Local Training Provider Application


Prince George’s County Local Training Provider List (LTPL) Initial Application Packet

The following information will be used by Employ Prince George’s, Inc. (EPG) in identifying organizations, agencies, training providers, and training institutions who meet the mandatory requirements and qualifications to provide occupational skills trainings in accordance with the definitions and criteria established by the Workforce Innovation Opportunity Act (WIOA), the Prince George’s County Local Workforce Development Board (PGCLWDB), and funders of the Prince George’s County Public Workforce System.

Instructions: Please complete the application below in its entirety. Incomplete applications will automatically be declined and deleted, with a requirement for the complete application be resubmitted. Any questions regarding this application may be submitted to adminandcontracts@co.pg.md.us

*Please do not submit duplicate copies

Training Provider Information

Upload Your Maryland ETPL Denial Letter From Your Maryland ETPL Application
Name of training provider
Federal ID number (FEIN)
Training site address line 1
City
State
Zip Code
Country
Mailing address
Training site address line 2(if different than training address)
City
State
Zip Code
Mailing address
Contact person name
Contact person title
Phone number & ext.
Fax number
Website address
Email address
School licensed/certified by
License/Certificate expiration date
If “other” selected above, indicate licensing/approving agency

Additional Training Provider Information

Do you offer customized training services?
Do you offer distance learning classes?
Do you have a testing facility?
Wheelchair accessible
Other languages spoken
If yes, please specify
Teacher: Student Ratio
Total number of instructors?
Career assistance/counseling available
Linkage to the American Job Center (AJC) System
Personal on-site job placement assistance
Childcare at facility
Assistance obtaining childcare
Evening courses
Weekend classes
Mode of delivery (i.e. online, classroom)
Describe whether the provider is in partnership with a business (if yes, name the business)
Bus Route 1(specify route or indicate none available)
Bus Route 2(specify route or indicate none available)
Train Route 1(specify route or indicate none available)
Train Route 2(specify route or indicate none available)

Training Program Information

Title of training program
Approving/Certifying Agency for program
Upload the resume, or resumes, of Training Program Instructors If “other” selected above, indicate licensing/approving agency
County
Tuition
Cost of fees
Cost of books and materials
Cost of supplies and tools
Other costs
Total costs
Prerequisites for admission to program
Mode of delivery (i.e. online, classroom)
Minimum class size
Maximum class size
Please describe the regular weekly course schedule(e.g. class days/times)
Does this program lead to a degree or certificate?
If yes, select
Does this program lead to a license?
If yes, indicate license name
Does this program lead to an industry recognized credential?
If yes, indicate name of credentialing agency AND credential
IN DEMAND industries include
This program is eligible for Pell Grants/Stafford Loans (or other Federal/State financial aid) but is not a two-year, four-year or one-year certificate program.
A description of the program to appear on the ETPL in 250 words or less
Credits earned
Total clock hours
Calendar length
If “other” selected above, indicate specify training length
Description of special features of the program in 250 words or less
Contact person name
Contact person title
Contact person phone number
Ext.
Contact person email address
Placement Information Number of participant’s enrolled in past two years
Completion Rate
Certification Attainment Rate
Employment Rate
Retention Rate
Please upload a copy of the offer letter including the name, address, and two (2) POC email addresses & phone numbers for the employer.

Do you have an additional training program to add?

Title of training program
Approving/Certifying Agency for program
Upload the resume, or resumes, of Training Program Instructors If “other” selected above, indicate licensing/approving agency
County
Tuition
Cost of fees
Cost of books and materials
Cost of supplies and tools
Other costs
Total costs
Prerequisites for admission to program
Mode of delivery (i.e. online, classroom)
Minimum class size
Maximum class size
Please describe the regular weekly course schedule
(e.g. class days/times)
Does this program lead to a degree or certificate?
If yes, select
Does this program lead to a license?
If yes, indicate license name
Does this program lead to an industry recognized credential?
If yes, indicate name of credentialing agency AND credential
Does this program align with IN DEMAND industry occupations?
This program is eligible for Pell Grants/Stafford Loans (or other Federal/State financial aid) but is not a two-year, four-year or one-year certificate program.
A description of the program to appear on the ETPL in 250 words or less
Credits earned
Total clock hours
Calendar length
If “other” selected above, indicate specify training length
Description of special features of the program in 250 words or less
Contact person name
Contact person title
Contact person phone number
Ext.
Contact person email address
Placement Information Number of participant’s enrolled in past two years
Completion Rate
Certification Attainment Rate
Employment Rate
Retention Rate
Please upload a copy of the offer letter including the name, address, and two (2) POC email addresses & phone numbers for the employer.

Career and Supportive Services

All Prince George’s County Local Training Provider List training programs are required to offer Career Services that adequately prepare graduates for employment after completing the training. At a minimum, graduates should have an updated resumes and be able to communicate the skills and certifications acquired during an interview. Applications that don’t include Career Services will automatically be denied.

Career Services

Career counseling services
Resume building
Internships, externships, on-the-job training, transitional employment opportunities
If yes, please provide additional detailed information
Mock interviewing
Job matching
Job development/Job placement
Post-placement follow-up services
Coordination for alumnae peer support networks

Supportive Services

Case management
If yes, please add additional information
Life skills/work readiness/professional skills development
Tutoring
Mentoring
Mental health services
Substance abuse counseling
Drug testing
Health care
Stipends
Childcare assistance
Driver’s license obtainment or driving record remediation
Transportation assistance
Legal assistance
Housing assistance
Assistance for individuals with disabilities
Assistance with work-related expenses
(uniforms, supplies, tools, etc.)
Financial counseling
(assistance with financial aid, other tax assistance, or debt removal)
Basic computer literacy
Other(please describe)

Training Application Agreement

The agreement that follows provides general guidelines on the responsibilities of the Training Provider. It is an agreement for services provided with any federal, state or local government funding.

By applying to become a Prince George’s County Local Training Provider, I agree to the following

A. Training Provider Responsibilities
  1. The training provider will ensure the individual's eligibility for financial aid is determined before training begins. All student financial aid awards will first be applied toward the total cost of training prior to the use of public funds.
  2. Information about training costs and supplemental fees for books, uniforms, supplies and etc. shall be communicated and supplied to the job seeker, WIOA Title I career service provider, and Career Consultant(s) prior to the start of the training.
  3. The training provider will submit any requested report of training, attendance and progress/performance reports to EPG. In cases where the individual must submit proof of attendance for other purposes (receipt of unemployment benefits, stipends, etc.) the training provider will certify such attendance on the appropriate form to designate appropriate attendance and satisfactory progress. Self-certifications of attendance and progress may be accepted for college credit degree programs.
  4. The training provider must immediately notify the AJC Career Consultant if individuals withdraw from training or if attendance or progress of any individual is unsatisfactory within 5 days from the contract.
  5. The training provider will submit all student enrollment and exit information, as well as any follow-up data required, to the AJC.
  6. The training provider agrees to comply with all requirements of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, Title IX of the Education Amendments of 1972, and the Americans with Disabilities Act, 42 U.S.C. 12102.
B. EPG and AJC Responsibilities

EPG and the AJC agree to abide by the following provisions

  1. Individuals will be referred to the training provider by an approved AJC Career Consultant. This training authorization will detail the individual course information, training dates, trainee identifying information, and other necessary information to clearly identify the individual and training. When an individual is accepted into a program or course, a cost and fee schedule for individual courses will be established. Negotiated course costs and fees will apply, and the training provider will be compensated for training on an ongoing basis as specified in the Agreement.
  2. The appropriate agency agrees to obligate all monies for all multiple course/semester courses at the time the applicant is enrolled in approved training. This applies to those courses included in the original training plan for the individual. Subsequent modifications to the original training plan must be developed with a new training authorization or a new contract and are subject to the availability of training funds.
  3. The agency agrees to compensate training providers for all training received by the individual as outlined in the training authorization or in the contract with the provider.
  4. In cases of training authorization’s, requests for the student's current progress and financial aid status will be sent to the training provider twenty-one (21) to twenty-eight (28) days before the scheduled invoice date to allow time for any necessary modifications.
C. General Provisions
  1. The total amount of any grant to any one individual shall not exceed the limit set by the PGCLWDB or appropriate state agency.
  2. All student financial aid awards will first be applied toward the total cost of training prior to the use of public funds, except for needs-based living expenses where permitted by law and regulation.
  3. Training providers may not make changes to programs, courses, hours, locations or other conditions of training as identified in the training authorization or negotiated contract for other training services without expressed written consent of the individual and individual's AJC Career Consultant or other responsible official.
  4. Training providers are expected to meet expected performance levels established by the state, EPG, or PGCLWDB.
D. Warranties
  1. The training provider does hereby warrant and represent that this Agreement has not been solicited or secured, directly or indirectly, in a manner contrary to the Laws of the State of Maryland and that said Laws have not been violated and shall not be violated as they relate to the procurement or the performance of this Agreement by any conduct including the paying or giving of any fee, commission, compensation, gift, gratuity, or consideration of any kind, directly or indirectly, to any state employee, office, or official.
  2. The training provider does hereby warrant and represent training and experience which reflect qualifications to perform the required training in a manner and on the terms and conditions set forth herein.
By signing this document, I agree to the terms contained in this Provider Agreement. Authorized Signature: Date:

Required Documentation

Instructions

The following documentation is required. Please submit a copy of each item unless specifically directed otherwise. Failure to include the required documentation may delay your ETPL approval.

Required Documentation

Approval/Denial Letter from the Maryland Higher Education Commission

  • (if applicable) Certification Regarding Lobbying
  • (Complete attachment below) Certification Regarding Acorn Prohibition
  • (Complete attachment below) Certification Regarding Acorn Prohibition
  • (Complete attachment below) Certification of Good Standing for the State of Maryland
  • (attach a copy) Tax Exemption
  • (attach a copy) W-9
  • (attach a copy) Americans with Disability Act
  • (attach current policy) Equal Employment Policy
  • (attach current policy) Equal Education Opportunity Policy
  • (attach current policy) Conflict of Interest Policy
  • (attach current policy) Liability Insurance Policy
  • (attach current policy) Grievance Procedures for Students
  • (attach current policy) Personnel Policies
  • (attach copy of table of content of handbook) Tuition Schedule and/or Catalog
  • (attach a copy) Organizational Structure
  • (attach organization chart)
Note

If approved, contracts executed as a result of this application process will be Firm Fixed Price (FFP) unless a different type of contract is determined by EPG and/or Board to be more advantageous. EPG and/or Board reserves the right to vary or change the terms of any contract executed as a result of this application the scope of work, performance standards, and shortening or extending the contract period, as it deems necessary in the interest of EPG and/or Board and its programs, pending availability of funds. EPG and/or Board will award to the responsible Offeror whose proposal, conforming to the solicitation, will be the most advantageous to the County, cost or price and other factors considered. EPG and/or Board will procure for its requirement on the basis of the Best Value to the County.

Application Rejection

The Issuing Office reserves the right to reject any, part of any, and all application, in its sole and complete discretion, for any answers received in response to this application. Incomplete applications, applications that do not meet the requirements of this conditional approval will not be accepted.

Certification Regarding Lobbying

The undersigned certifies, to the best of his or her knowledge and belief, that:

  1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan or cooperative agreement.
  2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying, in accordance with its instructions.
  3. The undersigned shall require that the language of this certification be included in the award documents for all* sub-awards at all tiers (including subcontracts, sub-grants and contract under grants, loans, and cooperative agreements) and that all* sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Grantee/Contractor Organization: Program/Title: Name of Certifying Official: Signature: Date:

*Note

In these instances, "All," in the Final Rule is expected to be clarified to show that it applies to covered grant transactions over $100,000 (per OMB).

Drug Free Workplace Requirements Certification

Alternate I. Pursuant to the Drug-Free Workplace Act of 1988, and its implementing regulations codified at 29 CFR 98, Subpart F, I, , the undersigned, in representation of Employ Prince George’s, Inc., the grantee, attest and certify that the grantee will provide a drug-free workplace by: 1. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; 2. Establishing an ongoing drug-free awareness program to inform employees about: (a) The dangers of drug abuse in the workplace; (b) The grantee's policy of maintaining a drug-free workplace; (c) Any available drug counseling, rehabilitation, and employee assistance programs; and (d) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; 3. Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (1); 4. Notifying the employee in the statement required by paragraph (1) that, as a condition of employment under the grant, the employee will: (a) Abide by the terms of the statement; and (b) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; 5. Notifying the agency in writing ten calendar days after receiving notice under subparagraph (4) (b) from an employee or otherwise receiving actual notice of such conviction. We will provide such notice of convicted employees, including position title, to every grant officer on whose grant activity the convicted employee was working. The notice shall include the identification number(s) of each affected grant. 6. Taking one of the following actions, within thirty (30) calendar days of receiving notice under subparagraph (4) (b), with respect to any employee who is so convicted: (a) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973 as amended; or (b) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; 7. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (1), (2), (3), (4), (5) and (6). 8. Notwithstanding it is not required to provide the workplace addresses under the grant, as of today the specific sites are known and we have decided to provide the specific addresses with the understanding that if any of the identified places change during the performance of the grant, we will inform the agency of the changes. The following are the sites for the performance of work done in connection with the specific grant including street address, city, county, state, and zip code: Check ( ) if there are workplaces on file that are not identified here. Check ( ) if an additional page was required for the listing of the workplaces. I declare, under penalty of perjury under the laws of the United States of America, and under the penalties set forth by the Drug-Free Workplace Act of 1988, that this certification is true and correct. I , certify that I am the ; that I who sign this Drug-Free Workplace Certification on behalf of , do so by the authority given by , and such signing is within the scope of my powers. Authorized Signature: Executed on:

CERTIFICATION REGARDING ACORN PROHIBITION

Section 511 of the Consolidated Appropriations Act, 2010 (P.L. 111-117, Division E) (“CAA”), requires that no direct or indirect funding from the Consolidated Appropriations Act may be provided to the Association of Community Organizations for Reform Now (“ACORN”) or any of its subsidiaries through Federal grantees or contractors. DOL is required to take steps so that no Federal funds from the Consolidated Appropriations Act, 2010, are awarded or obligated by DOL grantees or contractors to ACORN or its subsidiaries as sub grantees, subcontractors, or other sub recipients. This prohibition applies not only to a direct recipient of Federal funds, but also to a sub recipient (e.g., subcontractor, sub grantee, or contractor of a grantee). On behalf of the WIOA local area grant recipient, I hereby attest and certify that the grantee will comply with the above policy regarding ACORN prohibition. Authorized Signature: Executed on:

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The Prince George’s County American Job Center Community Network | Maryland | DC Area https://pgcajc.com
Signature Certificate
Document name: Local Training Provider Application
lock iconUnique Document ID: c33f13f67a5e44c228c9cbd724a53d92934cd2f3
Timestamp Audit
November 4, 2020 9:32 am GMTLocal Training Provider Application Uploaded by Prince George’s County American Job Center - adminandcontracts@co.pg.md.us IP 203.115.84.41