HomeMy WebLinkAbout28701CONTRACT INFORMATION SHEET
DATE: 10/28/16
Contract No.: P-16-601-P Vendor Number: 0000258832
Contract Title: Work Experience & Name/ Address: Purchasing Master
Supervised Training Agreement
Contract Period: 10/01/16 -09/30/17 Representative:
Using Agencies: 5610 Phone No.:
Email:
Terms: N45 ---------------------
Total Contract Amt.: $0.00 ~~~--------------
Buyer Name: Debbie Scharnick
Requisition No: _5..:..6_11_7_0_03_3_3 ______ _ Org: 56107001
Supersedes:
mNEW L_... _ _,l RENEWAL .__ _ _JI ADJUSTMENT
D TICKDATE I REFERENCE (RFQ# I RFP#) '----'
RFSQ 17-023
DESCRIPTION: Work Experience Activities & Supervised Work Training
Vendor: Hands On Central Ca.
SPECIAL INSTRUCTIONS: One year contract-May be extended for two additional one year periods by mutual consent
DISTRIBUTION:
DEPARTMENT: _D_ss _____ _
REQUISITIONER: Jessica Rangel
Dean Brawley
Rev 1/2115
Completed By: Date: Completed By: Date
PROCUREMENTAGREEMENTNUMBER:~16~01~
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October 3, 2016
CONTRACTOR TO COMPLETE:
Company: ~\ Q 111.ol S W Vl
Type of Entity:
0 Individual 0 Limited Liability Company
[J Sole Proprietorship
0 Corporation
0
0
Limited Liability Partnership
General Partnership
LlJa d Lu 1==-l . .o N15 '2 'c; 'i v<o.M.-~andTit~ ' · .·~,~ ~
Print Name and Title
Signature (In Blue Ink):
Date
Page5
\10/V\, ~ess Av ~5...-u) ~ '1372.'?
City State Zip
~([ -':L37 ~ ' a fe_ ll liio res @ lu:vvtr:ds (ftn. 6tA w
FAX UMBER E-MAIL ADDREss CCA..18 o::;
ACCOUNTING USE ONLY
ORG No.: 5610/7001
Account No.: 7870
Requisition No.: 5611700333
(09/2015)
G:\PUBLIC\CONTRACfS & EXTRACfS\P\P-16-601-P M<\STER AGREEMENT.OOCX
Issuance Date:
Closing Date:
Submittals:
Addressed To:
Mailing Address:
Mark Envelope:
Cost Limit for
Agreement(s):
REQUEST FOR STATEMENT OF QUALIFICATIONS
NO. 17-023
COUNTY OF FRESNO
Work Experience Activities and
Supervised Work Training
September 29, 2016
Wednesday, October 12,2016 2:00P.M.
Two (2) paper copies of the Statement of Qualifications
Debbie Scharnick, Purchasing Technician I
County of Fresno, Purchasin~
4525 E. Hamilton Avenue, 2n Floor
Fresno, CA 93702
"RFSQ-Work Experience Activities and Supervised Work Training"
No Cost to Vendors \-
STATEMENT OF QUALIFICATIONS (SOQ) PACKAGES RECEIVED AFTER THE TIME AND DATE
STATED ABOVE WILL BE RETURNED UNOPENED TO THE VENDOR.
Inquiries and Updates: Requests for clarification regarding this Request for Statement of Qualifications
(RFSQ) must be submitted in writing via email to Debbie Scharnick, Purchasing Technician I, at
dscharnick@co.fresno.ca.us, and received by the County no later than 10:00 A.M., Tuesday, October
4, 2016. Such information as is reasonably available and will facilitate preparation of responses hereto,
requests for clarification and associated responses, and any addenda to this RFSQ will be posted at:
https:l/www2.co.fresno.ca.us/0440/Bids/BidsHome.aspx and will not otherwise be distributed.
Organization
I \ . (:\ ; . ~ 1 • • ~"""' c
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t.. ~. " v
Individual/Contact Person Title
Zip Code
(~ h G ]/l(/s a ri C·i-'i
Telephone
Work Experience/Communty Service Qualification Survey
Employer Category:
~-L~~~~-------=~~--~--~~~~~~----~
D Private Non-profit*
D Public Non-profit*
D Private Business
*Must provide SOl(c) (3)
Extension:
Type of Service to be Provided: D Community Service
Worksite Location
Work,site Syp~rvisor:
.;/_~,, At. J·
Extension:
Job Title: Duties to be Performed: 1-_;;;;c/~'·· "'+(~~· ','---, ~··---4'--'l\~=--'"--:::::~--~-·l-4L~----i ('1 L.," ~'\ ,, ', L ( F· l·\.. V"' ' i ,
Number of Positio'ns Available:~)
----~-~~
-""'--__ _,;
Minimum Requirements for the Position:
\ 'I ' C\.
Length of Project:
t\. \ \)~
Weekly Hours Available (Maximum 40 hours/week): Special Clothing I Equipment Requirements: ,,,
17-023
Attachment A
W0rk&j~e Supervisor Signature: Date:
\.":.· ', :\_,~A