HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • July 25th, 2018
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia Chief Procurement Officer, or his or her designee, to award human care agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitate the process of pre-qualifying contractors for a human care agreement with the District of Columbia in accordance with D.C. Law 13-155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement Contractor Qualifications Record form. All information must be completed in the spaces provided, or marked “N/A.” 2. An original signature must be provided in those sections where a signature is required. Copies or a stamped signature is not acceptable. 3. Included in
ContractHuman Care Agreement • June 3rd, 2019 • District of Columbia
Human Care Agreement Scope of WorkHuman Care Agreement • May 4th, 2018
Government of the District of ColumbiaHuman Care Agreement • August 5th, 2021 • District of Columbia
HUMAN CARE AGREEMENT Pag1 e of Pages 57 1. HCA NumberDoc574375 2. Date of AwardSee Block 13C 3. DateSolicitation Issued 8/5/2021 4. Issued by: JM0Office of Contracting and Procurement On Behalf ofDepartment on Disability Services 250 E Street, SW,Washington, DC 20024 5. Administered by:Department on Disability Services (DDS) Developmental Disabilities Administration (DDA) 250 E Street, SW,Washington, DC 20024Telephone: 202-730-1700 6. NAME AND ADDRESS OF PROVIDER/CONTRACTOR (No. Street, county, state and ZIP Code) Phone: Fax: Email: 7. PROVIDER/CONTRACTOR SHALL SUBMIT ALL INVOICES TO: See Section G.3.4 INVOICESUBMITTAL 8. DISTRICT SHALL SEND ALL PAYMENTS TO: Address in Block 6. 9. DESCRIPTION OF HUMAN CARE SERVICE AND RATE COST LINE ITEM NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANTITY OF SERVICE REQUIRED TOTAL SERVICE UNITS SERVICE RATE TOTAL AMOUNT 0001thru 0006 952-92-65 Residential Habilitation, Supported Living, a nd Host Home Occupancy RelatedResidential Expenses for Di
Government of the District of ColumbiaHuman Care Agreement • November 14th, 2012 • District of Columbia
HUMAN CARE AGREEMENT PAGE OF PAGES 1 115 1. HUMAN CARE AGREEMENT NUMBER:DCRL-2013-H-0039 2. REQUISITION/PURCHASE REQUEST NO. 3. PURCHASE ORDER/TASK ORDER NUMBER 4. DATE OF AWARD 5. ISSUED BYChild and Family Services Agency 200 I Street, S.E., Suite 2030Washington, D.C. 20003 6. ADMINISTERED BY (If other than Item 5) See Section G 7. NAME AND ADDRESS OF PROVIDER/CONTRACTOR (No. street, county, state and ZIP Code) 8. PROVIDER/CONTRACTOR SHALL SUBMIT ALL INVOICES TO:Child and Family Services Agency Fiscal Operations200 I Street, S.E., Suite 2030Washington, DC 20003 9. DISTRICT SHALL SEND ALL PAYMENTS TO: 10. DESCRIPTION OF HUMAN CARE SERVICE AND COST (TO BE COMPLETED BY CFSA) ITEM/LINE NO. NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANITY OF SERVICE REQUIRED TOTAL SERVICE UNITS SERVICE RATE TOTAL AMOUNT SEE ATTACHED SCHEDULE B Total $ Total From Any Continuation Pages $ GRAND TOTAL $ 11. APPROPRIATION DATA AND FINANCIAL CERTIFICATION LINW AGY YEAR INDEX PCA OBJ AOB
HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • August 25th, 2017
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices of the Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia Chief Procurement Officer, or his or her designee, to award Human Care Agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitatethe process of pre-qualifying contractors for a Human Care Agreement with the District of Columbia in accordance with D.C. Law 13-155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement (HCA), Contractor Qualifications Record (CQR) form. All information must be completed in the spaces provided, or marked “N/A.” 2. Original signatures must be included. Copies or a stamped signature is not acceptable. 3. The Standard Contract Provisions (SCP) fo
HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • April 20th, 2009
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia Chief Procurement Officer, or his or her designee, to award Human Care Agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitate the process of pre-qualifying contractors for a Human Care Agreement with the District of Columbia in accordance with D.C. Law 13-155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement Contractor Qualifications Record (CQR) form. All information must be completed in the spaces provided, or marked “N/A.” 2. Original signatures must be included. Copies or a stamped signature is not acceptable. 3. Included in the package that will be provided to you w
HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • August 23rd, 2017
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices of the Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia ChiefProcurement Officer, or his or her designee, to award Human Care Agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitatethe process of pre-qualifying contractors for a Human Care Agreement with the District of Columbia in accordance with D.C. Law 13-155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement (HCA), Contractor Qualifications Record (CQR) form. All information must be completed in the spaces provided, or marked “N/A.” 2. Original signatures must be included. Copies or a stamped signature is not acceptable. 3. The Standard Contract Provisions (SCP) for
HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • September 22nd, 2010
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia Chief Procurement Officer, or his or her designee, to award human care agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitate the process of pre-qualifying contractors for a human care agreement with the District of Columbia in accordance with D.C. Law 13-155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement Contractor Qualifications Record form. All information must be completed in the spaces provided, or marked “N/A.” 2. An original signature must be provided in those sections where a signature is required. Copies or a stamped signature is not acceptable. 3. Included in
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • May 2nd, 2023
Government of the District of ColumbiaHuman Care Agreement • May 31st, 2007
HUMAN CARE AGREEMENT PAGE OF PAGES 1 20 1. CONTRACT NUMBERDCJA-2007-HC-0037 2. REQUISITION/PURCHASE REQUEST NO. 3. EFFECTIVE DATEMay 31, 2007 4. ISSUED BY 5. ADMINISTERED BY (If other than Item 5): Office of Contracting and Procurement Department of Human Services64 New York AvenueWashington, DC 20002 Contracting Officer Technical Representative as specified in Item E.2.1 Telephone: (202) 698-3915 Fax: (202) 724-8965 E-Mail: 6. NAMES AND ADDRESS OF PROVIDER/CONTRACTOR (No. Street, county, state and ZIP Code) POINT OF CONTACT:Telephone: Fax: E-Mail: 7. PROVIDER/CONTRACTOR SHALL SUBMIT ALL INVOICES TO:Office of the Controller/Agency CFOP.O. Box 54047, Room1702 Washington, D.C. 20032 8. DISTRICT SHALL SEND ALL PAYMENTS TO: 9. DESCRIPTION OF HUMAN CARE SERVICE AND RATE COST ITEM/LINE NO. NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANITY OF SERVICE REQUIRED TOTAL SERVICE UNITS SERVICE RATE TOTAL AMOUNT 0001 952-95 General Practitioner See Section See Section
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • May 2nd, 2023
ContractHuman Care Agreement • November 7th, 2018
GOVERNMENT OF THE DISTRICT OF COLUMBIAHuman Care Agreement • July 9th, 2018
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • May 2nd, 2023
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • July 10th, 2023
DISTRICT OF COLUMBIA GOVERNMENTHuman Care Agreement • November 1st, 2017 • District of Columbia
Human Care Agreement PAGE OF PAGES 1 49 1. HUMAN CARE AGREEMENT NUMBER 2. REQUISITION/PURCHASE REQUEST NO./SOLICITATION NO. 3. DATE OF AWARD RM-17-HCA-MHRS-XXX-BY4-RDS 4. ISSUED BY 5. ADMINISTERED BY (If other than Item No. 4): OFFICE OF CONTRACTING AND PROCUREMENT OBO/DEPARTMENT OF BEHAVIORAL HEALTH64 New York Avenue NE, 2nd Floor (west) Washington, DC 20002 Department of Behavioral HealthHuman Care Agreement/Contract Administrator – TBD 64 New York Avenue NE, 2nd Floor (west) Washington, DC 20002 6. NAME AND ADDRESS OF PROVIDER/CONTRACTOR (No. street, county, state and ZIP Code) 7. PROVIDER/CONTRACTOR SHALL SUBMIT ALL CLAIMS/ INVOICES TO: 8. DISTRICT SHALL SEND ALL PAYMENTS TO: Department of Behavioral Health (Reference Section G) 9. DESCRIPTION OF HUMAN CARE SERVICE AND RATE COST ITEM/LINE NO. NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANTITY OFSERVICE REQUIRED TOTALSERVICE UNITS SERVICE RATE TOTAL AMOUNT XXX-XX- XX See section B Total $
ContractHuman Care Agreement • October 3rd, 2019
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • April 1st, 2021
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • February 3rd, 2023
ContractHuman Care Agreement • January 2nd, 2020
ContractHuman Care Agreement • May 1st, 2019
ContractHuman Care Agreement • December 10th, 2020
Government of the District of ColumbiaHuman Care Agreement • May 17th, 2017
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia Chief Procurement Officer, or his or her designee, to award human care agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package thatwill facilitate the process of pre-qualifying contractors for a human care agreement with the District of Columbia in accordance with D.C. Law 13- 155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement Contractor Qualifications Record form. All information must be completed in the spaces provided, or marked “N/A.” 2. An original signature must be provided in those sections where a signature is required. Copies or a stamped signature is not acceptable. 3. Included in
ContractHuman Care Agreement • June 26th, 2015 • District of Columbia
CLIN Service Description Unit Price 0001 Job Development (Appendix A) 0001A 30 Days Job Development Progress Report Each $930.50 0001B 60 Days Job Development Progress Report Each $930.50 0001C 90 Days Job Development Progress Report Each $930.50 CLIN 0001 Total $2,791.50* 0002 Job Placement 0002A Job Placement Information Report (Appendix B) Each $930.50 0002B Job Stabilization Report (Appendix C) Each $930.50 0002C Job Stabilization Closure Report (Appendix D) Each $930.50 CLIN 0002 Total $2791.50
HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • February 10th, 2016
STATUTORY AND REGULATORY AUTHORITY D.C. Code section 2-354.06, authorizes the District of Columbia Chief Procurement Officer, or his or her designee, to award Human Care Agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitate the process of pre-qualifying contractors for a Human Care Agreement with the District of Columbia in accordance with 27 DMCR Chapter 19. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement (HCA), Contractor Qualifications Record (CQR) form. All information must be completed in the spaces provided, or marked “N/A.” 2. Original signatures must be included. Copies or a stamped signature is not acceptable. 3. The Standard Contract Provisions (SCP) for use with District of Columbia Government Supplies and Services Contracts dated March 2007 (“SCP”) are
GOVERNMENT OF THE DISTRICT OF COLUMBIAHuman Care Agreement • March 28th, 2018
The purpose of this Request for Qualifications (RFQ) is to provide core services within the homeless services Continuum of Care identified in this RFQ. Selected Provider(s) shall provide comprehensive services necessary to operate one or more Short Term Family Housing (STFH) sites as home-like environments for families experiencing homelessness located within the District. The sites covered by this RFQ shall each house no more than fifty (50) families in newly built or renovated residential settings designed to support families experiencing homelessness quickly transition to housing. Services selected Provider(s) will be providing include management of day-to-day operations (including basic maintenance), case management and other supportive services, linkage and connection to community supports, food, security, janitorial, and furniture services. The Provider(s) shall collaborate with DHS, the District of Columbia Interagency Council on Homelessness (ICH), and other community stakehold
Chairman Phil Mendelson at the request of the MayorHuman Care Agreement • April 30th, 2021
ContractHuman Care Agreement • April 1st, 2021
Government of the District of Columbia Child and Family Services AgencyHuman Care Agreement • April 13th, 2010
HUMAN CARE AGREEMENT PAGE OF PAGES 1 100 1. CONTRACT NUMBER: 2. REQUISITION/PURCHASE REQUEST NO. 3. PURCHASE ORDER/TASK ORDER NUMBER 4. DATE OF AWARD 5. ISSUED BYChild and Family Services Agency 955 L’Enfant Plaza, S.W., Suite 5200Washington, D.C. 20024 6. ADMINISTERED BY (If other than Item 5) See Section G 7. NAME AND ADDRESS OF PROVIDER/CONTRACTOR (No. street, county, state and ZIP Code) 8. PROVIDER/CONTRACTOR SHALL SUBMIT ALL INVOICES TO:Child and Family Services Agency Fiscal Operations2nd Street SW Washington, DC 20024 9. DISTRICT SHALL SEND ALL PAYMENTS TO: 10. DESCRIPTION OF HUMAN CARE SERVICE AND COST (TO BE COMPLETED BY CFSA) ITEM/LINE NO. NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANITY OF SERVICE REQUIRED TOTAL SERVICE UNITS SERVICE RATE TOTAL AMOUNT 0001 952-15-00952-47-00 Case ManagementFoster Home and Adoption Services SEE ATTACHED SCHEDULE B Total $ Total From Any Continuation Pages $ GRAND TOTAL $ 11. APPROPRIATION DATA AND FINANCIAL CERTIFICATION LI
Human Care Agreement for Pre and Post Transitional Care Home ServicesHuman Care Agreement • April 29th, 2019
ContractHuman Care Agreement • December 28th, 2021 • District of Columbia
HUMAN CARE AGREEMENTDoc592402 PAGE OF PAGES 1 37 1. HUMAN CARE AGREEMENT NUMBER 2. REQUISITION/PURCHASE REQUEST NO. 3. DATE OF AWARD 4. ISSUED BY 5. ADMINISTERED BY (If other than Item No. 4): Office of Contracting and ProcurementField Office: Department of Behavioral Health (DBH) 64 New York Avenue, NE, 2nd FloorWashington, D.C.20002 Department of Behavioral Health Saint Elizabeths Hospital1100 Alabama Avenue, SE Washington, DC 20032 6. NAME AND ADDRESS OF CONTRACTOR/CONTRACTOR (No. street, county, state and ZIP Code) 7. CONTRACTOR/CONTRACTOR SHALL SUBMIT ALL CLAIMS/ INVOICES TO: 8. DISTRICT SHALL SEND ALL PAYMENTS TO: (Reference Section G) 9. DESCRIPTION OF HUMAN CARE SERVICE AND RATE COST ITEM/LINE NO. NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANTITY OF SERVICEREQUIRED TOTAL SERVICEUNITS SERVICE RATE TOTAL AMOUNT See section B Total $ Total From Any Continuation Pages $ GRAND TOTAL NOT TO EXCEED $ 10. APPROPRIATION DATA AND F
ContractHuman Care Agreement • April 1st, 2021
ContractHuman Care Agreement • March 30th, 2017
HUMAN CARE AGREEMENT CONTRACTOR QUALIFICATIONS RECORDHuman Care Agreement • July 31st, 2015
STATUTORY AND REGULATORY AUTHORITY The Procurement Practices of the Human Care Agreement Amendment Act of 2000 (D.C. Law 13-155) authorizes the District of Columbia ChiefProcurement Officer, or his or her designee, to award Human Care Agreements for the procurement of social, health, human, and education services directly to individuals in the District. The Human Care Agreement Contractor Qualifications Record (CQR) is an application package that will facilitatethe process of pre-qualifying contractors for a Human Care Agreement with the District of Columbia in accordance with D.C. Law 13-155 and Chapter 19, 27 DCMR, the regulations. GENERAL INSTRUCTIONS 1. Please read and complete each section of the Human Care Agreement (HCA), Contractor Qualifications Record (CQR) form. All information must be completed in the spaces provided, or marked “N/A.” 2. The Standard Contract Provisions (SCP) for use with District of Columbia Government Supplies and Services Contracts dated July 2010
