ARPA Assistance Program for the Senior Services Division

Agency: Rockdale County
State: Georgia
Type of Government: State & Local
NAICS Category:
  • 541611 - Administrative Management and General Management Consulting Services
  • 541990 - All Other Professional, Scientific, and Technical Services
Posted Date: May 17, 2022
Due Date: Dec 28, 2023
Solicitation No: ion #22-19
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Application #22-19
ARPA Assistance Program for the Senior Services Division
DUE: Thursday, December 28, 2023 -OR- Until ARPA funding runs out. Send all applications anytime before the due date to Meagan Porch at Meagan.Porch@RockdaleCountyGA.Gov.
Application for Vendors
Application for Senior Citizens

Attachment Preview

ROCKDALE COUNTY, GEORGIA
PREFERRED VENDOR LIST
APPLICATION #22-19
ARPA Program Senior Services
For the Rockdale County
General Services Department
Division of Senior Services
Rockdale County Finance Department
958 Milstead Avenue
Conyers GA 30012
770-278-7552
Rockdale County is accepting applications for the Preferred Vendor List for the Senior Services
ARPA Program.
The American Rescue Plan Act (ARPA) was funded to assist persons in during or recovery from
the COVID pandemic.
Completing this application is not a guarantee of work. Applications will be reviewed and
kept on file with Rockdale County Finance. Vendors meeting criteria will be listed on the
preferred vendor list.
If a project is available that fits into your indicated scope of work, you may be contacted to
submit a written quote. It is very important that the applicant keep an active up to date email on
file with the program as this will be the main source of communication concerning potential
projects.
If selected for a specific project, the name of the technician(s) or laborer(s) assigned to the job,
if different from the applicant, must be identified prior to starting work.
Rockdale County provides equal opportunity for all persons or businesses and does not
discriminate against any person or business because of race, color, religion, sex, national origin,
and handicap or veteran status. This policy ensures all segments of the business community
have access to supplying the goods and services needed by Rockdale County.
PURCHASING CONTACT FOR THIS REQUEST:
All questions concerning this invitation and all questions arising subsequent to award are to be
addressed to the Purchasing Office at the following address:
Rockdale County Finance Department
Attn: Meagan Porch
958 Milstead Avenue
Conyers, GA 30012
Phone: (770) 278-7557, Fax: (770) 278-8910
E-mail: meagan.porch@rockdalecountyga.gov
To maintain a “level playing field”, and to assure that all proposers receive the same information,
proposers are requested NOT to contact anyone other than the contact above. Doing so could
result in disqualification of the proposer.
COPIES FOR EVALUATION:
One (1) original hard copy of application will be required for review purposes. Applications will be
received at the Rockdale County Finance Department, 958 Milstead Avenue, Conyers, GA 30012;
Attn: Meagan Porch or by email to Meagan.porch@rockdalecountyga.gov.
TERM:
The application process is open all year and applications may be submitted at any time during
the calendar year. Approved vendors will remain on the list through the end of the ARPA
program.
2
Rockdale County Dept. of General Services Senior Services Division
PREFERRED VENDOR APPLICATION for ARPA Program Senior Services
INSTRUCTIONS: Print or type name exactly as it appears on your drivers license (must be 18 years of age
or older to apply).
Applicant's Name (Last, First, M.I.)
APPLICANTS INFORMATION
Full Social Security No.
Driver’s License Number
Street Address
City
State ZIP
Home Telephone
Cell Telephone
(
)
(
)
Business / Organization (if applicable)
Business Address
City
State ZIP
County of Residence
Occupation
E-Mail
Business Telephone
(
)
County of Operation
Website URL (if applicable)
Date of Birth Sex/Race
Business Mobile / Cell Telephone
(
)
Do you have any disabilities (this information is voluntary and will be used for statistical purpose only) YES
NO
___________________________________________________________________________________________________________
Provide business licenses or certifications. (attach copies of licenses)
___________________________________________________________________________________________________________
______________________________________________________________________________________________________ _____
___________________________________________________________________________________________________________
Give two references who may have knowledge of your qualifications or work. (include name, address, phone and email)
1. Name _________________________________ Phone _____________________ Email _________________________________
Street Address ________________________________________________ City ________________ State ______ Zip __________
2. Name _________________________________ Phone _____________________ Email _________________________________
Street Address ________________________________________________ City ________________ State ______ Zip __________
Have you ever been convicted?
of a Misdemeanor (including moving violation) YES
NO
of a Felony
(if yes, explain ________________________
YES
NO
(if yes, explain _______________________________
_________________)
__________)
I hereby certify that the statements on this application are true. I understand certification can be
denied by Rockdale County if information has been falsified, misleading or incomplete. I grant
permission for Rockdale County to complete a background check to verify information provided.
Signature of Applicant
Date
3
Rockdale County Dept. of General Services Senior Services Division
PREFERRED VENDOR APPLICATION for ARPA Program Senior Services
Supplemental Information
Applicant Name:
1. Give a brief explanation of your interest to become a preferred vendor for this
program.
2. The ARPA Program - Senior Services is expected to operate for FY 2022-2024.
Indicate your availability and advanced notice needed to start a project.
a) Describe your general availability: (i.e., Monday-Friday, weekends, certain times of day)
b) Advance notice generally required to start a project: (i.e., one day, several days, one week,
month, etc.)
3. Indicate your scope of work. (check all that apply)
Deck repair
Drywall and wall repair
Electrical (license required)
Flooring
HVAC (license required)
Roof repair
Painting
Plumbing and Water Heaters (license required)
Ramp building/installation
Yard clearing/cleanup (not landscaping or regular yard maintenance)
General home repair
Other (describe)
4
5

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