| A | B | C | D | E | F | G | ||
|---|---|---|---|---|---|---|---|---|
| 1 | CONTRACT NO. ______________________ | |||||||
| 2 | Beginning Date______________Ending Date_______________ | |||||||
| 3 | Risk Level of Contract _________________ | |||||||
| 4 | Contract Manager_____________________________________ | |||||||
| 5 | ||||||||
| 6 | CRITERIA | RISK VALUE | SCORE | |||||
| 7 | ||||||||
| 8 | Department Priority | |||||||
| 9 | Mission Critical | 10 | ||||||
| 10 | Mission Support | 5 | RANGES | |||||
| 11 | ||||||||
| 12 | Contracted dollars | |||||||
| 13 | $1,000,000 and above | 10 | LOW | 0 | to | 29 | ||
| 14 | $500,000 to $999,999 | 8 | ||||||
| 15 | $250,000 to $499,000 or Open-Ended | 6 | ||||||
| 16 | $100,000 to $249,999 | 4 | ||||||
| 17 | Under $100,000 | 2 | MEDIUM | 30 | to | 37 | ||
| 18 | ||||||||
| 19 | Nature of Services | |||||||
| 20 | Direct | 10 | ||||||
| 21 | Indirect | 5 | HIGH | 38 | 50 | |||
| 22 | ||||||||
| 23 | Current Monitoring Plan | |||||||
| 24 | No current monitoring plan | 10 | ||||||
| 25 | Current monitoring plan in-place | 5 | ||||||
| 26 | Monitored by Federal Audit or independent source | 0 | ||||||
| 27 | ||||||||
| 28 | Provider History | |||||||
| 29 | Corrective actions: Major findings - Findings that would affect service delivery, put clients at risk or have potential for payment error, and has not been placed on the Vendors Suspended List. | 10 | ||||||
| 30 | Corrective actions: Minor findings - Findings that would not affect service delivery, put clients at risk or have potential for payment error, and has not been placed on the Vendors Suspended List. | 8 | ||||||
| 31 | New Provider | 6 | ||||||
| 32 | No findings | 0 | ||||||
| 33 | ||||||||
| 34 | Identify Exceptions: Considerations that impact the frequency of monitoring contracts. Check if appropriate. | |||||||
| 35 | ||||||||
| 36 | ||||||||
| 37 | ||||||||
| 38 | TOTAL SCORE | |||||||