LWSRA is looking for contractors and program proposals

LWSRA will provide aides to assist the instructors with accommodations. Please submit the form below for your proposal.

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Contact Information

Business Name

Main Representative/Instructor Name

Business owner name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Website / URL

Program Information

Program Title

Program Description

# of Classes/Sessions

# of Days/Weeks

Length of each class

Suggested days and times the program should meet

Second choice of days and time

Recommended minimum number of students per class

Recommended maximum number of students per class

Requested rate of pay for the contractor for this program

May be negotiated based on the specific facilities, equipment, supplies and support LWSRA must provide the contractor for the class to run properly.

Equipment and Supplies

Please provide an outline or lesson plan that gives specific details for the program including activities planned and skills targeted.

What equipment and/or supplies will be provided by the contractor?

The contractor is responsible for ensuing that all non-LWSRA equipment and supplies used for the program meet current safety and industry standards/guidelines and is in proper working order.

What equipment and/or supplies will LWSRA need to provide for this program?

including tables, chairs, AV equipment, screens, hoops, goals, etc.

What will the participants be required to bring? (in the case of special program materials, how much does each item cost?)

include required clothing, program materials, lunch, water, etc.

Acknowledgements

Instructor Qualifications

Contractors are responsible for ensuring that all instructors have and maintain the appropriate qualifications and certifications for program success and safety. Please list qualifications, certifications and experience that makes the instructor qualified to lead this program.

VERIFICATION STATEMENT

I agree that the statements and information provided are true and correct. I will notify LWSRA in writing of any changes to information in this document. I understand that I may need to provide verification of information/certifications referenced.

I also understand that in certain situations, contractors may be subject to a background check including but not limited to Illinois State and/or FBI criminal background checks and reference checks.

We may also request:

Signed agreement
Certificate of Insurance naming LWSRA additional insured
Current w-9
Contractors participate in a short training

I acknowledge and agree with the above Verification Statement