Rfa Approval Form - Department Of Health And Human Services (Page 2 of 2) in pdf

Rfa Approval Form - Department Of Health And Human Services Page 2

INSTRUCTIONS FOR COMPLETING REQUEST FOR APPLICATIONS (RFA) APPROVAL FORM

Enter the assigned internal tracking number.

RFA #

RFA Title

Indicate the title of the RFA (e.g., Business Analysis, Market Rate Study, Child Care

Resource and Referral).

Enter a brief purpose for conducting the RFA (e.g., to contract with outside source to

BRIEF PURPOSE

conduct pre-licensing workshops for potential child day care providers).

RFA SUBMITTED

Indicate to which sector the RFA is being submitted (can be more than one).

FUNDING SOURCE

Indicate the funding source. Check to ensure that the funding source permits the

RFA activity and check to determine what agency (public, private non-profit, or

private for profit) may receive the funding. For example, a funding source may limit

funding to 501(c)(3) agencies; therefore public agencies or private for profit

agencies would not be able to participate.

Enter the FUND TYPE (source). Enter the CO # -(company number assigned to the

FUND TYPE/

Division). Enter the ACCOUNT and CENTER codes whenever possible. These

CO #/ACCT/

budget codes will apply to contract(s). Example: FUND TYPE : SSBG CO # 2XXX

CENTER/AMOUNT

ACCT 53XXXX CENTER 1XXXXXXXXX AMOUNT $200,000.00. If codes are

unknown enter the FUND TYPE and AMOUNT available for contracting.

SERVICES

Indicate what type of service would be purchased. Direct: services provided directly

to client(s). Indirect: Services not provided directly to client(s). Both: a combination

of services would be provided.

ROUTING/REQUIRED APPROVAL SIGNATURES

Initiator

Initiator of the project needs to sign and date the form. Attach the DRAFT RFA and

all attachments to the completed Approval form.

Section/Program Chief should sign, date and check approved or disapproved. If

Section/Program Chief

disapproved provide reason in comments section and return to the Initiator. If

approved forward package to Contract Office.

Contract Office

Contract Office should sign, date and check approved or disapproved. If disapproved

provide reason in comments section and return to the Initiator. If approved, the

package will be forwarded required offices.

Budget Officer

Budget Officer should sign, date and check approved or disapproved. If disapproved

provide reason in comments section. Return package to the Contract Office.

Division Director/Designee should sign, date and check approved or disapproved. If

Division

disapproved provide reason in comments section. Return package to the Contract

Director/Designee

Office.

D-3

Rfa Approval Form - Department Of Health And Human Services Page 2

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