RFP, RFV, & OPPs

Appendix 1- Sample Service Development Agreement FY 24-25 Appendix 2 - NLACRC Board of Trustees Service Provider Insurance Policy Appendix 3 - NLACRC Board of Trustees Request for Proposals Policy Attachment A - Proposal Title Page (NLACRC-2425-2 and 2425-3) Attachment B - DS 1891 Applicant Vendor Disclosure Statement Attachment C - Statement of Obligation Attachment D - Budget for Start-Up Costs Attachment E- Cost Statement - Ongoing

Appendix 1 - Program Design Requirements Appendix 2 - Sample Service Development Agreement FY 24-25 Appendix 3 - NLACRC Board of Trustees Service Provider Insurance Policy Appendix 4 - NLACRC Board of Trustees Request for Proposals Policy Appendix 5 - Statutes and Regulations (NLACRC-2324-2 and 2324-3) Attachment A - Proposal Title Page (NLACRC-2425-2 and 2425-3) Attachment B - DS 1891 Applicant Vendor Disclosure Statement Attachment C - Statement of Obligation Attachment D - Budget for Start-Up Costs Attachment E- Cost Statement - Ongoing

Appendix 1 - Program Design Requirements Appendix 2 - Sample Service Development Agreement Appendix 3 - NLACRC Board of Trustees Service Provider Insurance Policy Appendix 4 - NLACRC Board of Trustees Request for Proposals Policy Appendix 5 - Statutes and Regulations Attachment A - Proposal Title Page Attachment B - DS 1891 Applicant Vendor Disclosure Statement Attachment C - Statement of Obligation Attachment D - Budget for Start-Up Costs Attachment E - Residential Facility Level 7 Rate Model_January 2025

Appendix 1 - Program Design Requirements Appendix 2 - Sample Service Development Agreement FY 24-25 Appendix 3 - NLACRC Board of Trustees Service Provider Insurance Policy Appendix 4 - NLACRC Board of Trustees Request for Proposals Policy Appendix 5 - Statutes and Regulations (NLACRC-2324-2 and 2324-3) Attachment A - Proposal Title Page (NLACRC-2425-2 and 2425-3) Attachment B - DS 1891 Applicant Vendor Disclosure Statement Attachment C - Statement of Obligation Attachment D - Budget for Start-Up Costs Attachment E - Facility Cost Statement - DS 6023 Budget for Start-Up or Transition Costs

Statewide Housing Access Services Request for Proposal

Attachment A - Proposal Title Page Attachment B - Statement of Obligation Attachment C - Statement of Equity and Diversity

Project 1- Socialization Training Program (028) Project 2- Social Recreational Programs (525) Project 3- Specialized Recreational Therapy (106) Project 4- Art Therapist (691) Project 5- Dance Therapist (692) Project 6- Music Therapist (693) Project 7- Recreation Therapist (694) Project 8- Camping Services (850) Project 9- Sports Club (008) Attachment A: Title Page Attachment B: Statement of Obligation Attachment C: Statement of Equity and Diversity Guide

SDP Standardized Vendorization Packet for Pre-Enrollment Services Person Centered Planning and Self-Directed Supports Guidance Attachment A: Vendor Packet Checklist Attachment B: General Self-Directed Supports Qualifications and Agreement Form Attachment C: Financial Management Services Self-Directed Supports Qualifications and Agreement Form Attachment D: DS 1890 Vendor Application Attachment E: DS 1891 Applicant/Vendor Disclosure Statement Attachment F: Conflict of Interest Form Attachment G: Business Associate Agreement/HIPAA Form Attachment H: Home and Community Based Services Provider Agreement Form Attachment I: W9 Request for Taxpayer Identification Number and Certification