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696-PF-19-P002 Exhibit^ J.

STAFFING PLAN INSTRUCTIONS

To be Completed for Phase I Adult Supportive Residential, TC lntensive ResidentialRe/apse, and/or lntensive SACP

Residential Re/apse Facility

Each Facility listed in Section 8.2, Pr¡cing Schedule, ofthe Contract should have a corresponding Staffing Plan reflecting lhe respeclive address.

Please note, lhis Slaffing Plan is divided into lwo (2) sections. The first section, lndirect Staff, may include staffing positions associated with the Facility and/or

Program, such as an Executive Director. The second section, Direct Staff, may include slaffing positions assigned to the Facility and/or Program, such as Counslor

and Counselor lntern.

Facility Name:

Address:

Position Title:

special Qual¡f icat¡ons

Total Hours/Week: Res¡dential % and

Enter the Facility name. Enter the Facility's physical street address, including City, State, and Zip Code. Each Facil¡ty locat¡on requ¡res a separate Exh¡b¡t J.1 to be completed.

Enter the title of each position associated with the Facility and/or Program. Position titles entered must match the^ position

titles on lhe job descriplions submitted. Enter all special qualifications required for êach position (these should match the job description qualifications). ln addition, for Upper Level Management (ULM) posilions, include ULM as a qualification. For each position, enler the number of hours per week spent on the Contracl at this Facility. Enter the percentage^ of time spent on the Conlract at this location, broken down by Program. Relapse %:

Calculated cells are locked and include the following: Total FTEs, Total lndirect Staff, Total Direct Staff, and Grand Total.

ËXAMFLE

Exhibit J. STAFFING PLAN AND BUDGET JUSTIFICATION FORM REHABILITATION TREATMENT SERVICES - Phase lAdult Support¡ve Residential, TC^ lntensive Residential^ Relapse,

and/or lntensive SACP Residential Relapse Facilily

STAFFING PLAN

Fac¡l¡ty Name Address city' state' zip code (^) Note: Additionat rows are hidden and may be as needed to list additional informat¡on Pos¡t¡on Tille

Executive D¡rector

Special Qualif ications

Bachelor Degree, 3 Yrs. Exp., ULM

Tolal Hours/Week

40 00

Total FTE

Residenlial %

50%

Relapse %

50% Business Manager 2 Yrs. college, 3 Yrs. Exp., ULM 40.00 1.00 50% 50% Reception¡st HS/GED, 2 Yrs. Exp. 40.00 1.00 50% 50%

Program Director LCDC, 10Yrs. Exp., UL[4 40.00 1.00 750k 25% lntake Coordinator HS/GED, 3 Yrs. Exp. 40.00 1.00 750,$ 25% Maintenance Tech HS/GED, 12 Months Exp. 40.00 1.00 75% 250Â Counselor LCDC 120.OO 3.00 1000/6 Oo/o Counselor LCDC 40.00 1.00 o% 1000Â Counselor lntern LCDC-Ct 120.00 3.00 1 00% 00, Counselor lntern LCDC-Ct 40.00 't.00^ 0% 100% Resident¡al Mon¡tor HS/GED, 6 l\¡onths Exp. 160 00 4.00 '1000Á^ 00Á Residential Monibr HS/GED, 6 l\¡onths Exp. 80.00 2.OO 00À '1000, cook HS/GED, FH Certificate, 1 Yr. Exp. 80.00 1.00 75% 25%

GRAND TOTAL 880.00 21.

TDCJ-PFCMOD

ULM = Upper Level Management

Page I (^) of 10 Revised 8/

696-PF-19-P

Facility Name:

Address:

COST CATEGORY / ITEM

Staffing Salary Direct Costs:

Base Period and Option Period

Columns:

Fac¡lity and Material Direct Costs:

lndirect Costs:

Number of Beds:

BUDGET JUSTIFICATION FORM INSTRUCTIONS To be Completed for Phase I Adult Supportive Residential Facility

Enter the Facility name. Enter the Facilily's physical street address, including C¡ty, State, and Zip Code.

Each Facility location regu¡res a separate Exh¡bìt J.1 to be completed.

This is the Tolal Salary Cost for Staff at the Facility. Each entry should be completed with a total salary for all the

positions associated wilh this location. lf a position is shared with another localion, the salary should reflect only the

percenlage (^) of time spent at the location identified on the Budget Justification. A Budget Justilication should be completed for each location.

Note: Enter total number ol FTE9 associated w¡fh sátf. If a position ¡s shared between Resìdent¡al and Resident¡al

Re/apse programs, the FTEs should be calculated accordingly on the respective Budget Deta¡L The comb¡ned

Residentlal and Resident¡al Re/apse FTE9 for each pos¡tion should not exceed that pos¡t¡on's FTE on the Staffing

Plan. ln these^ columns, the estimated expenditures for each individual budget line item must be entered for lhe lerm of the Contract. These are expend¡tures (^) associaled with the direct operation of the Facility, excluding salaries. These are expendilures associated with overseeing the Contract, but not directly related to lhe Facility. Enter the number of beds associaled with lhis localion.

Exhibit J.

Exhlbll J.

Galculated cells are locked and include the following: Subtotals, Grand Totals, and Operating Per Diems.

ËXAMPLH

STAFFING PLAN ANO BUDGET JUSTIFICATION FORM

REHABIL|TAI,ON TREATMENT SERVICES - Phase, Adult Suppott¡ve Res¡dential Fac¡lity BUDGÉ1J US'IIFICATION Fac¡lity NameAddress C¡ty, State, Zip Code

CATEGORY / ITEM

D¡rector

FlEs

o.7 s

Yoar I - FY

$ 60.

Yøar 2 -^ FY $ 6'i.

Yøar I - FY

$ 62.

Yøar 2 - ÊY $ 63,672^ I$ 64,946 $ ø6,245^ $ 67,570^ 68,92'l ntake Coødinator o.75 (^) $ 1 5,000 $ 15,300 I '15,606^ $ '15,918^ $ 16,236 $ '16,561 (^) $ 16,892 $ 17, \¡aintenance Tech o.7s (^) $ 30,000 $ 30,600 (^) $ 31,212$ 3't,836 (^) $ 32,473 $ 33,122 $ 33,785 $ 34, lounselor 3.00 $ 90,000 $ 91.800 $ 93.636 $ 95,509 $ 97,415 $ 90,367 (^) $ '101,355 $ 103, :dnselor lntern 3.00 (^) $ 60,000 $ 61,200 s 62,424 (^) $ 63,672 (^) $ 64,946 $ 66,24s (^) s 67.570 $ 68. lesidential Mon¡tor 4.00 $ 80.000 $ 81.600 43.232 (^) $ 84,897 $ 86,595 $ 88.326 $ 90,093 $ 91, 000

190

$

$

$

$

$

$ 38,

s 37.1 63

$ 38,

$ 37,

$ 39,

o.

C6ts

$ 35

nsurance Prem¡ums (^) $ 5.000 (^) $ 5.100 $ 5.202 (^) $ 5.306 (^) $ 5,412$ 5,520 (^) $ 5,ô31 $ 5, Vlaintenance (^) $ 6,000 $ 6,120 $ 6,242 $ 6,367 $ 6,495 $ 6,624 (^) $ 6,757 (^) $ 6, Jtilities (^) s 24,000 (^) $ 24,480 (^) $ 24,970 (^) $ 25,469 (^) $ 25,578 $ 26.498 (^) $ 27.028 $ 27. )ffce Supplies $ 2,000 $ 2,O40 $ 2,O81 $ 2,122 $ 2,165$ 2.208 (^) $ 2.252 (^) $ 2, lomputer Suppl¡es (^) $ 4,000 (^) $ 4,080 (^) $ 4,162 $ 4,245 $ 4,330 $ 4,416 $ 4,505 $ 4, rostage (^) $ 150 $ '153 $ 156 $ 15S (^) $ 162 $ 166 $ 169 $ 172 -^urriculum $ 750 $ 745 $ 780 I 796 $ 812 s (^828) $ 845 $ 862 lopiers / Fax Machines $ 1,000 $ 1,020 $ 1,040 $ '1,061^ $ 1 ,082 $ 1,104 $ 1,126 $ 1 149 lelecmmun¡cat¡ons (^) $ 150 $ 153 $ 156 $ 159 $ 162 $ '166 $ 189 $ 172 =quipment $^ 2,100^400 $^408 $^ 4't6 $^424 $^433 $^442 $^450 $^450

$ 99,

$ 142

$ 100,

185

I 03,

$

$ 't05,060^ 107,

$ 2,

$

2,31S

109

$

$ 111

2,

$

$ 2,

Salãries $ 11 720 ndirect Fringe Bên€fìls (^) $ 6,750 s 6,885 $ 7,O23 $ 7.163$ 7,306 $ 7,453 $ 7,602$ 7, :trtractor's Prolit Margin (^) $ 105,000 $ 107,1 00 $ 10s,242 6 11 1,427 $ 't't3,655 $ 1 15,928 $ 118.247 $ 120.

Statrng Salary D¡rect Cosls:

Facil¡ty ancl li4alerial Direct Costs:

Number of Beds (^40 40 40 40 40 40 40 ) Operat¡nq Pe¡ D¡em (^) $ 45.00 (^) $ 46.03 (^) $ 46.95 (^) $ 47.85 (^) s 48.71 (^) $ 45.42 (^) $ 50.82 (^) $ 5't.

TDCJ-PFCMOD Page 3 of 10 Revised 8120/

696-PF-r9-P

Facilily Name Address C¡ty, State, Zip Code

STAFF]NG PLAN AND BUDGET JUSTIFICATION^ FORM REHABILITATION TREATME Tf SERyTCES - Phase I Adult Supportive Residential Facility BUDGET JUSTIFICATION

Exhibit J.l

may be utilized as needed to l¡st ANNUAL TREATMENT COSTS CATEGORY / ITEM FTEs Base Per¡od^ Period^3

Year I - FY20 Yea¡ 2 -FY23 Yeal'l - FY24 Year 2 - FY25 Year I - FY26 Year 2 - FY

I

Yeat 2 - FY21 Year 1 - FY

$ $ $^ s

I

s $

I

I

I

s

I

$ $ s $ $ s $ t

Number of Beds

Operating Per Diem #Dtv/0! #Dlv/ot #Dtv/o!^ #Dtv/o!^ #Dtv/0!^ #Dtv/o!^ #Dtv/or^ #Dtv/o!

Stafi¡ng Salary Direct Costs:

Fac¡lity and Mater¡al Direct Costs:

lndirect Costs:

TDCJ-PFCMOD Page^4 of^ l0^ Revised^812012018

696-PX'-19-P

Fac¡l¡ty Name Address C¡ty, State, Z¡p Code

STAFFING PLAN AND BUDGET JUSTIFICATION FORM

REHABILITATION TREATMENT SERyTCES - TC^ lntensive Residential^ Relapse^ andlor^ lntens¡ye^ SACP^ Residentìal^ Relapse^ Fac¡lity

BUDGET JUSTIFICATION

Exhibit J.

Note: Addìl¡onal ro$ are hidden and may be

CATEGORY / ITEM FTEs Base Peftod^2 Option Per¡od^3 Year 2 - FY I I I

Year 2 - FY I

Yea¡ 1 - FY I

Year 2 - FY I

Year 1 - FY I

Number of Beds

operating Per D¡em #Dtv/0! #Dtv/0!^ #Dtv/0!^ #Dtv/0!^ #Dtv/0!^ #Drv/0!^ #Drv/0!^ #Dtv/0!

Staffing Salary Direct Costs:

Fac¡l¡ty and Uaterial D¡rect Costs:

TDCJ-PFCMOD Page^6 of^10 Revised 8120/

696-PF-r9-P002 Exhibit J.

STAFFING PLAN INSTRUCTIONS

To be Completed for Phase l-B or Phase ll Adult Supportive Outpatient, TC lntensive Outpatient Relapse, and/or SACP Level ll Outpatient Facility

Each Facility listed in Section 8.2, Pricing Schedule, of the Contract should have a corresponding Staffing Plan reflecting the respective address.

Please note this Staffing Plan is divided into two (2) sections. The first section, lndirect Staff, may include staffing positions associated with the Facility and/or Program, such as an Executive Director. The second section, Direct Staff, may include staffing positions assigned to the Facility and/or Program,

such as Counselor and Counselor lntern.

Facility Name:

Address:

Position Title:

Special Qualif ications:

Total HoursM/eek:

Enter the Facility name.

Enter the Facility's physical^ street address, including City, State, and Zip Code.

Each Facility location requires a separate Exhibit J.1 to be completed.

Enter the title of each position associated with the Facility and/or Program. Position titles entered must match the

position titles on the job descriptions submitted.

Enter all special qualifications required for each position (these should match the job^ description qualifications).^ ln

addition, for Upper Level Management (ULM) positions, include ULM as a qualification.

For each position, enter the number of hours per week spent on the Contract at this Facility.

Calculated (^) cells are locked and include the following: Total FTEs, Total lndirect Staff, Total Direct Staff, and Grand Total

ËXAMPå.H

Exhib¡t J.

STAFFING PLAN AND BUDGET JUSTITICITION FORM

REHABILITATION TREATMENT SERV/CES -^ Phase l-B or Phase Il Adult Supportive Outpatient, TC lntensive Outpatient Relapse, and/or SACP Levell ll Outpatient Facility

STAFFING PLAN

Facility Name

Address

City, State, Zip Code Nder Additional rows are h¡dden and may bê utilized

as needed to l¡st add¡tional infomãl¡on Position Titlê

Executive D¡rector

spec¡al Qualif¡cat¡ons

Bachelor Degree, 3 Yrs. Exp., ULM

Total HoursMleek

Total FTES

Business Manager 2 Yrs. College, 3 Yrs. Exp. 20.00 0. Receptionist HSGED, 2 Yrs. Exp. 40.00 1.

Program D¡rector LCDC, 10 Yrs Exp., ULM 40.00 1. lntake Coordinator HSGED, 3 Yrs. Exp. 40.00 1. Counælor LCDC 80.00 2.OO Counselor lntern LCDC-Ct 80.00 2.OO

GRAND TOTAL 320.00 8.

TDCJ-PFCMOD

ULM = Upper Level Management

Page 7 of 10 Revised 812012018

696-PX'-19-P

BUDGET JUSTIFICATION FORM ¡NSTRUCTIONS

To be Completed for Phase l-B^ or^ Phase ll^ Adult^ Suppotfive Outpatient,^ TC^ lntensive Outpatient Relapse,^ and/or SACP Level ll Outpatient Facility

Exhibit J.

Fac¡l¡ty Nâme:

Address:

Enter the Facility name.

Enter the Facility's physical street address, including City, State, and Zip Code.

Each Facility location requires a separate Exh¡bit^ J.1^ to be completed.

COST CATEGORY/ ITEM

Staffing Salary Direct Costs This^ is^ the^ Total^ Salary^ Cost for^ Staff^ at the Facility.^ Each^ entry should be^ completed^ with^ a^ total^ salary^ for^ all the

positions associated with this location. lf a position is shared with another location, the salary should reflect only the

percentage of time spent at the location identified on the Budget Justification. A Budget Justification should be

completed for each location.

Note: Enter total number of FTEs assoclafed with staff. This should match the Total FTEs on the Staffing Plan for

the associated location.

Base Period and Option Period ln these columns, the estimated expenditures for each individual budget line item^ must be entered for the^ term^ of^ the Columns: Contract. Other Direct Costs: These are expenditures associated with the direct operation of the Facility, excluding salaries. lndirect Costs: These are expenditures associated^ with^ oversee¡ng^ the Contract,^ but not d¡rectly^ related^ to^ the^ Facility. Calculated cells are locked and include the following: Subtotals and Grand Totals.

HXAS4Pt_Ë

qhtbl (^) J, STAFFING PLAN AND BUDGET JUSTIFICATION FORM

REHABIUTAnON TREATMENT SERVICES - Phase l-B or Phase ll Adult Suppütlve OuÞatlent TC tntenalve Outpaued Relapse, and/or S'ACP Level il Oulpatlent Facillty

Address^ Facility Name City, State, Zip Code

CATEGORY / ITEM Dkector

FTEs

YEAT 1 - FYZU I$ 48.

feat z - tYzl I$ 48.960 I$ 49,

fea¡ 1 - t\¿ I$ 51,

Year 2 -FY I$ 52,

Year I - FY

54,056 55,

Yeat 2 - FY2l I$ ntake Coord¡nator (^100) $ 20,000 20.400 $ 20.808 $ 21.224 $ 21.84ø $ 22.082 $ 22.523 22, lounselor 2.OO (^) $ 84,000 (^) $ 85,680 (^) $ 87,394 $ 89,141 $ 90,924 $ s2,743 û 94.598 $ s6, $

$

$

$ 93,

lntem 2.

$ 95,

$ 54,

$ 97,

$ 55,

$ s9,

$ 56,

$ 10't,

$

$ 1 LJtilities (^) $ 42,000 (^) $ 42,440 $ 43.697 s 44.571 $ 45,462 $ 48.371 $ 47.299 $ 48, Cffce Supplies (^) $ 2,500 (^) $ 2,550 (^) $ 2,601 (^) $ 2,653 (^) $ 2,706 (^) $ 2,760 $ $ 2, :uriculum (^) $ 1,500 $ 1,530 $ 1.561 (^) s 1.592 (^) $ 1.ø24 (^) $ 1,656 $ 1.689 (^) $ 1, $

50

$

$ 51

$ 2,

$

2,

54,

$

$

$ 2,

$ 55,

$ 2,

$ 56,

$ 2, EE-.= E r$ 57,

/ Fax l'rachine

Sãleries

2,O

lndirect Fr¡noe Benefits s 10.000 $ 10.200 s 't0,404^ $ '10.612^ $ 10,824 $ 11,041 $ 11,242 $ 11,

Contrator's Prof t Marg¡n s^ I^ 00 000 s^1 02.000^ $^ 104.040^ s 106.121 $ 't^ 08.243^ $ 't^ 10.408 $ 112.6't6^ $ 1'l^ 4.86S

Stafflng Salary Direct costs:

TDCJ-PFCMOD Page 9 of 10 Revised 812012018

696-PF-19-P002 Exhibit^ J.

STAFFING PLAN AND BUDGET JUSTIFICATION FORM

REHABILITATION TREATMENT SERVICES - Phase I-B or Phase Il Adult Supportive Outpatient,^ TC lntens¡ve Outpat¡ent Relapse,^ andlor^ SACP^ Levell^ ll^ Outpat¡ent

Fac¡l¡ty BUOGET JUSTIFICATION Faoility Name Address

city' state' z¡p code Note: Addiüonar rows are h¡dcren and may be

CATEGORY / ITEM FTEs Elase^ ter¡od^ Period Three

Year I - FY

I I I

Year I - FY

I

Year 1 - FY I

Yèat 2 - FYz'l I

Yea¡ 1 - FY I

YeaÍ 2 - FY Staff¡ng Salary D¡rect Costs I

Other D¡rect Costs (details requ¡red):

TDCJ-PFCMOD Page 10 of 10 Revised 8/

Enter your company's name here: Requisition#: 696-PF-'19-P

696-PF-19-P002 Exhibit^ J. e 2 Of 90 Rev^ 2t't

[[!reAÐ RespoNornls^ SUBcoNTRAcTNG^ INTENTToNS

Afer dividing the contract work into reasonable lots or portions to the extent consistent with prudent^ industry practices,^ and taking into consideration the scope of work to

be performed under the propæed^ contract, including all potential subcontracting opportunities, the respondent must determine what portions^ of work, including

contracted staffing, goods, services will be subcontracted. Note: ln accordance with 34 TAC S20.282, a "Subcontractor"^ means a person^ who contracts with^ a prime

contractor to work, to supply commodities, or to contribute toward completing work for a governmental^ entity.

a. (^) Check the appropriate box (Yes (^) or No) that identifies your (^) subcontracting intentions: {*. yes,^ I will be subcontracting portions of the contract. (lf Yes, complete ltem b of this SECTION and continue to ltem c of this SECTION.) f..^ lVo,^ I^ will not^ be^ subcontracting^ 4y portion^ of^ the contract, and^ I^ will^ be^ fulfilling the entire conhact with^ my^ own^ resources,^ including^ employees,^ goods,

services, transportation and delivery. (lf IVo, continue to SECTION 3 and SECTION 4.)

you expect to award to Texas certified HUBs, and the percentage ofthe contract you expect to award to vendors that are not a Texas certified HUB (i.e., Non-HUB).

Item # Subcontracting Opportunity 0escription

HUBs Non-HUBs Porcentage of the contract oxpscted to be subcontracled to HUBs with which you^ do (^) fot have a continuous contract* ¡n place

for more than five ($^ vears.

Percentage (^) of the contracl expected to be subcontracted to HUBs with which you have a continuous contracl* in^ place^ for more than five (5) vears.

Percentags of the contracl sxpected to be subcontracted to non.HUBs.

1 Yo o/^ o//o 2 Yo /o Yo 3 Yo ot^ o/o 4 o/o 5 10 to ot TO 6 to Yo Yo (^7) Yo Yo I Yo % I o/o^ % (^10) % o/o 11 Yo (^12) Yo Yo 13 to c/ 't4 10 o/o 15 Yo Yo Yo

Aggregate percentages^ ofthe contract expected to be subcontracted: o/o^ o/o^ o/o

c. (^) Check the appropriate box (Yes (^) or No) that indicates whether you will (^) be using onlv Texas certified HUBs to perform all of the subcontracting opportunities you listed in SECTION 2, ltem b. f.^ Yes (lf (^) Yes, continue to SECTION 4 and complete an "HSP (^) Good Faith Effort - (^) Method A (Attachment A)" for each of the subcontract¡ng opportunities you listed.) f -^ lVo^ (lf No,^ contlnue^ to^ ltem d, of^ this SECTION,)

d. Check the appropriate box (Yes or No) that indicates whether the aggregate expected percentage of the contract you will subcontract with Texas certified HUBs

with which you lþ no! have a continuous contract* in place with for more than five (5)^ vears, meets or exceeds the HUB goal the contracting agency identified on

page 1 in the "Agency Special lnstructions/Additional Requirements."

f-.^ Yes (lf Yes, continue to SECTION 4 and complete an "HSP Good Faith Effort -^ Method A (Attachment A)" for each of the subcontracting oppofunities you listed. l..^ No (lf (^) tVo, continue to SECTION 4 and complete an "HSP Good Faith Effort - Method B (Attachment (^) B)" for each of the subcontracting opportunities you listed. *9gIliUgJtSJgI@Í: (^) Any existing written agreement (including any renewdls (^) that are exercised) between a prime contractor and a HUB vendor, where the HUB^ vendor^ provides the^ prime contractor with^ goods^ or^ servìce,toincludetransportationanddelivery^ under the^ same contract

for a specified period^ of time. The frequency the HUB vendor is ut¡l¡zed or paid duñng the term of the contract is^ not^ relevdnt^ to^ whether

the contract ís considered cont¡nuous. Two or more contracts that run concufiently or ovørlap one another for different periods^ of^ time^ are considered by CPA to be individual contacts rather than renewals or extensions to the original contract ln such situations the prime^ contractor and HUB vendor are enter¡ng (have entered) into (^) "new" contracts.

696-PF-í9-P002 Exhibit^ J. P e3of90 Rev.2h

EEEreEÐ 4.) Self^ Penf^ ORMlNc^ JUSTIFICATION^ (tf you responded "No"^ to^ SECTTON 2,^ ltEm^ a,^ you must^ complete^ this^ SECTIoN^ and^ continue^ to^ sEcTloN

lf yoû responded "No"^ to SECTION 2, ltem a, in the space provided^ below^ explain how^ your company will perform the entire contract with its own^ employees,

supplies, materials and/or equipment.

As evidenced by my signature below, I affirm that I am an authorized representative of the respondent listed in SECTION 1 , and that the information^ and^ supporting

documentation submitted with ihe HSP is true and conect. Respondent understands and agrees that, if^ awarded anv^ oortion of^ the^ reouisition:

. (^) The respondent will provide notice as soon as practical to all the subcontractors (HUBs and Non-HUBs) of their selection as a subcontractor for the awarded contract. The notice must specify at a minimum the contracting agency's name and its^ point^ of^ contact^ for the^ contract,^ the^ contract^ award^ number,^ the subconfacting opportunity they (the subcontractor) will perform, the approximate dollar value of the subcontracting opportunity and the expected percentage^ of

the total contract that the subcontracting opportunity represents. A^ copy^ of the^ notice required by this section must also be provided^ to^ the contracting^ agency's

point of contact for the contract

. (^) The respondent must submit monthly compliance reports (Prime Contractor Progress Assessment Report (^) - PAR) to the contracting agency, verifying its compliance with the HSP, including the use of^ and^ expenditures^ made^ to^ its^ subcontractors^ (HUBs^ and^ Non-HUBs).^ (The^ PAR^ is^ available^ at httol/www.comptroller.texas.oov/purchasinqldoæ/hub-forms/ProqressAssæsmentReportForm.xls). o (^) The respondent must seek approval from the contracting agency prior (^) to making any modifications to its HSP, including the hiring of additional or different

subcontractors and the termination of a subcontractor the respondent identified in its HSP. lf the HSP is modified without the contracting agency's prior^ approval,

respondent may be subject to any and all enforcement remedies available under the contract or othenruise available by law, up to and^ including debarment^ from^ all state contracting,

. (^) The respondent must, upon request, allow the contracting agency to perform on-site reviews of the company's headquarters and/or work-site where services are being performed^ and must provide^ documentation regarding^ stafüng and^ other ræources.

Printed Name Title (mmlddiyyyy)

Reminder: Þ (^) tf you (^) responded "Yes" (^) to SECTION 2, ltems c or d, you must complete an "HSP^ Good Faith Effort - Method A (Attachment A)" for each of the subcontracting opportunities you^ listed in SECTION^ 2, ltem^ b, Þ tt you^ responded "No"^ SECTION 2, ltems c and d, you must complete an "HSP^ Good Faith Effort^ -^ Method^ B^ (Attachment B)"^ for each^ of^ the subcontracting opportunities you^ listed in SECTION 2, ltem b.

Date

Enter your company's name here:^ Requisition#: 696-PF-19-P

Enter your company's name here: Requisition#: 696-PF-19-P

696-PF-19-P002 Exhibit J. Page 5 of 90

HSP Good Faith Effort -^ Method B (Attachment^ B) (^) Rev. 2h

IMPORTANI: lf you responded "Âto" to SECTION 2, ltems c and d of the completed HSP form, you must submit a completed "HSP Good Faith Effort -

Method B (Attachment^ B)" for each of the subcontracting opportunitiæ you listed in^ SECTION^ 2,^ ltem^ b^ of^ the completed^ HSP^ form. You^ may photo-copy^ this^ page

or download the form at http://www,comptroller,texas.qov/purchasinq/docs/hub-forms/hub-sbcont-þlan{fe-achm-b,ndf.

E¡llllul¡fl Su^ ecoNrRrcïNc^ OppoRruNrry Enter the item number and description of the subcontracting opportunity you listed in SECTION 2, ltem^ b,^ of the completed^ HSP^ form for which you^ are^ completing^ the attachment.

Item Number: Description

lf respondent is participating^ as a Mentor in a State of Texas Mentor Protégé Program, submitting its Protégé (Protégé must be a State of Texas certified HUB) as a

subcontractor to perform the subcontracting opportunity listed in SECTION B-1, constitutes a good faith effort to subcontract with a Texas certified HUB towards that

specific portion of work,

Check the appropriate box (Yes or No) that indicates whether you^ will be subcontracting the portion of work you^ listed in SECTION B-1 to your^ Protégé.

f* -^ Yes (lf Yes, continue to SECTION 84.) f -^ No^ / Not^ Applicable^ (lf^ lVo^ or^ Not Applicable,^ continue to SECTION B-3 and SECTION B-4.)

E[pTAEfl Nor^ ncnro¡r^ Or^ Su^ ecoNrRAcr^ Nc^ Opponrunrw

When completing this section you^ MUST comply with items a, b, c and d, thereby demonstrating your Good Faith Effort of having notified Texas certifìed HUBs^ and hade

organizations or development centers about the subcontracting opportunity you^ listed in SECTI0N B-1. Your notice should include the scope of work,^ information

regarding the location to review plans and specifications, bonding and insurance requirements, required qualifications, and identify^ a^ contact^ person,^ When sending

notice of your subcontracting opportunity, you are encouraged to use the attached HUB Subcontracting Opportunity Notice form, which is^ also available^ online^ at

htto:/lwww.comptroller.texas.qovipurchasino/doæ/hub-forms/HUBSubcontractinq0ppodunitvNotificationForm.pdf.

Retain supporting documentation (i.e.,^ certified letter, fax, e-mail) demonstrating evidence of your good faith effort to notify the Texas^ certifìed HUBs^ and trade

organizations or development centers. Also,^ be^ mindful that a working day^ is^ considered^ a^ normal business day of a state agency, not including^ weekends,^ federal or

stateholidays,ordaystheagencyisdeclaredclosedbyitsexecutiveofficer,Theinitial daythesubcontractingopportunitynoticeissent/providedtotheHUBsandto the

trade organizations^ or development^ centers is^ considered to^ be "day^ zero"^ and does not count as one of the^ seven^ (7) working days.

a. Provide written notifìcation of the subcontracting opportunity you listed in SECTI0N B-1 , to three (3) or more Texas certified HUBs. Unless the conhacting agency

specified a different time period, you must allow the HUBs at least seven í) workinq davs to respond to the notice prior^ to you submitting your bid^ response^ to the

contracting agency. When searching for Texas certified HUBs, ensure that you^ use the State of Texas' Centralized Master Bidders List (CMBL)^ and^ Historically

Underutilized Business (HUB) Search directory located at http://mvcna.cpa.state.ü.us/toasscmblsearch/index.isp, HUB Status^ code^ "A"^ signifies^ that the^ company^ is a Texas certified HUB. b. List the three (3) Texas certified HUBs you notified regarding the subcontracting opportunity you listed in SECTION B-1. lnclude the company's Vendor lD (VlD) number, the date you (^) sent notice to that company, and indicate whether it was responsive or non+esponsive to your^ subcontracting opportunity notice.

Company Name (^) (0o not enter Texas VIDSocial Security t{umbere.}^ Date (mm/dd/yyyy)^ Notice Sent Did the HUB Respond? f -Yes^ f -No 1..-Yes f -No f -Yes {- -No c. Provide written notification of the subcontracting opportunity you listed in SECTION B-1 to two (2)^ or more hade organizations or development centers in Texas to

assist in^ identifying^ potential HUBs^ by^ disseminating^ the^ subcontracting opportunity^ to^ their^ members/participants. Unless^ the^ contracting agency specified^ a

different time period, you must provide your subcontracting opportunity notice to trade organizations or development centers at least seven (l^ workino days prior to

submitting your bid response to the contracting agency. A list of trade organizations and development centers that have expressed an interest in receiving noticæ of

subcontracting opportunities is available on the Statewide HUB Program's webpage at http://www.comptroller.texas.qov/purchasinq/vendor/hubhesources.php.. d. (^) Listtwo(2)tradeorganizationsordevelopmentcentersyounotifiedregardingthesubcontractingopportunityyoulistedinSECT|ONB-l.lncludethedatewhen you sent notice to it (^) and indicate if it accepted or rejected your notice.

Trade Organizations or Development Centers Date (mm/dd/yyw)^ Notice Sent Was the Notice Accepted? f" .Yes^ f- .No f* .Yes^ f -No

Page 1 of

(Attachment (^) B)

696-PF-r9-P

HSP Good Faith Effort -^ Method B ttachment B

Exhibit J. Page 6 of 90

Cont. Rev.2h

[[[IU|UE[! Suecoȡrnrcron^ Selecroru Enter the item number and description of the subcontracting opportunity^ you^ listed in^ SECTION^ 2,^ ltem^ b,^ of the^ completed^ HSP form for^ which^ you are^ completing^ the attachment.

a. Enter the item number and description of the subcontracting opportunity for which you are completing this Attachment B continuation page.

Item Number: Description:

b. List the subcontracto(s) you selected to perform the subcontracting opportunity you listed above in SECTION B-1,^ Also identify whether they are a Texas^ certified

HUB and their Texas Vendor ldentification (VlD) Number or federal Employer ldentifìcation, the approximate dollar value of the work^ to be subcontracted, and the

expected percentage^ of work to be subcontracted. When searching for Texas certified HUBs and verifying their HUB status ensure that you^ use the State of^ Texas'

HUB status code "4" signifies that the company is a Texas certified HUB.

c. (^) lf any of the subcontractors you have selected to perform the subcontracting opportunity you listed in SECTION B-1 is p!^ a Texas certified HUB, provide^ written justification for your (^) selection process (attach (^) additional page if necessary):

REMINDERI As spæified in SECTION 4 of the completed HSP form, if you (resoondent) are awarded any portion of the^ requisition,^ you^ are^ required^ to^ provide notice as soon as practical^ to all the subcontractors^ (HUBs^ and^ Non-HUBs)^ of^ their^ selection^ as^ a^ subcontractor.^ The^ notice^ must specify^ at^ a^ minimum^ the

contracting agency's name and its point^ of contact for the contract, the contract award number, the subcontracting opportunity^ it^ (the subconhactor) will perform, the

approximate dollar value^ of the subcontracting opportunity^ and^ the expected^ percentage^ of the total contract that^ the subcontracting opportunity repræents.^ A^ copy^ of^ the notice required by this section must also be provided to the contracting agency's point of contact for the contract no later than ten (10) working days^ after^ the^ contract is awarded.

Page 2 of 2

(Attachment B)

Enter your company's name here:^ Requisition#:^ 696-PF-19-P

Company Name^ Texas^ certified^ HUB

Texas VID or fede¡al EIN Do not enter Social Security Numbers. Ityou do not know their VID I ElN, leave the¡r Mt / EIN t¡eld blenk.

Approximate DollarAmount

Expected Percentage of Contract f .yes (^) f .¡lo (^) $ o/o f -Yes^ f* _No^ $ o/o ¡ .Yes^ f .No^ $ o/n ¡ -Yes^ l- -No^ $ o/o ¡ -Yes^ f -No^ $ o/o ¡ .Yes^ f .No^ $ o/o f -Yes^ (^ -No^ $ Yo ¡ .Yes^ f^ .No^ $ o/o f.Yes a .No^ $ o/o ¡ .Yes^ f .No^ $ o/o

696-PF-19-P002 Exhibit^ J. Page 8 of 90

Rev.2/

HUB Subcontracting Plan (HSP)

Contract/Requisition Number:

Prime Gontractor P

Texas Department of Criminal Justice

ress Assessment Re ort

Date ofAward: Object Code:

(mm/dd/yyyy) (Agency Onty)^ Us

This form must be completed and submitted to the contracting agency each month to document compliance with^ your^ HSP

Contracting Agency/Universig

Name:

Gontract Administrator Name:

Contractor (Company)^ Name: Point of Contact:

Reporting (Month) Period

State of Texas VID #: Phone #:

Total Amount Paid this Reporting Period to Contractor: $

Signature:

Report HUB*Note: and Non-HUB subcontractor information Texas ceñ¡f,ed HUB status can be verified on^ llne^ at: hll,s;//mvcpa.cpa.stale.û.usftpasscmblsearch/index.isp

Title: Date:

Subcontractor's

Name

*Texas certified HUB?

Subcontractor's VID or HUB Certificate Number {Requlred lf TexasHTIBì^ cert¡f led

Total Contract $ Amount from HSP with Subcontractor

Total $ Amount Paid This Reporting Period to Subcontractor

Total Contract $ Amount Paid to Date to Subcontractor

Object Code lAoêncv Us Onlv) $ o^ $ $ $ $ $ $ $ $ $ $ $ $ $ $ o^ $

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

TOTALS: $ o^ $

696-PF-19-P

Exhibit

J.

Page

of

EMAIL

asiancontractor@gmail.

com

rwashington@blackcontractors.orgchum@dbcc.orgconstruction@dfrvmsdc.

com

gquezada.gdhcc.

com

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beverly@gtmbc. com

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org

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com

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com

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org

info@namctexas. orgpoletf@sahcc.orgsmsdc@smsdc.orgxenia@smsdc.org taaacclT9@yahoo.com panlon@tamacc.orgpresident@tamacc.o¡gprocurement@tcbcc. orginfoØushca-austin.

com

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org

bids@wbea-texas.orgdirector@womencontractors.

org

F"A.X

512-926-s4r0214485-0467214421-5510 214-637¿24r2r4-s20-t687 361-698-t024 9ts-566-97t4 817-332-6438 409-722-5402 s124s9-l

183

713436-8333 210444-110r^ 912-786-09t0 7 13-644-7377^7 13-271-9770^7 13-843-3777^ 210-225:2485^5 12-386-8988 28

l-336-0870817469-9485 8r7 -'299-0949 713-681-9242 7 13-

-99t

PHONE

st2-926-5400214485-0483 21442t-5200 214-630-0747214-521-6007361-698-1025 915-5664066 8 17-871-6538409-962-8530512-407-8240 5 12-459-

18

I

832-2t6-2185 832-883-5078210-444-1100972-7&6-0909713-644-?070713-271-7805713-843-3791 210-225-04625t2-386-8766 5t2-6s9-2r60 5 12-535-

10

512444-5727 832-875-3977512-922-0507682-367-1393 8t7-299-05667t3-681-92327t3-807-

MATLING

ADDRESS

4201 Ed Bluestein

Blvd., Austin,

TX

S.

Lamar

Street, Suite 251, Dallas,

TX

Mafin

Luther King

Jr.

Boulevard

Dallas,

TX

N

Stemmons

Frwy,

5th

Floor,

Suite 550,

Dallas,TX

4622Maple

Avenue,

Suite.207,

Dallas,

TX

l0l

Baldwin Blvd.. CED-146.

Corpus

Christi,

TX

2401 E.

Missouri, El

Paso,

TX

South Freeway. Suite

2

1 1,

Fort

Worth.

TX

7

PO

Box

5064, Beaumont,

TX

7 7 7

8001 Centre Park

Dr. Suite

Austin,

TX

E.

1lth

Street, Suite

A,

AustirL

TX

17071/2 South Post Oak

Blvd., PMB

Houston,

TX

7 ParkerRoad,

Houston,

TX

QuintanaRoad.

SanAntonio,

TX

W.

Illinois

Avenue. Dallas,

TX

Main

Street, Suite 890, Houston.

TX

Three

Riverway,

Suite 555, Houston,

TX

3825 Dacoma St., Houston,

TX.

200 East Grayson, Suite 203,

San

Antonio,

TX

912 Bastrop

Highway, Suite.

Austin,

TX

NW

Loop

410 Suite 230,

San

Antonio,

TX

P.O.

Box

Austin,

TX7871l-

Main

Street. Buda, Texas 78610

P.O.

Box

Houston,TX

920 E. Dean Keeton,

Austin,

TX

202 E.

Border

Sheet,

Suite

Arlington,

TX

North Collins, Suite

Arlinglon,

TX

NW Frwy,

Suite

Houston,

TX

P.O.

Box

Houstos

TX.

ORGANIZATION

Asian

Contractor

Association

Black

Contractors Association

DallasÆort

Worth

Dallas

Black

Chamber

of

Commerce

DFW

Minority

Supplier Development

Council

Dallas Hispanic Chamber

of

Commerce

Del Mar

College

PTAC,

Corpus

Christi Black

C

of

C

El^

Paso

Hispanic Chamber

of

Commerce

Fort

Worth Metropolitan Black

Chamber

of

Commerce

Golden Triangle

Minority

Business

Council

Greater Asian Chamber

of

Commerce

Greater

Austin Black

Chamber

Greater Houston Business Procurement Forum Hispanic

Contractors Association

• Houston

Hispanic Contmctors Association

-San

Antonio

Hispanic Contractors Association

Regional

Houston Hispanic Chamber

of

Commerce

Houston

Minority

Supplier Development

Council

National

Assoc.

of

Minority

Contractors

Inc.-Houston

San

Antonio

Hispanic Chamber

of

Commerce

Southwest

Minority

Supplier Development

Council

Texas Assoc.

of

African

American

Chambers

of

Commerce

(TAAACC)

Texas Association

of

Mexican American

Chambers

of

Commerce

(TAMACC)

Tri-County Black

Chamber

of

Commerce

U.S. Hispanic Contractors Association

de

Austin

U.S-

Pan

Asian

American

Chamber

of

Commerce SW

Women's

Business

Council -

Southwest

Women's

Business Enterprise

Alliance

(WBEA)

Women Contractors Association

(WCA)