CONTRACT CHECKLIST CONTRACT CONTRACT ADMINISTRATOR: NUMBER: NAME OF CONTRACT AGENCY: PERIOD: PROVIDER INSTRUCTIONS: This checklist must be completed and returned with all documents prior to contract approval. The correct number of copies and any additional Division documents must be returned to your Contract Administrator. Forms that are not included in the following pages, can be found by accessing the website at and clicking on the link to Standard Contract Documents. Number of If not submitted with Please check if copies to package, indicate anticipated Document submitted with be date of submission or reason package submitted for non-submission Complete copy of signed DHS Standard Language 2 Document (SLD) Checklist, DVS and Award Letter 1 Executive Order 129 Source Disclosure 1 Certification of Suspension or Debarment 1 Standardized Resolution indicating who is 1 authorized to sign: Contracts and Checks Annex A (including summary sheet and supporting 3 schedules) Annex B Form (Expense Summary, Details –Budget 3 and Schedules 1-6) List of Contracts 1 Equipment Inventory 1 Liability Insurance 1 Bonding Certificate 1 Titles, Addresses and Terms of Board of 1 Directors 1 Copy of Audit Report Current Affirmative Action Certificate or copy of 1 renewal application sent to Treasury (AA302) Chapter 51, Public Law 2005—For-Profit 1 agencies only Federal Funding Accountability and Transparency Act 1 (FFATA) Worksheet (if applicable) Copies of Subcontracts 1
CONTRACT CHECKLIST CONTRACT ADMINISTRATOR: CONTRACT NUMBER: NAME OF AGENCY: CONTRACT PERIOD: PROVIDER INSTRUCTIONS: This checklist must be completed and returned with all documents prior to contract approval. The correct number of copies and any additional Division documents must be returned to your Contract Administrator. Forms that are not included in the following pages, can be found by accessing the website at and clicking on the link to Standard Contract Documents. Document Number of copies to be submitted Please check if submitted with package If not submitted with package, indicate anticipated date of submission or reason for non-submission Complete copy of signed DHS Standard Language Document (SLD) 2 Checklist, DVS and Award Letter 1 Executive Order 129 Source Disclosure 1 Certification of Suspension or Debarment 1 Standardized Resolution indicating who is authorized to sign: Contracts and Checks 1 Annex A (including summary sheet and supporting schedules) 3 Annex B –Budget Form (Expense Summary, Details and Schedules 1-6) 3 List of Contracts 1 Equipment Inventory 1 Liability Insurance 1 Bonding Certificate 1 Titles, Addresses and Terms of Board of Directors 1 Copy of Audit Report 1 Current Affirmative Action Certificate or copy of renewal application sent to Treasury (AA302) 1 Chapter 51, Public Law 2005—For-Profit agencies only 1 Federal Funding Accountability and Transparency Act (FFATA) Worksheet (if applicable) 1 Copies of Subcontracts 1
refugee_tag_annexa.docx