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4. Summary of Proposed Budget: <br /> <br /> AMOUNT <br />TOTAL COST OF PROPOSED PROGRAM > $63,074.00 <br />Total Number of Proposed Training Slots > 45 <br />Cost Per Training Slot > $t,402.00 <br /> <br />Are funds from other funding sources being requested in order to implement this proposed WIA program? <br /> <br />YES X NO If the answer to the above question is yes, please complete the following to indicate <br />sources, amounts and expected dates of funding approval. <br /> <br />OTHER EXPECTED FUNDING SOURCES EXPECTED EXPECTED <br /> AMOUNT DATE OF <br /> APPROVAL <br />TANF Employment Support Expenses $3~000.00 7-1-02 <br />Transportation Services (RGP) $2,000.00 7-1-02 <br /> <br />TOTAL OTHER FUNDS EXPECTED =--==> I $5,000.00 <br />! <br /> <br />CERTIFICATION: I certify that the information contained in this proposal, fairly represents this entity and <br />its operating plans and budget necessary to conduct the proposed WIA Employment, Training and <br />Services Program Activities deScribed herein. I acknowledge that I have read and understand the <br />requirements of the Request For 'Proposal (RFP) and that this entity is prepared to implement the <br />proposed activities as described herein. I further certify that I am authorized to sign this proposal and any <br />contractual agreement emanating therefrom on behalf of the entity submitting the proposal. This <br />PROPOSAL or OFFER is firm for a period of at I~ast ninety (90) days from the qlosing date for <br />submission, which is Friday May 17, 2002, at 4:00 PM..This Response Package Cover Sheet has the <br />following PARTS attached: <br /> <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br /> <br />Statement of Work Narrative with all appropriate attachments. <br />Program and Financial Management Form <br />Assurances and Certification Form (SIGNED & DATED) <br />Statement of Compliance Form (SIGNED & DATED) <br />Certificate Regarding Debarment, Suspension, etc., (SIGNED & DATED) <br />Interagency Coordination and Linkages Form <br />Job Description(s) <br />Budget Summary and Worksheets <br />Other Items as requested <br /> <br />(SIGNATURE and DATE of Signatory,~,fl <br /> / <br />_James F. Cook, Jr., DirectOr / <br />(Typed or Printed NAME and JO~TITL~ <br /> <br />WlA Title I Adult/Dislocated Worker RFP <br />April 2002 <br /> <br />~'atofy OffiCial) <br />/ / <br /> <br /> <br />