REQUEST FOR PROPOSALS For Bad Debt Collection Services For ...
REQUEST FOR PROPOSALS For Bad Debt Collection Services For ... REQUEST FOR PROPOSALS For Bad Debt Collection Services For ...
APPLICANT “SECTION 3” CERTIFICATION FORMName: ________________________________________________Legal Address: _________________________________________City: ______________________State: ____________Zip: ________Phone:____________________ or fax: ______________________Position Applied For: _______________________________(All applicants are required to complete and sign this form.)In general, Section 3 gives applica nts whose household income in the past year was less than80% of the area median income a preference in the hiring process so long as they are qualifiedfor the position for which they are applying.Only those applicants who complete the disclosure and meet the Section 3 requirements will beeligible for the preference, HOWEVER, employment offers for applicant s claiming a Section 3preference will be conditional upon providing proof of eligibility at the time of hire.CAUTION: Any applicant falsely claiming a Section 3 preference will immediately beremoved from consideration of employment.----------------------------------------------------------------------------------------------------------------------------_______ Option 1: I choose not to disclose this information and understand that I will notbe granted a Section 3 preference in the hiring processOR_______ Option 2: I choose to disclose the following information to determine if I ameligible for a Section 3 preference (complete questions below)1. Are you a resident of public housing or Section 8? (Check One) _____ Yes_____ No2. The number of persons in my household is _______.3. From the chart below, locate the number of persons in your household and enter thedollar amount from that box here ____________.# of persons in Household 1 2 3 4 5 6 7 880% Area Median Income$34,100 $38,950 $43,800 $48,650 $52,550 $56,450 $60,350 $64,250(FY 2012 Income Limits)Section 3 Preference Eligibility Test_____ Yes _____ No My legal address is within Bexar County, TX._____ Yes _____ No My household income last year was equal to orless than the amount listed on Line 3.If the answers to both questions are YES, you are entitled to a Section 3 preference.By signing, I authorize my employer to release relevant information to the San Antonio Housing Authorityfor contract compliance purposes and I further certify that all of the information given above is true andaccurate. If any information is found to be inaccurate, I understand that I may be disqualified as anapplicant and/or a certified section 3 resident and may be grounds for termination of any employment orcontract that resulted from this application and/or certification.Signature_______________________________DATE: _____________S3-6003b
Request for Proposals No. 1204-946-33-3797 Bad Debt Collection ServicesATTACHMENT EForm of ProposalProposal Fee SheetHOUSING AUTHORITY OF THE CITY OF SAN ANTONIO, TEXAS (210-477-6059)Page 37
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Request for Proposals No. 1204-946-33-3797 <strong>Bad</strong> <strong>Debt</strong> <strong>Collection</strong> <strong>Services</strong>ATTACHMENT E<strong>For</strong>m of ProposalProposal Fee SheetHOUSING AUTHORITY OF THE CITY OF SAN ANTONIO, TEXAS (210-477-6059)Page 37