4.) the per cost for one way trip 5.) identify the type of transportation service i.e. on demand, modified fixed route, feeder, etc. 6.) what procedures are in place to evaluate the success of the route(s) 7.) identify whether the vehicle(s) are handicapped accessible 8.) identify the methodology that will be utilized to document ridership 9.) if children will be transported, describe the method of transportation 10.) if services will be available to both TANF and non-TANF recipients, the method used to allocate the costs to TANF (funded through the contract) must be explained. Provide the method developed by the county to track these services and identify the other funding sources i.e. county private, etc. available. If providing driver training either for license obtainment or restoration state the cost per person per hour, who is providing this service, what is included, length of time toward completion, criteria for offering this service to an individual and the projected number to be offered this training. The payment of fines which are the result of criminal offenses such as DUI is not permitted. Identify how special needs (person with physical challenges) will be addressed. Car Repairs require the two estimates unless it will be provided through an agency under state contract. The car must also be otherwise road worthy. The Total Cost and Level of Service must be stated for each program offered. Please note that all Transportation funding must be identified in the Annex A and allocated in the Annex B. Unallocated funds cannot be included in the Annex A or Annex B. Unallocated funds may be modified into the Contract when the county has determined how the unallocated funds will be spent. DFD will have final approval of all activities developed. Administration and Other Contract Requirements: 1. Monitoring of Subcontract Vendors
As the recipient of Federal and State contract funds, the provider agency is responsible for the selection and performance of services subcontracted to vendors. The contract renewal package must identify each subcontract, the value of the agreement and include a copy of the agreement. In the contract narrative, please describe the program monitoring process for all subcontracts. Submit a copy of the monitoring tool including approximate timelines for monitoring as part of this contract. At a minimum, monitoring must, at a minimum, include the following: comparison of actual services provided with Annex A description of projected services to be provided, and documentation of the review, approval and payment process. DFD program staff will perform on-site monitoring of your contract including detailed review of the client eligibility, services provided, and subcontract services. Subcontract Requirements: Counties are required to follow the local public contract law. Signed subcontracts must be sent to DFD per the contract regulations within 30 days of the start of the contract. At a minimum, subcontracts should contain the following sections: General Terms and Conditions Program Description of Services to be Provided Level of Service Budget The subcontract must be written so that it does not contradict or compromise any of the language of this Contract or the DHS/DFD Standard Language Document (SLD). These terms and conditions must also incorporate all SLD terms and conditions. Administrative Costs CAP If administrative costs are being charged to this contract, the entire amount of the administrative costs, both contracted and subcontracted, should not exceed 12% of the contract ceiling. Administrative costs must be allocated by Budget Category (i.e. Personnel, Consultants in the G&A column) and by program component (i.e. Transportation). Administrative costs are all costs incurred by or allocated to the Agency except:
If this is a renewal contract, describe at a minimum how your program developed and made progress toward its goals in the past year? What barriers, if any, have impacted your agency’s ability to meet program goals? How are services evaluated? What are the results? Identify strengths and weaknesses noted in evaluations. If fees will be collected from recipients of any services outlined in the Contract Requirements, state the anticipated annual amount of revenue. Also state how those revenues will be used to offset the contract’s costs. Instructions for the Projected Level of Service Forms LOS forms are located on the DFD website. You must complete the forms and submit them with the renewal package. The following forms, as related to the approved components of the program are required: TS Projected County LOS TS Projected Provider LOS TIP Quarterly LOS CM Projected Level of Service REMINDERS: All program details must reconcile to the Annex A narrative details, the Annex B and the LOS. Please ensure the mathematical accuracy of the data presented.
STATE OF NEW JERSEY DIVISION OF FAMILY DEVELOPMENT CONTRACT ADMINISTRATOR: CONTRACT NUMBER: NAME OF AGENCY: CONTRACT PERIOD: INDEX OF REQUIRED CONTRACT DOCUMENTS This index provides details of all required documents that must either be included with the contract package (see checklist) or must be available on site for inspections as noted in the Document Verification Sheet (DVS). Forms that are not included in the following pages, can be found by accessing the website at and clicking on the link for Standard Contract Documents. Document Required with first Contract and as Amended Required Annually and as Amended Checklist Required for on-site - DVS Form Check if submitted with package Contract Documents Standard Language Document (SLD) with original signatures (additional copies requested must also have original signature) 2 copies Annex A (including summary sheet and supporting schedules) 3 copies Annex B – Budget Form with all required forms, schedules, and signatures and required Budget Narrative. 3 copies Executive Order 129 (Public Law 2005, Chapter 92) Source Disclosure Certification Form ● Federal Funding Accountability and Transparency Act (FFATA) Worksheet (if applicable) ● Certification of Suspension and Debarment ● Disclosure of Investment Activities in Iran Form ● Agreements Copies of Subcontract/Consultant Agreement(s) ● Private/Public Donor Agreement (s) for Match Responsibilities ● HIPAA Business Associate Agreement (BAA) ● ● A copy of the Acknowledgement of Receipt of the New Jersey State Policy and Procedures for EEO/AA ● Insurances/Licenses/Certificates Liability Insurance Declaration Page and/or Malpractice Insurance ● Bonding Certificate ● Applicable Licenses (business and professional licenses) ● Current Affirmative Action Certificate or copy of renewal application sent to Treasury (AA302 – Affirmative Action Employee Information Report) ● Health/Fire Certificates, Certificate of Occupancy ●
STATE OF NEW JERSEY DIVISION OF FAMILY DEVELOPMENT List of Contracts/Grants Check here if this information already appears on the Annex B, Schedule 2 - Contract Information Form. If so, then it is not necessary to duplicate the information here. Contracting Division/Office Program Name Type of Service Contract Number Contract Term Amount Division/Office Contact Person and Phone Number Provider Agency Contact Person and Phone Number