Project Management Form 650-25-75-05-20

(Revised 1/1/13 ML#3359)

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The Department of Human Services, Aging Services Division, requires the completion and submission of a Project Management Form. The form identifies the following:

1. the legal entity;
2. principle officers and board members by name and title; and
3. staff members involved in operating the project including a narrative description of the type of work performed and relevant credentials, including education and experience, and the full-time equivalent (FTE) percent of project time commitment for each.

 

An organizational chart (diagram form) that shows the structure of the organization, illustrating staff by name and title, lines of authority, and a current review date must be attached.

 

Through the procurement process, Aging Services Division will forward the Project Management Form to entities for completion and submission to Aging Services Division. Throughout the contract term, contract entities are responsible for updating and resubmission of the names and titles of principle officers, board members, and key staff, including any updated attachments to the form. The contract entity must submit the following: Identifying Data Form that indicates the reason for resubmission; and the updated Project Management Form, including a copy of the updated organizational chart.

 

Upon receipt of resubmission forms, the documents will be reviewed; acknowledgement of receipt and/or approval will be indicated by signature of the Director of Aging Services Division on the Identifying Data Form.

 

A copy of the signed Identifying Data Form will be forwarded to the contract entity.