR AGREEMENT AND STUDENT ACTIVITY SCHEDULE I understand that (name of student) _ is applying for an Off-campus Physical Education waiver and the student must participate in his/her activity, including postcode] Email: [Insert email address] Contact number: [Insert contact numberunder professional supervision, including area code] RFQ a minimum of 15 hours each week for CATEGORY I activities or a minimum of 10 hours each week for CATEGORY II activities. All activities must be completed at a single (one) approved agency, and Proposed Order Details RFQ Release Date [insert date the RFQ is released] RFQ Closing Date [insert date hours must be practice hours, and time the RFQ closes] Proposed Order Commencement Date [insert date the Services will commence] Proposed Order Term may not include competitions times and/or Completion Date [insert the order term and/or completion date] Request For Quotation for Services Options to extend meetings. The Agency may extend the Contract for [insert time period] by providing written notice records concerning daily attendance, grades, records of competitions, etc. must be completed and returned to the Service Provider prior District on dates specified by the district. The above-named student is scheduled to participate in a physical education program meeting this requirement as designated below: DAY BEGINNING TIME ENDING TIME ACTIVITY TOTAL HOURS OF PARTICIPATION MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY TOTAL HOURS OF PARTICIPATION PER WEEK As the instructor in the program, I support the following conditions of the OCPE Program: 1. I will provide copies of my credentials, certification, and/or documentation of instructor training and experience to the Order Completion DateOCPE District Liaison upon request. Milestones [Insert proposed milestones for 2. I will include the delivery agreed upon Physical Education TEKS during scheduled practices, and submit a written outline of program objectives and activities to the Services] Statement of Work Service Area [Insert which Service Category within a Service Area the Services required relate to (Financial/Corporate/Commercial)] Service Category [Insert the relevant Service Category that the services relate to] Service Sub-category [Insert the relevant Service Subcategory that the services relate to] Detailed Statement of Work [Insert a detailed description of the Services required and any Associated Outputs, including relevant background material and whether any licences/authorisations are required OCPE Campus Liaison upon request. 3. I agree to provide the services required documentation, including student’s hours of participation, an accurate record of student attendance, and any reporting that may be required. A separate Statement of Work may be referenced a marking period grade, on the form provided by the district, and attached] Deliverables [include details of any deliverables required under a resulting Contract] Subcontractors [Select one return this form to the OCPE Campus Liaison by mail, email, or fax within five (5) days of the following statementsend of each grading period. 4. I agree to contact the OCPE Campus Liaison if the student’s attendance becomes irregular, is not completing the required number of hours, or is no longer enrolled in the program. 5. I agree to contact the OCPE Campus Liaison if the student chooses to transfer into a general physical education class and/or does not meet the 90% attendance requirements. For the OCPE Program, one day of participation is equivalent to one day of attendance or absence. 6. I agree to release the student on designated Fitness Gram administration date. I understand that I am accountable to Aledo ISD for the participation of each student in Off-Campus Physical Education. I will make every effort to cooperate with the district. As a qualified instructor, my signature verifies the above schedule and recommends this student for participation in the program. Signature of OCPE Agency Instructor Date Signature of OCPE Agency Coordinator Date Aledo Independent School District Off‐Campus Physical Education Grade Reporting Form Student’s Name: The Service Provider may nominate subcontractors to provide some or all Student’s Activity: School Campus: OCPE Campus Liaison: Activity Site: Contact Person: Grade Reports will be due within (5) days of the Services; or The Service Provider may not nominate subcontractors last day of each grading period. Please submit the grade reports to provide some or all of the Services.] Location [Insert the required work location/site, or insert ‘Not Applicable’] Fees [Insert details of fee structure e.g. hourly/daily rates, fixed fee] Payment Terms [Select the relevant payment terms] [For Non-corporate Commonwealth entities: (a) five calendar days where the Agency and the Service Provider both have the capability to deliver and receive e Invoices through the Pan-European Public Procurement On-Line Framework and have agreed to use this method of invoicing; or (b) 20 calendar days] [For Agencies other than Non-corporate Commonwealth entities: [insert payment terms]] Travel [Insert details of any travel that may be required and whether the Service Provider OCPE Campus Coordinator. Each student will be reimbursed issued a grade of “pass” or “fail” for travel costs or if travel will be paid for their participation in the Off Campus PE program Citizenship grades are: E ‐ Excellent S ‐ Satisfactory N ‐ Needs improvement U ‐ Unsatisfactory 1st Marking Period: Citizenship: Due Date: October 11, 2019 2nd Marking Period: Citizenship: Due Date: December 20, 2019 3rd Marking Period: Citizenship: Due Date: March 13, 2020 4th Marking Period: Citizenship: Due Date: May 28, 2020 Contact Person Signature: Attach the participation log and submit by the Agency, or insert Not Applicable]. Agency Material [List any documents attached to the RFQ] Existing Material [Insert details of any Existing Material or insert ‘Not Applicable’] Contract Material [Unless specified in the Statement of Work, insert details of any Contract Material] Request For Quotation for Services Confidential Information [Include details in table below or insert Not Applicable] Key Personnel Requirements Required Qualifications and Experience [Include details of mandatory/desired qualifications, expertise, capacity and capability of Key Personnel, and whether or not they must have a security clearance]due date to: Aledo High School Xxxxx Xxxx XxXxxxxxxx Off‐Campus PE Coordinator Aledo High School 0000 Xxxxxx Xxxxx Xx Xxxxxx 9th Grade Xxxxx Xxxxxx Off‐Campus PE Coordinator Xxxxxx 9th Grade 000 Xxxxxx Xxxxx Rd Aledo Middle School Xxxxxxx Xxxx Off‐Campus PE Coordinator Aledo Middle School 000 XX 0000 Xxxxx Xxxxx XX 00000 Aledo TX 76008 Xxxxx XX 00000 Or fax to: Attn: Xxxxx Xxxx XxXxxxxxxx Off‐Campus PE Coordinator xxxxxxxxxxx@xxxxxxxx.xxx Attn: Xxxxx Xxxxxx Off‐Campus PE Coordinator xxxxxxx@xxxxxxxx.xxx Attn: Xxxxxxx Xxxx Off Campus PE Coordinator xxxxx@xxxxxxxx.xxx 817‐441‐5136 817‐441‐2146 817‐441‐5133 Aledo Independent School District Off‐Campus PE Attendance Log Student Name: Activity: Activity Site: Contact Person:

Agency Information. Agency [Insert is applying for: (Please Check) Category 1 Status Category 2 Status Agency name] Name Agency File Reference [Insert Phone # Agency file reference number] RFQ Reference [Insert Address Email OCPE Agency RFQ reference number] Coordinator Phone # Cell # Email Signed on the date or dates below by authorized representatives of each party Agency Date: Agency Owner/Manager Date: OCPE Agency Coordinator Aledo Independent School District Date: AISD Representative NameDate: [Insert contact name] Position: [Insert title] Address: [Insert addressSuperintendent TO BE COMPLETED BY OCPE AGENCY COORDINATOR AND INSTRUCTOR The following schedule must be completed and signed by the OCPE Agency Coordinator and Instructor before the application will be considered. The instructor/facility should notify the OCPE Campus Coordinator if a change occurs in the number of hours the student is participating. OCPE INSTRUCTOR AGREEMENT AND STUDENT ACTIVITY SCHEDULE I understand that (name of student) _ is applying for an Off-campus Physical Education waiver and the student must participate in his/her activity, including postcode] Email: [Insert email address] Contact number: [Insert contact numberunder professional supervision, including area code] RFQ a minimum of 15 hours each week for CATEGORY I activities or a minimum of 10 hours each week for CATEGORY II activities. All activities must be completed at a single (one) approved agency, and Proposed Order Details RFQ Release Date [insert date the RFQ is released] RFQ Closing Date [insert date hours must be practice hours, and time the RFQ closes] Proposed Order Commencement Date [insert date the Services will commence] Proposed Order Term may not include competitions times and/or Completion Date [insert the order term and/or completion date] Request For Quotation for Services Options to extend meetings. The Agency may extend the Contract for [insert time period] by providing written notice records concerning daily attendance, grades, records of competitions, etc. must be completed and returned to the Service Provider prior District on dates specified by the district. The above-named student is scheduled to participate in a physical education program meeting this requirement as designated below: DAY BEGINNING TIME ENDING TIME ACTIVITY TOTAL HOURS OF PARTICIPATION MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY TOTAL HOURS OF PARTICIPATION PER WEEK As the instructor in the program, I support the following conditions of the OCPE Program: 1. I will provide copies of my credentials, certification, and/or documentation of instructor training and experience to the Order Completion DateOCPE District Liaison upon request. Milestones [Insert proposed milestones for 2. I will include the delivery agreed upon Physical Education TEKS during scheduled practices, and submit a written outline of program objectives and activities to the Services] Statement of Work Service Area [Insert which Service Category within a Service Area the Services required relate to (Financial/Corporate/Commercial)] Service Category [Insert the relevant Service Category that the services relate to] Service Sub-category [Insert the relevant Service Subcategory that the services relate to] Detailed Statement of Work [Insert a detailed description of the Services required and any Associated Outputs, including relevant background material and whether any licences/authorisations are required OCPE Campus Liaison upon request. 3. I agree to provide the services required documentation, including student’s hours of participation, an accurate record of student attendance, and any reporting that may be required. A separate Statement of Work may be referenced a marking period grade, on the form provided by the district, and attached] Deliverables [include details of any deliverables required under a resulting Contract] Subcontractors [Select one return this form to the OCPE Campus Liaison by mail, email, or fax within five (5) days of the following statementsend of each grading period. 4. I agree to contact the OCPE Campus Liaison if the student’s attendance becomes irregular, is not completing the required number of hours, or is no longer enrolled in the program. 5. I agree to contact the OCPE Campus Liaison if the student chooses to transfer into a general physical education class and/or does not meet the 90% attendance requirements. For the OCPE Program, one day of participation is equivalent to one day of attendance or absence. 6. I agree to release the student on designated Fitness Gram administration date. I understand that I am accountable to Aledo ISD for the participation of each student in Off-Campus Physical Education. I will make every effort to cooperate with the district. As a qualified instructor, my signature verifies the above schedule and recommends this student for participation in the program. Signature of OCPE Agency Instructor Date Signature of OCPE Agency Coordinator Date Aledo Independent School District Off‐Campus Physical Education Grade Reporting Form Student’s Name: The Service Provider may nominate subcontractors to provide some or all Student’s Activity: School Campus: OCPE Campus Liaison: Activity Site: Contact Person: Grade Reports will be due within (5) days of the Services; or The Service Provider may not nominate subcontractors last day of each grading period. Please submit the grade reports to provide some or all of the Services.] Location [Insert the required work location/site, or insert ‘Not Applicable’] Fees [Insert details of fee structure e.g. hourly/daily rates, fixed fee] Payment Terms [Select the relevant payment terms] [For Non-corporate Commonwealth entities: (a) five calendar days where the Agency and the Service Provider both have the capability to deliver and receive e Invoices through the Pan-European Public Procurement On-Line Framework and have agreed to use this method of invoicing; or (b) 20 calendar days] [For Agencies other than Non-corporate Commonwealth entities: [insert payment terms]] Travel [Insert details of any travel that may be required and whether the Service Provider OCPE Campus Coordinator. Each student will be reimbursed issued a grade of “pass” or “fail” for travel costs or if travel will be paid for their participation in the Off Campus PE program Citizenship grades are: E ‐ Excellent S ‐ Satisfactory N ‐ Needs improvement U ‐ Unsatisfactory 1st Marking Period: Citizenship: Due Date: October 16, 2020 2nd Marking Period: Citizenship: Due Date: December 18, 2020 3rd Marking Period: Citizenship: Due Date: March 12, 2021 4th Marking Period: Citizenship: Due Date: May 27, 2021 Contact Person Signature: Attach the participation log and submit by the Agency, or insert Not Applicable]. Agency Material [List any documents attached to the RFQ] Existing Material [Insert details of any Existing Material or insert ‘Not Applicable’] Contract Material [Unless specified in the Statement of Work, insert details of any Contract Material] Request For Quotation for Services Confidential Information [Include details in table below or insert Not Applicable] Key Personnel Requirements Required Qualifications and Experience [Include details of mandatory/desired qualifications, expertise, capacity and capability of Key Personnel, and whether or not they must have a security clearance]due date to: Aledo High School Xxxxx Xxxx XxXxxxxxxx Off‐Campus PE Coordinator Aledo High School 0000 Xxxxxx Xxxxx Xx Xxxxxx 9th Grade Xxxxx Xxxxxx Off‐Campus PE Coordinator Xxxxxx 9th Grade 000 Xxxxxx Xxxxx Rd Aledo Middle School Xxxxxxx Xxxx Off‐Campus PE Coordinator Aledo Middle School 000 XX 0000 Xxxxx Xxxxx XX 00000 Aledo TX 76008 Xxxxx XX 00000 Or fax to: Attn: Xxxxx Xxxx XxXxxxxxxx Off‐Campus PE Coordinator xxxxxxxxxxx@xxxxxxxx.xxx Attn: Xxxxx Xxxxxx Off‐Campus PE Coordinator xxxxxxx@xxxxxxxx.xxx Attn: Xxxxxxx Xxxx Off Campus PE Coordinator xxxxx@xxxxxxxx.xxx 817‐441‐5136 817‐441‐2146 817‐441‐5133 Aledo Independent School District Off‐Campus PE Attendance Log Student Name: Activity: Activity Site: Contact Person:

Agency Information. Agency [Insert is applying for: (Please Check) Category 1 Status Category 2 Status Agency name] Name Agency File Reference [Insert Phone # Agency file reference number] RFQ Reference [Insert Address Email OCPE Agency RFQ reference number] Coordinator Phone # Cell # Email Signed on the date or dates below by authorized representatives of each party Agency Representative NameDate: [Insert contact name] PositionAgency Owner/Manager Date: [Insert title] AddressOCPE Agency Coordinator Aledo Independent School District Date: [Insert addressExecutive Director of Curriculum Date: Superintendent TO BE COMPLETED BY OCPE AGENCY COORDINATOR AND INSTRUCTOR The following schedule must be completed and signed by the OCPE Agency Coordinator and Instructor before the application will be considered. The instructor/facility should notify the OCPE Campus Coordinator if a change occurs in the number of hours the student is participating. OCPE INSTRUCTOR AGREEMENT AND STUDENT ACTIVITY SCHEDULE I understand that (name of student) _ is applying for an Off-campus Physical Education waiver and the student must participate in his/her activity, including postcode] Email: [Insert email address] Contact number: [Insert contact numberunder professional supervision, including area code] RFQ a minimum of 15 hours each week for CATEGORY I activities or a minimum of 10 hours each week for CATEGORY II activities. All activities must be completed at a single (one) approved agency, and Proposed Order Details RFQ Release Date [insert date the RFQ is released] RFQ Closing Date [insert date hours must be practice hours, and time the RFQ closes] Proposed Order Commencement Date [insert date the Services will commence] Proposed Order Term may not include competitions times and/or Completion Date [insert the order term and/or completion date] Request For Quotation for Services Options to extend meetings. The Agency may extend the Contract for [insert time period] by providing written notice records concerning daily attendance, grades, records of competitions, etc. must be completed and returned to the Service Provider prior District on dates specified by the district. The above-named student is scheduled to participate in a physical education program meeting this requirement as designated below: DAY BEGINNING TIME ENDING TIME ACTIVITY TOTAL HOURS OF PARTICIPATION MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY TOTAL HOURS OF PARTICIPATION PER WEEK As the instructor in the program, I support the following conditions of the OCPE Program: 1. I will provide copies of my credentials, certification, and/or documentation of instructor training and experience to the Order Completion DateOCPE District Liaison upon request. Milestones [Insert proposed milestones for 2. I will include the delivery agreed upon Physical Education TEKS during scheduled practices, and submit a written outline of program objectives and activities to the Services] Statement of Work Service Area [Insert which Service Category within a Service Area the Services required relate to (Financial/Corporate/Commercial)] Service Category [Insert the relevant Service Category that the services relate to] Service Sub-category [Insert the relevant Service Subcategory that the services relate to] Detailed Statement of Work [Insert a detailed description of the Services required and any Associated Outputs, including relevant background material and whether any licences/authorisations are required OCPE Campus Liaison upon request. 3. I agree to provide the services required documentation, including student’s hours of participation, an accurate record of student attendance, and any reporting that may be required. A separate Statement of Work may be referenced a marking period grade, on the form provided by the district, and attached] Deliverables [include details of any deliverables required under a resulting Contract] Subcontractors [Select one return this form to the OCPE Campus Liaison by mail, email, or fax within five (5) days of the following statementsend of each grading period. 4. I agree to contact the OCPE Campus Liaison if the student’s attendance becomes irregular, is not completing the required number of hours, or is no longer enrolled in the program. 5. I agree to contact the OCPE Campus Liaison if the student chooses to transfer into a general physical education class and/or does not meet the 90% attendance requirements. For the OCPE Program, one day of participation is equivalent to one day of attendance or absence. 6. I agree to release the student on designated Fitness Gram administration date. I understand that I am accountable to Aledo ISD for the participation of each student in Off-Campus Physical Education. I will make every effort to cooperate with the district. As a qualified instructor, my signature verifies the above schedule and recommends this student for participation in the program. Signature of OCPE Agency Instructor Date Signature of OCPE Agency Coordinator Date Aledo Independent School District Off‐Campus Physical Education Grade Reporting Form Student’s Name: The Service Provider may nominate subcontractors to provide some or all Student’s Activity: School Campus: OCPE Campus Liaison: Activity Site: Contact Person: Grade Reports will be due within (5) days of the Services; or The Service Provider may not nominate subcontractors last day of each grading period. Please submit the grade reports to provide some or all of the Services.] Location [Insert the required work location/site, or insert ‘Not Applicable’] Fees [Insert details of fee structure e.g. hourly/daily rates, fixed fee] Payment Terms [Select the relevant payment terms] [For Non-corporate Commonwealth entities: (a) five calendar days where the Agency and the Service Provider both have the capability to deliver and receive e Invoices through the Pan-European Public Procurement On-Line Framework and have agreed to use this method of invoicing; or (b) 20 calendar days] [For Agencies other than Non-corporate Commonwealth entities: [insert payment terms]] Travel [Insert details of any travel that may be required and whether the Service Provider OCPE Campus Coordinator. Each student will be reimbursed issued a grade of “pass” or “fail” for travel costs or if travel will be paid for their participation in the Off Campus PE program Citizenship grades are: E ‐ Excellent S ‐ Satisfactory N ‐ Needs improvement U ‐ Unsatisfactory 1st Marking Period: Citizenship: Due Date: September 29, 2017 2nd Marking Period: Citizenship: Due Date: November 3, 2017 3rd Marking Period: Citizenship: Due Date: December 19, 2017 4th Marking Period: Citizenship: Due Date: February 16, 2018 5th Marking Period: Citizenship: Due Date: April 13, 2018 6th Marking Period: Citizenship: Due Date: May 31, 2018 Contact Person Signature: Attach the participation log and submit by the Agency, or insert Not Applicable]. Agency Material [List any documents attached to the RFQ] Existing Material [Insert details of any Existing Material or insert ‘Not Applicable’] Contract Material [Unless specified in the Statement of Work, insert details of any Contract Material] Request For Quotation for Services Confidential Information [Include details in table below or insert Not Applicable] Key Personnel Requirements Required Qualifications and Experience [Include details of mandatory/desired qualifications, expertise, capacity and capability of Key Personnel, and whether or not they must have a security clearance]due date to: Aledo High School Xxxxx Xxxxxx Off‐Campus PE Coordinator Xxxxxx 9th Grade Xxxxx Xxxxxx Off‐Campus PE Coordinator Aledo Middle School Xxxx Xxxx Off‐Campus PE Coordinator Aledo High School 0000 Xxxxxx Xxxxx Xx Xxxxxx 9th Grade Aledo Middle School 000 Xxxxxx Xxxxx Rd 000 XX 0000 Xxxxx Xxxxx XX 00000 Aledo TX 76008 Xxxxx XX 00000 Or fax to: Attn: Xxxxx Xxxxxx Off‐Campus PE Coordinator xxxxxxx@xxxxxxxx.xxx 817‐ Attn: Xxxxx Xxxxxx Attn: Xxxx Xxxx Off‐Campus PE Coordinator Off Campus PE Coordinator xxxxxxx@xxxxxxxx.xxx xxxxx@xxxxxxxx.xxx 441‐5136 817‐441‐2146 817‐441‐5133 Aledo Independent School District Off‐Campus PE Attendance Log Student Name: Activity: Activity Site: Contact Person: