Consultant Directory Application
Are you a new applicant or are you updating your previously accepted information? Please check below.
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New Applicant
Updating Consultant
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Contact Information
Name of Individual, Firm, or Business
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Biography: A brief biography about the consultant/firm
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0/125
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Point of Contact Name
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First Name
Last Name
Point of Contact Title
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Point of Contact Email
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example@example.com
Point of Contact Phone Number
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Please enter a valid phone number.
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Organization Information and Service Areas
Please refer to the category descriptions in the associated RFQ document. By checking the appropriate box below, we request that you apply for only one of those categories per application.
Which category are you applying for?
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Data/Evaluation
Executive Search
Finance
Governance/Leadership
Human Resources
Operations
What services within the above category does Respondent provide?
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Approach: A two/three sentence narrative describing Respondent's approach to capacity building within above category.
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0/125
Which geographical area(s) does your organization serve?
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Central IN
Northeast IN
Northwest IN
Southeast IN
Southwest IN
Does the Respondent have experience with Community Action?
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Yes
No
If yes to the question above, please briefly describe that experience.
Is the Respondent registered in the State of Indiana? (inbiz.in.gov)
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Yes
No
Qualifications and Experience: A two/three sentence narrative describing Respondent's qualifications and relevant experience.
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0/125
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Client References
In the spaces below, please provide the requested contact information for at least two references.
Reference One: Organization Name
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Reference One: Brief Description of Project
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0/125
Reference One: Point of Contact
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First Name
Last Name
Reference One: Contact Email
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example@example.com
Reference Two: Organization Name
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Reference Two: Brief Description of Project
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0/125
Reference Two: Point of Contact
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First Name
Last Name
Reference Two: Point of Contact
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example@example.com
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Cost Proposal
This information will not be public posted. It is only for IHCDA to gauge whether your consulting costs are within range of average feasibility for Indiana’s community action agencies. Please do not worry about giving an exact amount; IHCDA understands that this is an average cost and may change based on the services required. Please only submit an average hourly, cost for your services, including but not limited to travel, hourly rate, and supplies.
Average Hourly Cost
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Resumes and Bios
Please upload current resumes and bios for Respondent's key personnel. Please do not upload CVs.
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Browse Files
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Certification of Respondent
I hereby certify that the information contained in this response and any attachments is true and correct and may be viewed as an accurate representation of proposed services to be provided by this organization. I acknowledge that I have read and understood the requirements and provisions of the RFQ and agree to abide by the terms and conditions contained herein. 18 U.S.C. § 1001, “Fraud and False Statements,” provides among other things, in any matter within the jurisdiction of the executive, legislative, or judicial branch of the Government of the United States, anyone who knowingly and willfully: (1) falsifies, conceals, or covers up by any trick, scheme, or device a material fact; (2) makes any materially false, fictitious, or fraudulent statement or representation; or (3) makes or uses any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry; shall be fined under this title, and/or imprisoned for not longer than five (5) years.
I Certify (Full Name)
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First Name
Last Name
Signature
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Memorandum of Agreement
Should we be chosen to be included in the IHCDA Consultant Directory, we understand that, unless otherwise noted, all information reported in this application will be made publicly available on the IHCDA Community Services Block Grant (CSBG) web page. IHCDA may also use this information in other procurement processes.
I Understand (Full Name)
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First Name
Last Name
Signature
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Submit
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