List of Procurement Forms

Name of Form: Purpose of Form:
Advertisement Letter Letter sent to the newspaper to notify the public of RFPs, RFAs, and IFBs.
Certification of PERS Service Retirement Form that is used to document an individual's status as a PERS retiree.
Confidentiality Form Form to be completed by each reviewer prior to reviewing proposals for the MDE.
Conflict of Interest Form Form to be completed by each reviewer prior to reviewing proposals for the MDE.
Contract Justification - Contract Worker Form used for all requests to contract with individuals who are classified as contract workers.
Contract Justification - Contract Worker Modification/Renewal Form used to document the review and approval of a modification to a previously approved contract.
Contract Justification - Independent Contractor Form used for all requests to contract with individuals/businesses who are classified as independent contractors.
Contract Justification - Independent Contractor Modification/Renewal Form used  to document the review and approval of a modification to a previously approved contract.
Contract Modification Signature Sheet and Contract Budget Summary Forms used to modify contracts with both contract workers and independent workers.
Contract with a Regional Educational Service Agency (RESA) Contract used with a Regional Educational Service Agency (RESA).
Contract Worker Checklist Checklist listing the documents necessary for the completion of a contract worker contract.
Contract Worker contract - personal services only Contract used for contract workers that will be paid for personal services only.
Contract Worker contract - personal services and travel Contract used for contract workers that will be paid for both personal services and travel.
Contract Worker contract with PERS retirees - personal services only 07/01/11 Contract used for contract workers who are PERS retirees and will be paid for personal services only. 07/01/11
Contract Worker contract with PERS retirees - personal services and travel
07/01/11
Contract used for contract workers who are PERS retirees and will be paid for both personal services and travel. 07/01/11
Employee vs. Independent Contractor Determination Questionnaire Form required by PERS to be submitted for all requests for a PERS retiree to be classified as an independent contractor. This form must be completed and submitted to PERS for their determination of the contractor's status. The determination must occur prior to the agency entering into a contract with the retiree that is classified as an independent contractor.
Evaluator Guidelines Set of guidelines that each evaluator is required to adhere to during the proposal review process. Evaluator and a witness must sign the bottom of the page before the proposal review begins.
Evaluator Sign-In Sheet Sign-in sheet for evaluators during the proposal review process.
Form I-9 Form required to be completed by the U.S. Department of Homeland Security upon employment an of an individual. The purpose of the form is to document that each new employee (both citizen and noncitizen) hired after November 6, 1986, is authorized to work in the United States.
Form W-4 Form required for all employees and contractors classified as contract workers to document federal withholding authorizations.
Form W-9 Form required for all independent contractors to document their tax identification number for reporting of earnings.
Grant Award Justification Form used to document the request and approval of a grant award.
Grant Award Modification Justification Form used to document the request and approval of a modification to a grant previously awarded.
Grants Checklist Listing of the documents necessary for the award of grants.
Grant Agreement - Short Grant agreement used to award funds for basic grants.
Grant Agreement - Long Grant agreement used to award funds for complex grants.
Grant Agreement for ARRA Awards Grant agreement used to award ARRA funds.
Grant Agreement for IHL Grant agreement used to award funds to the IHL.
Grant Modification Signature Sheet and Grant Budget Summary Forms used to modify grants.
Independent Contractor Checklist Listing of the documents necessary for the completion of an independent contractor contract.
Independent Contractor - Long Contract Contract used for independent contractors with complicated work statements.
Independent Contractor - Long Contract Over $100,000 Contract used for contracts over $100,000 procured through the competitive sealed proposals process.
Independent Contractor Short Contract Contract used for trainers, speakers, etc.
IRS Checklist Checklist used to determine an individual's status as a contract worker or an independent contractor.
PERS Form 4B Form required to be submitted to PERS upon the re-employment of a retiree. 
Proposals Not Evaluated Form Form used to list proposals not evaluated.
Request for Proposals/Request For Applications/Invitation For Bids Form used to document the request for release of an RFP, RFA, or IFB.
Request for Proposals/Request For Applications/Invitation For Bids Checklist Checklist listing the documents necessary for the processing and approval of a request for release of an RFP, RFA, or an IFB.
Request for Proposals Tentative Time Line Checklist Checklist designed to assist with the development of a tentative timeline for the RFP packet.
Request To Purchase Food And/Or Space For Business Meetings Form used to document the request and approval of the purchase of food and/or space for business meetings.
Requisition Form used by the Office of Accounting to set up a purchase order to obligate funds for contracts with independent contractors.
State Withholding Form Form required for employees and contractors classified as contract workers. This form is used to document the authorized deduction from gross pay for state withholdings.
Request for Computer or ITS-Related Services Form Form used when securing information technology-related goods and services.
Termination Form
• Independent Contractor
• Contract Worker  
Agreement used to terminate a contract.
Travel Policy Policies established for the use by individuals who are required to travel in-state and out-of-state on official Mississippi Department of Education government business. These policies are based on the guidelines established by the State Department of Finance and Administration (formally the State Fiscal Management Board) in accordance with Section 25-3-41, Mississippi Code Annotated (1972).

Office of Procurement     P.O. Box 771     Jackson, MS 39205-0771     Phone: (601) 359-5716     Fax: (601) 576-3503

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