TEXAS DEPARTMENT OF TRANSPORTATION GENERAL SERVICES DIVISION. SPECIFICATION NO. TxDOT 952-38-40* REVISED: AUGUST 2010

TEXAS DEPARTMENT OF TRANSPORTATION GENERAL SERVICES DIVISION SPECIFICATION NO. * STATEWIDE EMPLOYEE ASSISTANCE PROGRAM SERVICES PUBLICATION This specification is a product of the Texas Department of Transportation (TxDOT). It is the practice of TxDOT to support other entities by making this specification available through the National Institute of Governmental Purchasing (NIGP). This specification may not be sold for profit or monetary gain. If this specification is altered in any way, the header, and any and all references to TxDOT must be removed. TxDOT does not assume nor accept any liability when this specification is used in the procurement process by any other entity. 1. SCOPE: This solicitation is a Request for Proposal (RFP) for statewide Employee Assistance Program (EAP) services for TxDOT and TxDMV employees and employees immediate family members. The current number of employees is 11,951 for TxDOT and 513 for TxDMV. EAP services shall assist participants with challenges in the areas of substance abuse, marital or family problems, psychological or emotional problems, work-related and vocational problems (Ref. Attachment A List of TxDOT Employees by District, Division, Office, Region and Administration). NOTE: TxDOT typically hires approximately 1,200 seasonal employees, usually college students. These employees shall be covered by the EAP and are NOT included in the total number of employees shown above. Respondent shall consider this when preparing the proposal. 2. DEFINITIONS OF TERMS AND ACRONYMS 2.1. AFTERCARE: The second phase in treatment for alcohol, inhalant or drug dependency. This phase follows initial treatment and may include additional treatment requirements (Ref. Paras. 2.17. and 2.26.). The treatment program s staff physician designates the frequency and duration of these treatment requirements. 2.2. ALCOHOL OR DRUG RELATED DRIVING OFFENSE: A conviction or deferred adjudication for any offense involving the driving of a vehicle, whether on duty or off duty, while under the influence of alcohol or drugs or while intoxicated. 2.3. ASSESSMENT: The process, through face-to-face communication, by which the vendor s Substance Abuse Professional (SAP) or EAP counselor determines the participant s EAP service needs as well as social, emotional, and psychological strengths and weaknesses and support systems. Assessment is an ongoing process throughout the relationship between the participant and the SAP, EAP counselor or both. 2.4. CFR: Code of Federal Regulations. 2.5. COUNSELING SESSIONS: A scheduled face-to-face conference between a participant and counselor for the purpose of discussing and identifying areas of concern and problem solving. Telephone conferences shall not be the usual or routine method of providing counseling services except in case of emergency (Ref. Para. 2.12.). * This Specification Supersedes Specification No., Dated December 2003. 1-22

2.6. DER: Designated Employer Representative: A team member of the Substance Abuse Program Staff of TxDOT s Human Resources Division (HRD). 2.7. DHS: U.S. Department of Homeland Security. 2.8. DOT: U.S. Department of Transportation. 2.9. DRUG: A narcotic drug, controlled substance or marijuana as defined in Public Law 91-513 Comprehensive Drug Abuse Prevention and Control Act of 1970 and 21 United States Code (U.S.C.), Chapter 13, Subchapter 1, Part A, Section 802 Controlled Substance Act Definitions. 2.10. DSHS: Texas Department of State Health Services. 2.11. EAP: Employee Assistance Program. 2.12. EMERGENCY: A life-threatening situation where the individual could be harmful to self or others. 2.13. EMPLOYEE(S): A person employed by TxDOT or TxDMV in a full-time, part-time, temporary recruitment, project or seasonal position and includes contract vessel crewmembers. This does not include a temporary employee under contract to TxDOT or TxDMV. 2.14. HHSC: Texas Health and Human Services Commission. 2.15. HRD: TxDOT s Human Resources Division. 2.16. IMMEDIATE FAMILY MEMBER: Those individuals related by kinship, adoption, marriage or foster children certified by the Texas Health and Human Services Commission (HHSC), living in the same household or, if not in the same household, are totally dependent upon the employee for financial assistance or personal care or services on a continuing basis (Ref. Para. 2.25.). 2.17. INITIAL TREATMENT: The first period in treatment for problems associated with the use of alcohol, inhalant or drug dependency. Treatment shall consist of inpatient treatment, intensive outpatient treatment, educational sessions, counseling sessions or a combination of these treatments. 2.18. JCAHO: Joint Commission on Accreditation of Healthcare Organizations. 2.19. MANDATORY REFERRAL: Any referral that requires an employee to go to a SAP or EAP counselor or both and complete treatment or be terminated from TxDOT. A mandatory referral is precipitated by a meeting between an employee, the employee s supervisor or other appointed TxDOT personnel. The purpose of the meeting is to address an employee s alcohol, inhalant or drug dependency as it relates to the employee s work performance or harassing, threatening or violent behavior or any situation which warrants a mandatory referral to the EAP. The circumstances for a mandatory referral include: 2.19.1. An employee fails an alcohol or drug test. 2.19.2. An employee, excluding commercial drivers, vessel crewmembers and safetysensitive employees, refuses a drug or alcohol test. 2.19.3. An employee possesses an open container of alcohol or drugs in the workplace. 2-22

2.19.4. A commercial driver, vessel crewmember or safety-sensitive employee possesses alcohol in the workplace, consumes alcohol four hours prior to coming to work or within eight hours following an accident or prior to undergoing a post-accident alcohol test. 2.19.5. An employee voluntarily admits having an alcohol, inhalant or drug problem. 2.19.6. A suspicious substance is found or an investigation reveals an employee is using alcohol, inhalants or drugs inside the workplace. 2.19.7. An employee is directly observed consuming an alcoholic beverage, taking a drug or inappropriately using an inhalant in the workplace. 2.19.8. An employee is suspected of working under the influence of alcohol, drugs or inhalants. 2.19.9. An employee has received an alcohol- or drug-related driving offense. 2.19.10. An employee s behavior in the workplace is seriously disruptive or an employee engages in harassing, threatening or physically violent behavior, which constitutes a danger to other employees or the public. 2.19.11. An employee has a behavioral or performance problem that could be helped by counseling. 2.20. PARTICIPANTS: Employees and employees immediate family members (Ref. Paras. 2.13. and 2.16.). 2.21. REFERRAL SOURCE: Any outside referral paid for by the participant or the participant s health insurance, such as a licensed psychiatrist, EAP counselor or medical doctor. 2.22. SAP: Vendor s Substance Abuse Professional. 2.23. SCO: Substance Control Officer: An employee that administers TxDOT s Substance Abuse Program in coordination with the Designated Employer Representative (DER). 2.24. SELF REFERRAL: Participants utilizing the EAP services by calling a toll-free number for confidential counseling services and are not mandatory referrals (Ref. Para. 2.19.). 2.25. TOTALLY DEPENDENT ON A CONTINUING BASIS: A situation in which an employee has the responsibility for the personal care or services of an immediate family member for any period during which the employee is the primary source of continual care (Ref. Para. 2.16.). 2.26. TREATMENT: Medical or psychological treatment for alcohol, inhalants or drug dependency or harassing, threatening or violent behavior, which may consist of inpatient treatment, intensive outpatient treatment, educational sessions or counseling sessions followed by aftercare (Ref. Para. 2.1.). 2.27. U.S.C.: United States Code. 2.28. VPM: Violence Program Manager: An employee that administers TxDOT s Violence Prevention Program in coordination with the Violence Program Staff of HRD. 3-22

2.29. WARNING LETTER: A letter sent to an employee not meeting the standards of compliance of their mandatory referral. The letter shall identify the standards of compliance not being met with the specific actions the employee must complete by an established time frame. 2.30. WST: Workplace Support Team: A vendor s specialized team, consisting of a minimum of one staff counselor and a backup staff counselor to manage and administer mandatory referrals (Ref. Paras. 2.19. and 8.7.). 3. APPLICABLE LAWS AND STANDARDS: The vendor shall provide the specified service requirements in accordance with all federal, state and local applicable laws, standards and regulations necessary to perform the services, including, but not limited to: 3.1. 21 U.S.C., Chapter 13, Subchapter 1, Part A, Section 802 Controlled Substances Act Definitions. 3.2. 33 Code of Federal Regulations (CFR), Part 95 Operating a Vessel While Under the Influence of Alcohol or a Dangerous Drug. 3.3. 41 U.S.C., Chapter 10, Sections 701 through 707 Drug-Free Work Place. 3.4. 46 CFR, Part 4 Marine Casualties and Investigations. 3.5. 46 CFR, Part 5 Marine Investigations Personnel Actions. 3.6. 46 CFR, Part 16 Chemical Testing. 3.7. 49 CFR, Part 40 Procedures for Transportation Workplace Drug and Alcohol Testing Programs. 3.8. 49 CFR, Part 382 Controlled Substances and Alcohol Use and Testing. 3.9. Public Law 91 513 Comprehensive Drug Abuse Prevention and Control Act of 1970. 3.10. Public Law 100 690, Subtitle D Drug Free Workplace Act of 1988. 3.11. Texas Administrative Code, Sections 4.30. through 4.46. Substance Abuse Program. 4. BACKGROUND: TxDOT provides EAP services for all employees and employees immediate family members as a benefit through an EAP vendor. Vendor will support TxDOT s mission to: 4.1. Maintain the health and safety of employees and the safety of the traveling public. 4.2. Provide an alcohol and drug-free workplace. 4.3. Provide a workplace free of violence. 4.4. Improve productivity on the job. 4.5. The EAP s mission, in part, is to: 4.5.1. Provide employees with services to assist with problems affecting job performance. 4-22

4.5.2. Educate employees and supervisors on the dangers of alcohol and substance abuse. NOTE: TxDOT conducts a Violence Prevention Program and a Substance Abuse Program, which include drug and alcohol testing of all employees including commercial drivers, vessel crewmembers and employees in safetysensitive positions. Drug and alcohol testing is handled for TxDOT by another vendor and is not included in this specification. 5. RESPONDENT QUALIFICATIONS: The respondent shall: 5.1. Be a company engaged in the business of providing EAP services in the areas of substance abuse, marital or family problems, psychological or emotional problems, work-related problems and vocational problems for a minimum of ten years within the last 12 years. Recent start-up businesses do not meet the requirements of this solicitation. A start-up business is defined as a new company that has no previous operational history or expertise in the relevant business and is not affiliated with a company that has that history or expertise. 5.2. Have a minimum of five years experience within the ten years of experience, required in Para. 5.1., providing EAP services to a minimum of 15 companies with national decentralized locations within the network. 5.3. Be in good financial standing, current in payment of all taxes and fees such as state franchise fees. TxDOT reserves the right to request a copy of the respondent s audited financial statement. When financial statements are requested, TxDOT will review the respondent's audited financial statement to this solicitation in accordance with Texas Government Code, Title 10, Subtitle D, Section 2156.007 to evaluate the sufficiency of the respondent's financial resources and ability to perform the contract or provide the service required in the solicitation. TxDOT will be the sole judge in determining the sufficiency of the respondent's financial resources and ability to perform the contract or provide the service. Factors to be reviewed include: 5.3.1. Balance sheets. 5.3.2. Net working capital. 5.3.3. Current asset ratio. 5.3.4. Liquidity ratio. 5.3.5. Auditor(s) notes. 5.3.6. Any notes to the financial statements. 6. VENDOR REQUIREMENTS: The vendor shall: 6.1. Adhere to the TxDOT Terms and Conditions identified on the solicitation. 6.2. Provide a list of proposed affiliated offices at different locations throughout the state of Texas (Ref. Attachment B Required EAP and Affiliated Provider Office Sites). 5-22

6.3. Have affiliated offices providing service under this purchase order that shall meet the same requirements and provide the same services as those required of the vendor. No affiliate contract executed under this purchase order shall relieve the vendor of their responsibility under this purchase order. 6.4. Provide a list of proposed counselors which are accessible to participants with disabilities, such as mobility, hearing or visually impaired or participants that may require bilingual speaking or language translation. 6.5. Have on file for each affiliated office a copy of their certificate of licensure or degree, verify their credentials as authentic and provide proof to TxDOT upon request. 6.6. Have a 24 hour, seven days a week, toll-free helpline staffed only with qualified counselors available to all participants. No answering or paging services shall be used. The helpline shall provide a bilingual counselor at all times and shall provide a telephone line for the hearing impaired. Helpline counselors shall be permanent staff of the vendor. 6.7. Meet with the DER on an as needed basis to facilitate the implementation and administration of the EAP services purchase order. 6.8. Maintain a specialized EAP Workplace Support Team (WST) available to TxDOT between the hours of 8:00 a.m. and 5:00 p.m. CT, Monday through Friday to advise and discuss issues related to specific employee s performance or behavioral problems, throughout the term of the purchase order (Ref. Para. 2.30.). 6.9. Ensure all vendor employees and affiliates are knowledgeable of the following: 6.9.1. Requirements of the EAP services. 6.9.2. Local referral sources and various health insurance plans (Ref. Paras. 8.4.1. and 18.2.). 6.9.3. TxDOT s Violence Prevention Program policies and procedures (Ref. Para. 18.3.). 6.9.4. TxDOT s Substance Abuse Program, rules, policies and procedures (Ref. Para. 18.4.). 6.9.5. TxDOT s EAP policy and procedures (Ref. Para. 18.6.). 6.10. Provide services to all participants statewide at locations that are convenient and easily accessible. Participants shall travel a maximum of 60 miles from the TxDOT work location nearest to the participant to reach SAP or EAP services. TxDOT reserves the right to grant exceptions to the 60 mile radius upon verbal request from the vendor on a case by case basis (Ref. Schedule 5 Respondent Information Worksheet). NOTE: TxDOT encourages vendors to be creative in meeting this requirement (i.e., mobile or portable counseling offices for rural areas). 6.11. Provide counseling services at sites, which are accessible to participants with disabilities, in particular mobility, hearing or visually impaired or participants that may require language translation. 6.12. Provide face-to-face counseling during normal work hours of 8 a.m. through 5 p.m., Monday through Friday and preferably one night per week and on one day each weekend. 6-22

6.13. Establish an employee Statement of Understanding for mandatory referrals, including any compliance requirements to be signed by each employee at the beginning of the mandatory referral. 6.14. Utilize sample forms provided by TxDOT to meet reporting requirements and confidentiality (Ref. Para. 18.5.). 6.15. Provide to Psychiatrist, SAP or counselor, an information packet of required forms, including but not limited to a Confidentiality Statement, Statement of Understanding and sample SAP letter. 6.16. For mandatory referrals, require employees to sign a confidentiality statement. Employees shall be advised that if they do not sign a release, TxDOT will not be able to determine whether or not they are in compliance with their treatment plan. TxDOT will terminate an employee if they choose not to sign the statement. 6.17. Provide counselors for face-to-face counseling sessions as needed. If needed, participants will request counselors that are bilingual or that can communicate with the hearing, visually impaired or participants with disabilities at the time an appointment is scheduled. 6.18. Provide a minimum of quarterly in-service training to all helpline counselors. 6.19. Ensure all helpline counselors and WST are employees of the vendor. 6.20. Ensure all SAPs perform services in accordance with DOT and DHS regulations. 7. RESPONDENT PERSONNEL REQUIREMENTS 7.1. COUNSELORS: Counselors shall: 7.1.1. Have a minimum of a master s degree from an accredited college or university in a behavioral science. NOTE: TxDOT may make an exception to the master s degree requirement for licensed or certified staff and counselors in fields requiring specialized knowledge, training and expertise obtained through professional training programs that do not award academic degrees. Counselors certified as Alcohol and Drug Abuse Counselors, Licensed Professional Counselors or have a Bachelor of Social Work degree and have a minimum of three years of experience within the last five years in mental health or substance abuse meet the criteria. 7.1.2. Be licensed or certified by the appropriate professional groups or state regulating agencies. NOTE: Only Certified Alcohol and Drug Abuse Counselors shall provide counseling services to participants suffering a problem related to substance abuse. 7.1.3. Have a minimum of three years clinical experience within the last five years. NOTE: Residents or interns shall not be used to provide services. 7.2. SAP shall meet U.S. Department of Transportation (DOT) and U.S. Department of Homeland Security (DHS) requirements. 7-22

8. SERVICE REQUIREMENTS: The vendor shall: 8.1. IMPLEMENTATION 8.1.1. Meet with the DER to formulate a mutually agreeable implementation plan at the post award meeting after award of a purchase order (Ref. Para. 22.) 8.1.2. Have EAP services fully operational statewide within 60 calendar days after award of the purchase order. 8.1.3. Conduct EAP services consistent with TxDOT EAP policies and procedures. These will be provided to the vendor at the post award meeting (Ref. Paras. 18.6. and 22.). 8.2. ASSESSMENT AND EVALUATION 8.2.1. Perform an assessment of an employee s problem or reason for mandatory referral and assess each life area of the employee, including an assessment for chemical or alcohol dependency or for harassing, threatening or violent behaviors (Ref. Para. 2.19.). 8.2.2. Perform an assessment for a mandatory referral within five calendar days from notification by TxDOT. 8.2.3. Perform an evaluation, during the initial assessment, to determine whether the number of sessions a participant needs is within the parameters of the purchase order. If a participant needs more than the number of sessions provided under the purchase order, the participant shall be referred to an outside referral source covered by the employee s insurance provider, if available (Ref. Para. 8.3.1.). 8.2.4. DOT and DHS referrals shall be assessed in accordance with federal regulations. 8.2.5. Assess a mandatory referral for a commercial driver, vessel crewmember or safety-sensitive employee as needing assistance. SAP or EAP counselor provides the initial and follow-up evaluation letters. 8.2.6. Have all mandatory referrals under the TxDOT Violence Prevention Program be assessed by a licensed psychiatrist. 8.2.7. Assess a mandatory referral for harassing, threatening or violent behaviors as needing assistance. 8.2.8. Provide an evaluation letter to the DER for mandatory referrals when: 8.2.8.1. A counselor determines treatment is necessary. The letter shall state that the employee needs assistance in resolving problems associated with alcohol, inhalant or drug dependency. 8.2.8.2. A counselor determines treatment is not necessary. The letter shall state that the employee does not need assistance in resolving problems associated with alcohol, inhalant or drug dependency. (Ref. Para. 8.2.5.) 8.2.9. Perform assessments face-to-face for non-emergency cases. 8-22

8.2.10. Perform assessments over the telephone only in emergency situations. (Ref. Para. 2.12.) 8.3. COUNSELING 8.3.1. Provide a total of six counseling sessions to include, but not be limited to assessment, evaluation, counseling, referral if necessary and follow-up at no cost to the participant, per incident or problem, per participant, per contract year. If additional services are required after a counselor has provided six counseling sessions, the participant shall be referred to an outside referral source. 8.3.2. Continue to provide EAP services to employees that leave the agency for any reason and those individuals immediate family members for a period of six months from the date the employee ends employment. 8.3.3. Provide self referral counseling sessions within calendar days after a request is made. Counseling sessions shall be a minimum of 50 minutes in length. 8.3.4. Provide a counselor who shall return the participant s call within 24 hours to arrange a face-to-face appointment. The appointment shall be held within five calendar days of the original call to the helpline. 8.3.5. Have counseling appointments available a minimum of once a week, subsequent to a participant s first appointment. 8.3.6. In order to ensure confidentiality, schedule participants a minimum of two hours from another participant s sessions, if at all possible, unless the sessions occur at separate office sites. If double scheduling is unavoidable, counselors and receptionist shall make every effort to prevent the participants from seeing each other. 8.3.7. Not provide counseling services in the homes of participants, except on an emergency basis, or at any site with religious affiliations (Ref. Para. 2.12.). 8.3.8. Only provide pastoral-based counseling upon request from the participant. 8.4. VENDOR REFERRAL 8.4.1. Recommend quality and affordable services to participants, which are covered by the participant s insurance, if available. TxDOT reserves the right to approve or disapprove all referral sources (Ref. Paras. 6.9.2., 18.2. and 18.7.). 8.4.2. If a referral is indicated, have the counselor coordinate with the WST to determine which referral sources are most appropriate to meet the needs of the participant. Assist the participant in locating a source by giving the participant a minimum of two referral choices, when available. Additional costs incurred, as a result of a referral, will be borne by the participant or participant s health insurance company. Referrals shall be made within two calendar days of the initial assessment. 8.4.3. Have counselors or WST assist participants in accessing a referral source and follow-up within 30 calendar days to determine whether services have been received and whether the referral was appropriate and useful (Ref. Para. 8.5.). The counselor shall coordinate with a participant s primary care physician and insurance provider when making a referral. 9-22

8.4.4. Discontinue use of any referral source that receives three validated complaints from the vendor, affiliates or participants, unless TxDOT determines after a minimum of one validated complaint that the referral source not be used. The vendor shall validate complaints within three working days after a complaint is received (Ref. Paras. 8.10. and 10.3.). 8.5. FOLLOW-UP 8.5.1. Have the counselor follow-up via telephone, after participant completes the vendor s recommended counseling sessions to determine the status of the presenting problem and offer additional assistance, including vendor referral, when needed. 8.5.2. Follow-up with referral sources used by the vendor and have the referral sources participate in the vendor s client satisfaction survey. 8.6. HELPLINE 8.6.1. Provide the name of a local counselor to participants that contact the helpline and want to make an appointment. Participants will contact the counselor to make an appointment unless a participant is unable to or requests assistance from the helpline counselor in making the appointment. 8.6.2. Honor a request from a participant for a specific counselor, if possible. 8.6.3. Receive mandatory referrals on the helpline from the supervisor, Substance Control Officer (SCO), Violence Program Manager (VPM), or DER (Ref. Para. 18.8.). The mandatorily referred employee will contact the SAP or EAP counselor to make the appointment. 8.6.4. In case of an emergency, the helpline counselor shall arrange a face-to-face appointment for the participant within two hours from receipt of the call (Ref. Para. 2.12.). 8.7. WORKPLACE SUPPORT TEAM (WST) 8.7.1. Manage all mandatory referrals. 8.7.2. Coordinate with the SCO, VPM, DER and Violence Program Staff of HRD. 8.7.3. Warning Letter for Mandatory Referrals 8.7.3.1. Provide a warning letter and timeline via fax or email to the DER two days prior to letter being sent to the employee. The timeline should include a history of activities of the referral. 8.7.3.2. Provide a warning letter to an employee not meeting the standards of compliance by certified and regular mail. The letter identifies the standards the employee has to complete within a specified timeframe. 8.7.3.3. Follow-up with the DER or Violence Program Staff of HRD concerning the employee s compliance with the requirements via fax or email. Provide a compliance report monthly or non-compliance report when necessary (Ref. Paras. 8.11.4. and 8.11.8.). 10-22

8.8. TREATMENT SPECIFICATION NO. 8.7.3.4. Work with mandatorily referred employees, by maintaining contact at least once a month by telephone, to ensure the requirements of the referral are being met. 8.8.1. When necessary, refer mandatory referrals to treatment programs at facilities approved by HHSC, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or approved as a licensed site facility by the Texas Department of State Health Services (DSHS). All substance abuse facilities to which the vendor refers shall provide free aftercare for employees who have completed treatment there or at an affiliate facility of that treatment center located in the State of Texas, convenient to the employee. 8.8.2. When a mandatorily referred employee is referred to a treatment program, the SAP, EAP Counselor or WST shall monitor the employee s progress. Monthly the vendor shall report the employees progress, in writing to TxDOT. Monthly compliance reports shall not be based solely on employee information. Monitoring shall be by telephone or face-to-face contact between the employee and the SAP, EAP Counselor or WST monthly, at admission, midway through treatment and prior to discharge. 8.8.3. Refer employees to a medical doctor or other practitioner to receive a return-towork form when the counselor determined a referral was necessary. Referrals for a return-to-work form shall be provided once the employee has completed the treatment requirements, excluding aftercare, which may include return-to-duty testing. 8.8.4. Offer additional assistance to a mandatorily referred employee as requested by supervisors, SCOs, VPMs or the DER through telephone consultations with local counselors. Assistance shall be provided to employees within one working day from receipt of the request. 8.8.5. Have the WST continue to track and monitor the aftercare requirements of the SAP and EAP counselors. 8.8.6. Upon an employee s completion of aftercare, have the WST coordinate with the DER and Violence Staff of HRD prior to submitting written certification that the aftercare program has been completed. 8.9. INFORMATION AND EDUCATIONAL SERVICES: TxDOT will approve all information to be provided to employees, including but not limited to informational campaigns, promotional materials, educational material or all other information prior to distribution or presentation (Ref. Para. 18.9.). The use of materials that are not approved by TxDOT, prior to distribution or presentation, may be grounds for termination of the purchase order. The vendor shall: 8.9.1. Informational Campaign: Submit an informational campaign to the DER within 60 calendar days after award of a purchase order. The informational campaign shall acquaint all employees and immediate family members with the EAP services and shall include, but may not be limited to: 8.9.1.1. EAP brochures and wallet cards. 8.9.1.2. EAP publicity posters. 11-22

8.9.1.3. Envelopes stuffed with a wallet card, brochure and a TxDOT provided announcement letter for mailing to participants. Prepared envelopes shall be provided to TxDOT for addressing, postage and mailing. The envelope should identify TxDOT as the return address. 8.9.2. Orientation Sessions 8.9.2.1. Orientation Presentation: The vendor shall provide an orientation presentation in a digital electronic format for TxDOT to reproduce and present to all employees statewide. The presentation shall include but not be limited to information on EAP services (including self and mandatory referral procedures), benefits to participants and TxDOT, and the benefits of using the EAP. The presentation shall be a maximum of 20 minutes in length and provided within 60 days after award of a purchase order. 8.9.2.2. Optional Service: As required, the vendor shall conduct orientation sessions in all districts, divisions, offices, regions and administration when requested by the DER (Ref. Attachment A - List of Employees by District, Division, Office, Region and Administration). 8.9.2.3. Counselors shall be used as trainers. There will be approximately 30 employees per session. The orientation sessions shall be a maximum of 60 minutes in length, include information on EAP services (including self and mandatory referral procedures), benefits to participants and the types of problems that the EAP services handle. The vendor shall provide this service within 30 calendar days of a request. 8.9.3. Brown Bag Seminars: As requested by the DER, the vendor shall provide quarterly brown bag seminars to employees or supervisors on relevant issues. TxDOT reserves the right to request the vendor provide additional seminars on these issues or other issues, which will be presented at safety meetings, employee forums, supervisor meetings or other special meetings. A counselor shall provide the presentation and facilitate any subsequent discussions. TxDOT reserves the right to record and copy the presentations. 8.9.4. Critical Incident Stress Debriefing (CISD): As requested by the DER, provide group meetings for employees that have experienced a traumatic situation inside or outside the workplace. The trauma may be a result of a fatal accident on the job, a violent or sudden death of a co-worker away from work or a violent co-worker in the workplace. The purpose of these sessions is to help the employees begin the grieving process in a productive manner or learn coping skills, so that work performance impairment may be kept to a minimum. These meetings shall be scheduled within 48 hours of a request from the DER, as the need arises within TxDOT statewide. The meeting shall not exceed four hours. 8.9.5. Substance Abuse Training 8.9.5.1. SCO Training: As requested by the DER, the vendor shall assist TxDOT in training SCOs on identifying the signs and symptoms of alcohol and drug use and making determinations for reasonable cause testing pursuant to all applicable federal regulations. Training shall be a maximum of three hours. 12-22

8.9.5.2. Optional Service: As requested by the DER, provide training to all TxDOT supervisors and employees in all districts, divisions, offices, regions and administration. This training shall comply with the training requirements in 49 CFR Part 40, 49 CFR Part 382, 33 CFR Part 95, 46 CFR Parts 4, 5 and 16, and Public Law 100-690 Subtitle D. This training shall be provided, annually as scheduled by the DER, throughout the term of the purchase order. Training shall be a maximum of three hours. 8.9.6. Violence Awareness Training 8.9.6.1. VPM Training: As requested by the DER, the vendor shall assist TxDOT in providing violence awareness training to VPMs. The training shall consist of ways to recognize the signs and deal with potentially violent employees. Training shall be a maximum of two hours. 8.9.6.2. Optional Service: As requested by TxDOT, the vendor shall assist TxDOT in training supervisors and employees in each district, division, office region and administration on violence awareness. This training shall be provided upon request each year of the contract. Training shall be a maximum of two hours. NOTE: TxDOT reserves the right to conduct its own in-house training for Substance Abuse or Violence Awareness. 8.9.7. Provide an inventory of optional services which are not specified above but which may be a benefit to TxDOT including work life and wellness services. 8.10. GRIEVANCE PROCEDURE: Submit a written grievance procedure including appeals through the chain of command to handle a participant s grievance to TxDOT for approval. Any edits required by TxDOT shall be made and the revised grievance procedure returned to TxDOT for approval within 10 calendar days from receipt of the requested edits. 8.11. REPORTING REQUIREMENTS MANDATORY REFERALS: Provide a written report for mandatorily referred employees to the appropriate SCO, VPM, DER and Violence Program Staff of HRD for each of the following: 8.11.1. The determination of an employee s need for assistance in resolving problems associated with alcohol, inhalants or use of drugs or harassing, threatening or violent behavior within two weeks after the date of the mandatory referral (Ref. Para. 8.2.8.). 8.11.2. Whether or not the employee is able to work while in treatment, the time off work needed or specific duties involved in the employee s EAP appointments, evaluations and treatment. 8.11.3. Notification of specifics of non-compliance submitted to the DER the same working day after vendor is notified by the DER or SCO that an employee tested positive or refused to test for a TxDOT required test while in treatment. A timeline shall not be required. 8.11.4. A written report within two working days of an employee s non-compliance with the treatment (Ref. Para. 8.7.3.). 13-22

8.11.5. Employee has completed initial treatment, is ready for return-to-work requirements and includes the frequency schedule for follow-up testing, if any within two work days. 8.11.6. Completed return-to-work form completed after notification of completion of return-to-duty testing requirement, if any. 8.11.7. Employee has completed all treatment requirements including aftercare related to the mandatory referral, within two days (Ref. Para. 9.8.4.). 8.11.8. Monthly status report for each employee s compliance with the treatment plan by the fifth working day of the month. 8.12. CUSTOMER SERVICE REPORT REQUIREMENTS: Provide the DER with automated statistical and evaluative data on a quarterly and annual basis. These statistics shall consist of an unduplicated count. Quarterly reports shall be submitted reporting year to date statistical information with an annual report being submitted with the cumulative total of all quarterly reports at the end of each 12 month period. The data shall be broken down by referral type and further by district, division, office, region and administration and shall include, but not be limited to: 8.12.1. Age. 8.12.2. Sex. 8.12.3. Race of participant(s) (with an other category). 8.12.4. Job category. 8.12.5. District, division, office, region and administration. 8.12.6. participants, broken down as follows: 8.12.6.1. Employees. 8.12.6.2. Immediate family members. 8.12.6.3. Mandatory Referrals. 8.12.7. calls received. 8.12.8. sessions and referrals provided. 8.12.9. Kinds of problems presented. 8.12.10. sessions per problem, per participant. 8.12.11. participants receiving treatment from the EAP services not being referred. 8.12.12. participants assessed and referred. 8.12.13. mandatorily referred employees that refused to sign a release of confidential information. 8.12.14. Listing of referral sources and kinds of services used. 14-22

8.12.15. Whether or not the referral sources utilized were covered by participants health insurance and which insurance companies provided this coverage. 8.12.16. Referral sources, which are approved by HHSC, JCAHO or approved as a licensed site facility by DSHS. 8.12.17. Follow-up data to reflect participant satisfaction as well as service appropriateness and effectiveness. 8.12.18. Summary Reports: Summaries shall consist of an unduplicated count. 8.12.18.1. A summary of the number of participants referred to each referral source. 8.12.18.2. A summary of the number of self-referrals which accessed services without intervention by TxDOT. 9. LOCATION(S): Location(s) of facilities are specified on Attachment B Required EAP and Affiliated Provider Office Sites. TxDOT reserves the right to add or delete facilities serviced under the purchase order. TxDOT will provide ten working days written notice to the vendor of any additional facilities requiring service within the same area or region. 10. UNSATISFACTORY PERFORMANCE: Unsatisfactory performance will result in a negative vendor performance report, cancellation of the purchase order or both. TxDOT may consider the following performance by the vendor as unsatisfactory performance. An unsatisfactory performance determination includes, but is not limited to: 10.1. One instance of distribution or presentation of materials that have not been approved by TxDOT prior to distribution or presentation (Ref. Para. 8.9.). 10.2. Two instance within a one year period of vendor not meeting the scheduled time. 10.3. One instance of using a referral source that has received three validated complaints or that TxDOT has determined will not be used (Ref. Paras. 8.4.4. and 11.4.). 11. PERSONNEL CONTINUITY AND REPLACEMENT 11.1. TxDOT recognizes that events beyond the control of the vendor such as the death, physical or mental incapacity, long-term illness, or the voluntary termination of employment of the respondent personnel will require the vendor propose a replacement. In the event such a replacement is necessary, vendor agrees that personnel shall not begin work on the project without prior written approval from TxDOT. 11.2. The vendor agrees that a counselor providing EAP services to a participant shall remain available until EAP services have been completed, as long as the counselor is employed by the vendor. 11.3. If TxDOT determines any respondent personnel is unable to perform in accordance with the service requirements or to communicate effectively, the vendor shall immediately remove the respondent personnel. 11.4. If TxDOT determines that a referral source shall not be used after a validated complaint, the vendor shall not use the referral source again (Ref. Para. 8.4.4.). 15-22

11.5. Proposed replacement personnel shall meet minimum qualifications and have experience comparable to the person(s) being replaced. Replacement personnel shall be provided at no additional cost to TxDOT. Resume(s) and reference(s) will be requested for the proposed replacement(s). TxDOT may reject any replacement if references or past working performance is questionable or unfavorable. TxDOT will be the sole judge of the qualifications of the proposed replacement personnel. 12. QUALITY ASSURANCE PLAN: The vendor shall provide a comprehensive, continuous, and measurable quality assurance plan. The plan shall include: 12.1. An internal quality assurance policy. 12.2. An anonymous client satisfaction survey to be provided to each participant receiving EAP services or services from outside referral sources. The anonymous client satisfaction survey shall be returned by the participant directly to the vendor by mail. The vendor shall forward the surveys to the DER on a monthly basis throughout the contract period. 13. SUBCONTRACTING 13.1. Subcontractors providing service under the purchase order shall meet the same service requirements and provide the same quality of service required of the vendor. 13.2. No subcontract under the purchase order shall relieve the primary vendor of responsibility for the services. 13.3. The vendor shall be the primary contact for TxDOT and subcontractor(s). 13.4. The vendor shall manage all quality and performance, project management, and schedules for subcontractors. The vendor shall be held solely responsible and accountable for the completion of all work for which the vendor has subcontracted. 13.5. TxDOT retains the right to check subcontractor's background and make a determination to approve or reject the use of submitted subcontractor(s). Any negative responses may result in disqualification of the subcontractor. 13.6. TxDOT reserves the right to request the removal of vendor s subcontractor staff deemed unsatisfactory by TxDOT. 13.7. Subcontracting shall be at the vendor s expense. 13.8. During the term of the purchase order, if the vendor determines a need for a subcontractor change, TxDOT shall be notified in writing by the vendor within 30 calendar days of any proposed change. The vendor shall be required to provide references and work history for any proposed subcontractor to TxDOT. No change will be allowed without written authorization by TxDOT. 13.9. SOLICITATIONS OVER $100,000: TxDOT will make an initial determination of whether subcontracting is probable. It is the respondent s determination if they choose to subcontract any of the work under this purchase order with a Texas Certified Historically Underutilized Business (HUB) or other businesses. 13.9.1. If TxDOT has determined that subcontracting opportunities are probable, the class and items in which HUBs may be registered will be noted in the solicitation. 16-22

13.9.2. The respondent shall identify all proposed HUB and other subcontractors at the time of response submittal. The required forms with video instructions can be found at the following website: http://www.window.state.tx.us/procurement/prog/hub/hub-subcontracting-plan/ 13.10. HUB SUBCONTRACTING PLAN (HSP) PRIME CONTRACTOR PROGRESS ASSESSMENT REPORT: After award of the purchase order, the vendor shall report all HUB and non-hub subcontractor information using the HSP Prime Contractor Progress Assessment Report form. The report shall be submitted to the TxDOT contract manager monthly. The report shall be submitted monthly even during the months the vendor is not invoicing TxDOT. All payments made to subcontractors shall be reported. TxDOT may verify the amounts being reported as paid by requesting copies of cancelled checks paid to subcontractors. 14. BUSINESS CONTINUITY PROCEDURES AND DISASTER RECOVERY PLAN: The respondent shall submit business continuity procedures and a disaster recovery plan (limit one page) which shall include the following: 14.1. Business continuity procedures shall be implemented to fulfill all requirements of the purchase order including, but not limited to: Fire, theft, natural disaster, technical difficulty, workforce problems, equipment failure or other disruption of business. 14.2. A disaster recovery plan for this service shall be maintained. The vendor shall be responsible for all cost of disaster recovery. 15. TRAVEL: All travel and per diem shall be included in the unit price. 16. CONFLICT OF INTEREST: The vendor, vendor s personnel, and vendor s subcontractor(s) shall affirm not to have, nor acquire any interest during the term of the purchase order that would conflict in any manner with the performance of the vendor s obligations in regards to services authorized. 17. INVOICING INSTRUCTIONS: The vendor shall provide a comprehensive and detailed monthly invoice based on the cost per employee per month as stated on the Purchase Order. Invoicing for specified optional services shall be billed separately as these expenses are incurred. The original invoice shall be sent to the address shown on the purchase order or emailed to FIN_Invoices@txdot.gov with a copy to the Contract Manager to ensure timely payment. An invoice requiring correction shall be resubmitted with anew invoice date. NOTE: Even though the number of employees will fluctuate throughout the year, the monthly price shall be based on the number of employees stated in Para. 1. The number of employees will be updated when an option to renew the purchase order is exercised, to reflect the current number of employees for the purchase order renewal term of service. 18. TxDOT RESPONSIBILITIES: TxDOT will: 18.1. Provide a contract manager. 18.2. Provide TxDOT s various health insurance plans information (Ref. Para 6.9.2. and 8.4.1.). 18.3. Provide TxDOT s Violence Prevention Program policies and procedures (Ref. Para. 6.9.3.). 18.4. Provide TxDOT s Substance Abuse Program rules, policies and procedures (Ref. Para. 6.9.4.). 18.5. Provide sample forms (Ref. Para. 6.14.). 17-22

18.6. Provide TxDOT s EAP policy and procedures (Ref. Paras. 6.9.5. and 8.1.3.). 18.7. Approve or disapprove referral sources as necessary within two working days from receipt of information (Ref. Para 8.4.1.). 18.8. Inform the helpline counselor that the request is for a mandatory referral and provide necessary information (Ref. Para. 8.6.3.). 18.9. Approve all material and information for employees and participants such as informational campaigns, promotional materials, educational material or other information, within five working days from receipt of the material (Ref. Para. 8.9.). 18.10. Distribute informational and campaign materials to employees in the districts, divisions, offices, offices, regions and administration other than the initial announcement. (Ref. 8.9.1.3.). 18.11. Approve grievance procedures within ten working days from receipt (Ref. Para. 8.10.). 19. RESPONSE SUBMISSION: Failure by the respondent to submit the documentation listed below will disqualify the respondent from further consideration. TxDOT may reject any or all proposals and may waive informalities and minor irregularities in the proposals it receives. The response submission shall be submitted in the following format: 19.1. GENERAL FORMAT: The respondent shall submit one signed and dated original (marked Original) and five copies (marked Copy). The submission shall be in separate loose leaf binders on one sided 8-1/2 x 11 inch paper and shall be tab-indexed corresponding to the sections listed below. Plastic spine-bound or wire bound submittals are highly discouraged. Include only the information specified for each section. 19.2. ORIGINAL RESPONSE: The original response shall include the following: 19.2.1. Section 1 Schedule 1 - Pricing NOTE TO RESPONDENT: Include five copies of the Schedule 1 Pricing in a sealed, separate envelope with the original submittal. NOTE TO RESPONDENT: If addendums are generated as part of this solicitation, include the original signed and dated addendum(s) in Section 1. 19.2.2. Section 2 Schedule 2 Original, signed and dated Execution of Proposal (RFP): Submit the original, signed and dated Execution of Proposal (RFP). 19.2.3. Section 3 Schedule 3 Respondent Qualifications and Experience: The respondent shall demonstrate successful past performance through submission of documentation of relevant qualifications and experience. 19.2.4. Section 4 Schedule 4 State Agency Contract or Purchase Order Information: The vendor shall list all contracts or purchase orders with state agencies that expired or were canceled during the last five years and the reason the contract or purchase order was not renewed or the reason for cancellation. 19.2.5. Section 5 Schedule 5 Respondent Information Worksheet. 19.2.6. Section 6 Schedule 6 Respondent Personnel Qualifications and References: Complete Schedule 6 documenting the following: 18-22

19.2.6.1. Counselor s name and title. 19.2.6.2. Education (Ref. Para. 7.1.1.). 19.2.6.3. Licenses or certifications held by counselors (Ref. Para. 7.1.2.). 19.2.6.4. Documentation of qualifications for a minimum of three years clinical experience within the last five years for counselors (Ref. Para. 7.1.3.). 19.2.6.5. Description of qualifications for SAPs (Ref. Para. 7.2.). 19.2.7. Section 7 Respondent References: Respondent shall submit a minimum of three references to substantiate the qualifications and experience requirements for services completed for ten years within the last 12 years. References shall illustrate respondent s ability to provide the services outlined in the specification. References shall include name, point of contact, telephone number, and dates services were performed. The response may be disqualified if TxDOT is unable to verify qualification and experience requirements from the respondent s references. The response may be disqualified if TxDOT receives negative responses. TxDOT will be the sole judge of references (Ref. Schedule 7 Respondent References). 19.2.8. Section 8 Performance Requirements: Respondent shall provide the following: 19.2.8.1 A detailed response specifying exactly how the requirements outlined in Para. 8. of the specification shall be fulfilled. 19.2.8.2 A proposed staffing plan for the WST, Helpline and SAPs to demonstrate staff qualification and experience, including affiliates and subcontractors. This plan should describe the number of staff proposed for this project, the functions they shall perform, and the percentage of time to be assigned to this project during the contract term. 19.2.9. Section 9 Business Continuity and Disaster Recovery Plan: Respondent shall submit a contingency and recovery plan detailing how they propose to meet the specifications in the event vendor service is interrupted. The plan shall detail the vendor s backup and recovery process (Ref. Para. 14.). 19.2.10. Section 10 Additional Information: Respondent shall provide: 19.2.10.1. A sample of respondent s current reporting format and options for reporting currently provided to clients (See Paras. 8.11. and 8.12.). 19.2.10.2. A proposed internal quality assurance policy (Ref. Para. 12.1.). 19.2.10.3. A sample of an anonymous participant satisfaction survey. (Ref. Para. 12.2.). 19.2.10.4. A sample of one current presentation provided to a company covering one of the topics listed in Para. 9.8. or a relevant subject. The presentation will be provided in DVD format. 19.2.10.5. A sample training outline with samples of training materials on one of the topics listed in Para. 9.8. or a relevant subject. 19.2.10.6. An inventory of value added services provided at no charge to TxDOT. 19-22

19.2.11. Section 11 HUB Subcontracting Plan (if applicable). SPECIFICATION NO. 19.2.12. Section 12 Financial Standing: The following should be submitted with the response or within two working days of a request from TxDOT. Failure by the respondent to submit the documentation listed below may disqualify the respondent from further consideration. 19.2.12.1. The most recent three years audited financial statements, or if audited financial statements are unavailable, un-audited financial statements shall be submitted and certified as true, correct and accurate by the chief financial officer or treasurer of the respondent s company (Ref. Para. 5.3.). 19.2.12.2. Additional information demonstrating financial stability and ability to meet the financial responsibilities for the requirement to perform this service. 19.3. COPIES: The five reproduced copies (marked Copy) shall include only the following tab-indexed sections: 19.3.1. Section 3 Schedule 3 Respondent Qualifications and Experience (Ref. Para. 19.2.4.). 19.3.2. Section 4 Schedule 4 State Agency Contract or Purchase Order Information (Ref. Para. 19.2.5.). 19.3.3. Section 5 Schedule 5 Respondent Information Worksheet (Ref. Para. 19.2.6.). 19.3.4. Section 6 Schedule 6 Respondent Personnel Qualifications and References (Ref. Para. 19.2.7.). 19.3.5. Section 7 Schedule 7 Respondent References (Ref. Para. 19.2.8.). 19.3.6. Section 8 Performance Requirements (Ref. Para. 19.2.9.). 19.3.7. Section 9 Business Continuity and Disaster Recovery Plan (Ref. Para. 19.2.10.). 19.3.8. Section 10 Additional Information (Ref. Para. 19.2.11.). 19.4. OPTIONAL SERVICES: TxDOT reserves the right to request optional or additional services agreed to between TxDOT and the vendor. 20. RESPONSE EVALUATION: Only a complete response with the listed required submittal documents (Ref. Para. 19.) and meeting minimum qualifications will be considered. Failure to meet the minimum qualifications and submit the required documents will result in a response being declared non-responsive. 20.1. STEP 1 INITIAL EVALUATION: A TxDOT evaluation committee will evaluate and score each response based on established criteria. Respondents shall not contact members of the evaluation team. Responses will be evaluated according to the respondent s ability to best satisfy TxDOT requirements. 20-22

20.1.1. Respondent qualifications are based on a best value determination and the information submitted with a response and will compromise 60 percent of the evaluation total. Best value criteria are stated in the TxDOT Terms and Conditions, Para. 2.07a. 20.1.2. Pricing submitted for the solicitation requirements will be 40 percent of the evaluation total. 20.2. STEP 2 DISCUSSION MEETING: TxDOT may request that selected respondents, including personnel, participate in a discussion meeting. The respondent and TxDOT may discuss and clarify various requirements of the solicitation, vendor response, discuss any negotiable points, further confirm proposed personnel qualifications and determine the respondent s capability to perform the service. A TxDOT evaluation committee may evaluate and score each discussion. 20.2.1. TxDOT will advise each respondent in writing of the location, date and time of the scheduled discussion meeting. A minimum of two weeks notice will be given to the respondent(s) selected for the discussion meeting phase. 20.2.2. TxDOT may provide the respondent with a list of proposed respondent personnel required to attend and participate in the meeting. 20.2.3. Respondent and proposed respondent personnel should be prepared to address any questions that may be asked by TxDOT evaluators. 20.3. NEGOTIATIONS: Upon completion of discussion meeting evaluation scoring, TxDOT reserves the right to enter into negotiations with one or more selected respondents. 20.4. STEP 3 BEST AND FINAL OFFER (BAFO): TxDOT reserves the right to request a BAFO from selected respondent(s). 20.4.1. The respondent(s) shall submit a final price and any added value. If more than one respondent reaches this level, the negotiated terms, references, BAFO and added values will be considered in the award. TxDOT will make the final determination on the best value. 20.4.2. TxDOT may award the purchase order for the service without requesting a BAFO. 21. AWARD: TxDOT reserves the right to award a purchase order to the company that provides the best value to TxDOT in performance of this service. 22. POST AWARD MEETING: Vendor may be required to attend a post award meeting in Austin, Texas with TxDOT within 10 working days after the award of the purchase order (Ref. Paras. 8.1.1. and 8.1.3.). The purpose of the meeting is to discuss the terms and conditions of the purchase order and to provide additional information regarding the purchase order. 23. TRANSITION PERIOD: At the termination date of this purchase order, the vendor shall cooperate fully, with a subsequent vendor, to transfer all publications, documents, and/or other material in which TxDOT retains ownership right, and any other material related to work under this current purchase order. During this transition period, this contract may be extended for an additional 60 days for time only. This will allow for the transition of all TxDOT data/material and education of contract change to the new vendor. TxDOT will provide assistance as needed for the efficient and smooth transfer of all material to the new vendor. 21-22

24. CONTRACT ADMINISTRATION: Administration of the purchase order is a joint responsibility of the TxDOT Contract Administrator and TxDOT Purchasing. TxDOT Purchasing staff will be responsible for administering the contractual business relationship with the vendor. 24.1. Any proposed changes to work to be performed, whether initiated by TxDOT or the vendor, must receive final written approval in the form of a Purchase Order Change Notice signed by the authorized TxDOT purchasing agent. 24.2. Upon issuance of purchase order, TxDOT will designate an individual who will serve as the Contract Manager and point of contact between the agency and the vendor. The Contract Manager does not have any express or implied authority to vary the terms of the purchase order, amend the purchase order in any way or waive strict performance of the terms or conditions of the purchase order. This individual s contract management and contract administration responsibilities include, but are not limited to: 24.2.1. Monitoring the vendor s progress and performance and ensuring services conform to established specification requirements. 24.2.2. Managing the financial aspects of the contract including approval of payments. 24.2.3. Meeting with the vendor as needed to review progress, discuss problems, and consider necessary action. 24.2.4. Identifying a breach of contract by assessing the difference between contract performance and non-performance. 24.2.5. Other areas as identified by the Comptroller of Public Accounts Contract Management Guide, latest edition. 22-22

ATTACHMENT A LIST OF EMPLOYEES BY DISTRICT, DIVISION, OFFICE, REGION AND ADMINISTRATION (PROVIDED FOR INFORMATIONAL PURPOSES ONLY) DISTRICT, DIVISION OFFICE, REGION AND ADMINISTRATION NUMBER OF EMPLOYEES ESTIMATED NO. OF SUPERVISORS ABILENE 270 25 AMARILLO 322 28 ATLANTA 273 24 AUSTIN 523 46 BEAUMONT 285 22 BROWNWOOD 173 14 BRYAN 291 23 CHILDRESS 183 20 CORPUS CHRISTI 364 28 DALLAS 838 62 EL PASO 281 22 FORT WORTH 562 46 HOUSTON 1,134 83 LAREDO 217 17 LUBBOCK 331 27 LUFKIN 252 23 ODESSA 261 23 PARIS 284 23 PHARR 323 23 SAN ANGELO 210 19 SAN ANTONIO 568 37 TYLER 284 22 WACO 301 25 WICHITA FALLS 241 20 YOAKUM 279 24 NORTH REGIONAL SUPPORT CENTER 245 16 SOUTH REGIONAL SUPPORT CENTER 169 12 EAST REGIONAL SUPPORT CENTER 174 14 WEST REGIONAL SUPPORT CENTER 180 13 1-3

ATTACHMENT A LIST of EMPLOYEES BY DISTRICT, DIVISION, OFFICE, REGION AND ADMINISTRATION (PROVIDED FOR INFORMATIONAL PURPOSES ONLY) DISTRICT, DIVISION OFFICE, REGION AND ADMINISTRATION NUMBER OF EMPLOYEES ESTIMATED NO. OF SUPERVISORS AVIATION 58 5 BRIDGE 91 6 CONSTRUCTION 224 20 DESIGN 63 6 ENVIRONMENTAL 64 9 FINANCE 129 12 GENERAL SERVICES 242 19 HUMAN RESOURCES 86 10 OFFICE OF CIVIL RIGHTS 31 3 TECHNOLOGY SERVICES 267 22 ADMINISTRATION 22 5 AUDIT 23 2 GOVERNMENT & PUBLIC AFFAIRS 51 7 INTERNAL COMPLIANCE PROGRAM 1 0 MAINTENANCE 93 12 MOTOR CARRIER 105 11 OCCUPATIONAL SAFETY 29 4 OFFICE OF GENERAL COUNSEL 24 3 PUBLIC TRANSPORTATION 42 4 RAIL DIVISION 32 4 RESEARCH & TECHNOLOGY IMPLEMENTATION 12 2 RIGHT OF WAY 55 5 STRATEGIC POLICY & PERFORMANCE MANAGEMENT 8 1 TEXAS TURNPIKE AUTHORITY 36 9 TRAFFIC OPERATIONS 129 14 TRANSP PLAN & PROGRAM 110 11 TRAVEL 106 16 TOTAL 11,951 1,003 (included in Total Employees) 2-3

ATTACHMENT A LIST OF EMPLOYEES BY DISTRICT, DIVISION, OFFICE, REGION AND ADMINISTRATION (PROVIDED FOR INFORMATIONAL PURPOSES ONLY) Employees that have transferred to Texas Department of Motor Vehicles will continue to be covered by the TxDOT EAP. Vendor will be notified in writing by TxDOT of any change for TxDMV. TXDMV BUS UNIT DMV DIVISIONS NUMBER OF EMPLOYEES ESTIMATED NO. OF SUPERVISORS 41DMV Administration - DMV 18 8 42ADM Administration 91 4 43FNS Finance Section 11 1 44GCO General Counsel Office 2 0 52VTR Vehicle Titles & Reg Division 237 26 61MVD Motor Vehicle Division 34 2 65ENF Enforcement 49 4 68CRL Consumer Relations 38 5 73MCO Motor Carrier Operations 28 2 82ATP Auto Burg Theft Prev Authy 5 1 TOTAL 513 53 (included in Total Employees) 3-3

ATTACHMENT B REQUIRED EAP AND AFFILIATED PROVIDER OFFICE SITES (PROVIDED FOR INFORMATIONAL PURPOSES ONLY) Various Divisions within TxDOT have headquarters in Austin and satellite offices throughout the state. Please keep in mind that the cities listed here do not encompass all the necessary site locations required for EAP services. This list simply specifies the largest cities in each area that the vendor is required to have offices. DISTRICT ABILENE AMARILLO ATLANTA AUSTIN BEAUMONT BROWNWOOD BRYAN CHILDRESS CORPUS CHRISTI DALLAS EL PASO FORT WORTH HOUSTON LAREDO LUBBOCK LUFKIN ODESSA PARIS PHARR SAN ANGELO SAN ANTONIO TYLER WACO WICHITA FALLS YOAKUM EAP OR AFFILIATED OFFICE SITES ABILENE AMARILLO ATLANTA, MARSHALL AUSTIN BEAUMONT BROWNWOOD BRYAN CHILDRESS CORPUS CHRISTI, KINGSVILLE DALLAS, DENTON EL PASO FORT WORTH HOUSTON, GALVESTON LAREDO, DEL RIO LUBBOCK LUFKIN ODESSA PARIS, DENISON PHARR SAN ANGELO SAN ANTONIO TYLER, LONGVIEW WACO, TEMPLE WICHITA FALLS YOAKUM, VICTORIA 1-1

SCHEDULE 1 PRICING SPECIFICATION NO. RESPONDENT NAME DESCRIPTION QUANTITY UNIT UNIT COST EXTENDED COST 1. EAP services. Cost per employee, per month based on 11,981 TxDOT employees. 24 Months $0.00 * ($ per employee per month = bid price). DESCRIPTION QUANTITY UNIT UNIT COST EXTENDED COST 1. EAP services. Cost per employee, per month based on 513 TxDMV employees. 24 Months $0.00 * ($ per employee per month = bid price). INFORMATION AND EDUCATIONAL SERVICES The items below will not be considered in the pricing evaluation. Costs are for informational purposes only. QUANTITY (ESTIMATED QUANTITES SHOWN FOR A PERIOF OF DESCRIPTION 1 YEAR) UNIT UNIT COST EXTENDED COST 2. Orientation Presentation in a difital electronic format (Ref. Para. 8.9.2.1.). 1 EA $0.00 3. Orientation Sessions - Optional Services (Ref. Para. 8.9.2.2.) 2 EA $0.00 4. Brown Bag Seminars (Ref. Para. 8.9.3.). 2 EA $0.00 5. Critical Incident Stress Debriefing (Ref. Para. 8.9.4.). 6 EA $0.00 6. Substance Abuse Training (Ref. Para. 8.9.5.1.). 6 EA $0.00 7. Substance Abuse Training - Optional Services (Ref. Para. 8.9.5.2.) 2 EA $0.00 8. Violence Awareness Training (Ref. Para. 8.9.6.1.). 6 EA $0.00 9. Violence Awareness Training - Optional Services (Ref. Para. 8.9.6.2.). 2 EA $0.00 Respondent Signature Date Printed Name THE COMPLETED SCHEDULE 1 - PRICING OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS COMPLETED SCHEDULE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 1-1

SCHEDULE 2 EXECUTION OF PROPOSAL (RFP) RFP NO. QXXXXXXXXXXXXXXX SPECIFICATION NO. By signature hereon, Respondent certifies that: All statements and information prepared and submitted in the response to this RFP are current, complete, and accurate. Respondent has not given, offered to give, nor intends to give at anytime hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted response. Neither Respondent nor the firm, corporation, partnership, or institution represented by Respondent or anyone acting for such firm, corporation, or institution has (1) violated the antitrust laws of the state of Texas under Texas Business and Commerce Code, Chapter 15, or the federal anti-trust laws; or (2) communicated the contents of this Proposal either directly or indirectly to any competitor or any other person engaged in the same line of business during the procurement process for this RFP. When a Texas business address shown hereon that address is, in fact, the legal business address of Respondent and Respondent qualifies as a Texas Resident Bidder under 1 TAC 111.2. Under Government Code 2155.004, no person who prepared the specifications or this RFP has any financial interest in Respondent s Proposal. If Respondent is not eligible, then any contract resulting from this RFP shall be immediately terminated. Furthermore, under Section 2155.004, Government Code, the vendor (Respondent) certifies that the individual or business entity named in this bid or contract is not ineligible to receive the specified contract and acknowledges that this contract may be terminated and payment withheld if this certification is inaccurate. Under Family Code 231.006, relating to child support obligations, Respondent and any other individual or business entity named in this solicitation are eligible to receive the specified payment and acknowledge that this contract may be terminated and payment withheld if this certification is inaccurate. Any Proposal submitted under this RFP shall contain the names and social security numbers of person or entity holding at least a twenty-five percent ownership interest in the business entity submitting the Proposal. Under Government Code 669.003, relating to contracting with an executive of a state agency, Respondent represents that no person who, in the past four years, served as an executive of the Texas Department of Transportation (TxDOT) or any other state agency, was involved with or has any interest in this Proposal or any contract resulting from this RFP. If Respondent employs or has used the services of a former executive head of TxDOT or other state agency, then Respondent shall provide the following information: Name of former executive, name of state agency, date of separation from state agency, position with Respondent, and date of employment with Respondent. Respondent agrees that any payments due under this contract will be applied towards any debt, including but not limited to delinquent taxes and child support that is owed to the state of Texas. 1-3

SCHEDULE 2 (cont.) EXECUTION OF PROPOSAL (RFP) RFP NO. QXXXXXXXXXXXXXXX Respondent represents and warrants that the individual signing this Execution of Proposal is authorized to sign this document on behalf of Respondent and to bind Respondent under any contract resulting from this offer. RESPONDENT (COMPANY): SIGNATURE (INK): NAME (TYPED/PRINTED): TITLE: DATE: STREET: CITY/STATE/ZIP: TELEPHONE: FACSIMILE NUMBERS: EMPLOYER S IDENTIFICATION NUMBER (EIN): >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> PREFERENCES: Reference Part I, Para. 3. and Para. 4. of the TxDOT Terms and Conditions, Revised September 2009. In the case of a tie between two or more respondents, the award will be made in accordance with preferences as outlined in Rule 34 TAC 20.38. If a tie still exists after review of preferences claimed by respondents, TxDOT will draw lots to break the tie. Check below if preference claimed under Rule 34 TAC 20.38. 2-3

SCHEDULE 2 (cont.) EXECUTION OF PROPOSAL (RFP) RFP NO. QXXXXXXXXXXXXXXX Tie Bid Preferences 1. Supplies, materials, equipment, or services produced in Texas or offered by Texas bidders. 2. Agricultural products produced or grown in Texas. 3. Agricultural products and services offered by Texas bidder. 4. USA produced supplies, materials or equipment. 5. Products produced at facilities located on formerly contaminated property. 6. Products and services from economically depressed or blighted areas. 7. Goods produced or offered by a Texas bidder that is owned by a service-disabled veteran who is a Texas resident. Source Preferences 1. Products of persons with mental or physical disabilities. 2. Vendors that meet or exceed air quality standards. For contracts to be performed in whole or in part, in a designated non-attainment area or an affected county, as those terms are defined by Health and Safety Code 386.001, Texas Emissions Reduction Plan. 3. Manufacturer that has a recycle program for computer equipment. 4. Contractor providing foods of higher nutritional value. Specification Preferences 1. Products made of recycled materials, remanufactured, or environmentally sensitive materials including recycled steel. 2. Energy efficient products. 3. Rubberized asphalt paving material. 4. Recycled motor oil and lubricants. THE EXECUTION OF PROPOSAL SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THE EXECUTION OF PROPOSAL WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 3-3

SCHEDULE 3 RESPONDENT QUALIFICATIONS AND EXPERIENCE SOLICITATION NO. QXXXXXXXXXXXXXXXX SPECIFICATION NO. Respondent shall use this schedule to clearly show how they meet the requirements set forth in the specification (Ref. Para. 5.). Respondent Name: Addresses: Physical: Mailing: Phone Number: Fax Number: Name: Phone Number: Email address: of person to contact with questions regarding the solicitation. years in business Name and title of person signing the response: DOCUMENTATION OF COMPANY QUALIFICATIONS AND EXPERIENCE: Qualifications and experience in the areas of services to be provided. Respondent should address the following: 1. Provide documentation showing a minimum of ten years experience within the last 12 years providing EAP provider services (Ref. Para. 5.1.). 2. Provide documentation showing a minimum of five years experience within the ten years experience required in Para. 5.1. providing EAP provider services to a minimum of 15 companies with national decentralized locations within the network (Ref. Paras. 5.2.). Attach additional pages if additional space is needed to document the qualifications and experience. THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 1-1

SCHEDULE 4 STATE AGENCY CONTRACT OR PURCHASE ORDER INFORMATION RESPONDENT NAME: Complete the information for all State of Texas contracts or purchase orders that expired or were canceled within the last five years (Ref. Para. 19.2.5.). 1. Name of State Agency: City, State and Zip Code: Name and Title of Person to Contact: Telephone Number: Service Provided Contract or PO number Did the contract or PO expire or was it canceled? State the reason PO was not renewed or was canceled. 2. Name of State Agency: City, State and Zip Code: Name and Title of Person to Contact: Telephone Number: Service Provided Contract or PO number Did the contract or PO expire or was it canceled? State the reason PO was not renewed or was canceled. 3. Name of State Agency: City, State and Zip Code: Name and Title of Person to Contact: Telephone Number: Service Provided Contract or PO number Did the contract or PO expire or was it canceled? State the reason PO was not renewed or was canceled. 4. Name of State Agency: City, State and Zip Code: Name and Title of Person to Contact: Telephone Number: Service Provided Contract or PO number Did the contract or PO expire or was it canceled? State the reason PO was not renewed or was canceled. This page may be reproduced as needed to document all State of Texas contracts or purchase orders that expired or were canceled within the last five years. THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 1-1

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes ABILENE DISTRICT Abilene 102 79601 Albany 10 76430 Anson 17 79501 Aspermont 9 79502 Baird 17 79504 Big Spring 19 79720 Colorado City 14 79512 Gail 8 79738 Hamlin 9 79520 Haskell 11 79521 Jayton 9 79528 Roby 11 79543 Snyder 21 79549 Stamford 3 79553 Sweetwater 17 79556 ABILENE TOTALS 277 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 1-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes AMARILLO DISTRICT Amarillo 11 79101 Amarillo 117 79102 Borger 9 79007 Canadian 14 79014 Canyon 15 79015 Channing 11 79018 Claude 10 79019 Dalhart 14 79022 Darrouzett 6 79024 Dumas 21 79029 Groom 11 79039 Gruver 13 79040 Hereford 13 79045 Pampa 22 79065 Panhandle 10 79068 Perryton 6 79070 Stratford 10 79084 Vega 13 79092 AMARILLO TOTALS 326 ATLANTA DISTRICT Atlanta 93 75551 Carthage 11 75633 Daingerfield 11 75638 Gilmer 13 75644 Jefferson 13 75657 Linden 20 75563 Marshall 39 75670 Mt. Pleasant 35 75455 New Boston 14 75570 Texarkana 36 75501 ATLANTA TOTALS 285 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 2-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes AUSTIN DISTRICT Austin 338 78701 Bastrop 28 78602 Burnet 26 78611 Cedar Park 14 78613 Fredericksburg 16 78624 Georgetown 26 78626 Giddings 11 78942 Johnson City 11 78636 Llano 12 78643 Lockhart 12 78644 Mason 12 76856 Oak Hill 5 78735 San Marcos 16 78666 Taylor 12 76574 AUSTIN TOTALS 539 BEAUMONT DISTRICT Anahauc 13 77514 Beaumont 119 77701 Cleveland 6 77327 Jasper 27 75951 Kountze 15 77625 Liberty 25 77575 Magnolia Springs 1 75957 Nederland 1 77627 Newton 12 75966 Orange 33 77630 Pt Arthur 27 77640 Woodville 13 75979 BEAUMONT TOTALS 292 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 3-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes BROWNWOOD DISTRICT Brady 13 76825 Breckenridge 10 76424 Brownwood 72 76801 Coleman 14 76834 Comanche 12 76442 Eastland 32 76448 Goldthwaite 9 76844 Irene 1 76650 Lampasas 15 76550 San Saba 9 76877 BROWNWOOD TOTALS 187 BRYAN DISTRICT Brenham 26 77833 Bryan 125 77801 Buffalo 16 75831 Caldwell 11 77836 Cameron 14 76520 Fairfield 12 75840 Hearne 25 77859 Huntsville 32 77320 Madisonville 14 77864 Navasota 15 77868 BRYAN TOTALS 290 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 4-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes CHILDRESS DISTRICT Childress 67 79201 Clarendon 12 79226 Crowell 10 79227 Dickens 10 79227 Guthrie 3 79238 Matador 13 79244 Memphis 10 79245 Munday 14 76371 Paducah 8 79248 Quanah 11 79252 Shamrock 8 79079 Silverton 7 79257 Wellington 9 79095 CHILDRESS TOTALS 182 CORPUS CHRISTI DISTRICT Alice 25 78332 Beeville 12 78102 Corpus Christi 146 78401 Driscoll 1 78351 George West 15 78022 Goliad 15 77963 Karnes City 19 78118 Kingsville 13 78363 Port Aransas 54 78373 Refugio 11 78377 Robstown 8 78380 Rockport 11 78382 Sinton 32 78387 CORPUS CHRISTI TOTALS 362 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 5-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes DALLAS DISTRICT Corsicana 59 75110 Dallas 499 75201 Denton 73 76201 Grand Prairie 23 75050 Hutchins 16 75141 Kaufman 36 75142 McKinney 82 75069 Rockwall 1 75087 Waxahachie 67 75165 DALLAS TOTALS 856 EL PASO DISTRICT Alpine 20 79830 Dell City 8 79837 El Paso 198 79901 Ft. Davis 9 79734 Ft. Hancock 4 79839 Marathon 4 79842 Marfa 9 79843 Presidio 10 79845 Salt Flat 5 79847 Sierra Blanca 4 79851 Terlingua 4 79852 Van Horn 13 79855 EL PASO TOTALS 288 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 6-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes FORT WORTH DISTRICT Arlington 3 76010 Cleburne 41 76031 Decatur 33 76234 Euless 40 76039 Fort Worth 310 76101 Glen Rose 16 76043 Gordon 2 76453 Granbury 2 76048 Jacksboro 13 76458 Mineral Wells 14 76067 Saginaw 24 76179 Stephenville 22 76401 Weatherford 41 76086 FORT WORTH TOTALS 561 HOUSTON DISTRICT Angleton 66 77515 Beasley 1 77417 Brazoria 2 77422 Conroe 53 77301 Galveston 111 77550 Genoa 3 77034 Hempstead 21 77445 Houston 749 77001 Humble 44 77338 La Marque 58 77568 Montgomery 11 77356 Rosenberg 78 77471 Sugar Land 10 77478 HOUSTON TOTALS 1,207 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 7-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes LAREDO DISTRICT Big Wells 1 78830 Brackettville 11 78832 Carrizo Springs 21 78834 Comstock 1 78837 Cotulla 14 78014 Del Rio 24 78840 Eagle Pass 15 78852 Freer 9 78357 La Pryor 12 78872 Laredo 115 78040 LAREDO TOTALS 223 LUBBOCK DISTRICT Bovina 14 79009 Brownfield 17 79316 Dimmitt 9 79027 Floydada 13 79235 Hart 1 79043 Lamesa 11 79331 Levelland 10 79336 Littlefield 19 79339 Lubbock 137 79401 Morton 10 79346 Muleshoe 7 79347 Plains 8 79355 Plainview 24 79072 Post 10 79356 Ralls 13 79357 Seminole 9 79360 Shallowater 1 79363 Tahoka 12 79373 Tulia 15 79088 LUBBOCK TOTALS 340 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 8-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes LUFKIN DISTRICT Bronson 10 75930 Center 14 75935 Crockett 16 75835 Groveton 14 75845 Hemphill 6 75948 Livingston 26 77351 Lufkin 98 75901 Nacogdoches 29 75961 San Augustine 19 75972 Shepherd 15 77371 LUFKIN TOTALS 247 ODESSA DISTRICT Andrews 9 79714 Balmorhea 9 79718 Crane 10 79731 Ft. Stockton 23 79735 Iraan 9 79744 Kermit 10 79745 McCamey 10 79752 Midland 35 79701 Monahans 12 79756 Odessa 97 79760 Pecos 20 79772 Sanderson 8 79848 Stanton 11 79782 ODESSSA TOTALS 263 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 9-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes PARIS DISTRICT Bonham 22 75418 Clarksville 15 75426 Cooper 13 75432 Emory 16 75440 Greenville 41 75401 Mt. Vernon 13 75457 Paris 96 75460 Sherman 52 75090 Sulphur Springs 29 75482 PARIS TOTALS 297 PHARR DISTRICT Boca Chica 3 78520 Brownsville 16 78521 Edcouch 17 78538 Falfurrias 4 78355 Hebbronville 21 78361 Mission 19 78572 Pharr 166 78577 Raymondville 15 78580 Rio Grande City 15 78582 San Benito 43 78586 San Isidro 2 78588 Zapata 2 78076 PHARR TOTALS 323 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 10-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes SAN ANGELO DISTRICT Ballinger 13 76821 Big Lake 9 76932 Eden 7 76837 Eldorado 1 76936 Garden City 2 79739 Junction 29 76849 Leakey 10 78873 Menard 2 76859 Ozona 9 76943 Robert Lee 10 76945 Rocksprings 10 78880 San Angelo 93 76901 Sonora 19 76950 Sterling City 7 76951 SAN ANGELO TOTALS 221 SAN ANTONIO DISTRICT Bandera 12 78003 Boerne 17 78006 Devine 9 78016 Floresville 17 78114 Hondo 21 78861 Kerrville 29 78029 Medina 1 78055 New Braunfels 34 78130 Pearsall 14 78061 Pleasanton 23 78064 San Antonio 347 78201 Seguin 31 78155 Tilden 9 78072 Uvalde 19 78801 SAN ANTONIO TOTALS 583 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 11-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes TYLER DISTRICT Athens 29 75751 Canton 19 75103 Henderson 9 75652 Jacksonville 12 75766 Longview 31 75601 Mineola 33 75773 Palestine 17 75801 Rusk 8 75785 Tyler 138 75701 TYLER TOTALS 296 WACO DISTRICT Belton 49 76513 Gatesville 25 76528 Hamilton 12 76531 Hillsboro 33 76645 Jonesboro 1 76538 Killeen 13 76541 Marlin 21 76661 Meridian 10 76665 Mexia 8 76667 Temple 1 76501 Waco 141 76701 WACO TOTALS 314 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 12-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes WICHITA FALLS DISTRICT Archer City 12 76351 Bowie 13 76230 Electra 10 76360 Gainesville 31 76240 Graham 14 76450 Henrietta 13 76365 Loving 1 76460 Montague 1 76251 Nocona 11 76255 Olney 9 76374 Seymour 11 76380 Throckmorton 9 76483 Vernon 18 76384 Wichita Falls 101 76301 WICHITA FALLS TOTALS 254 YOAKUM DISTRICT Bay City 18 77414 Bellville 13 77418 Columbus 16 78934 Cuero 16 77954 Edna 14 77957 Gonzales 17 78629 Hallettsville 15 77964 La Grange 28 78945 Matagorda 3 77457 Port Lavaca 15 77979 Victoria 31 77901 Wharton 26 77488 Yoakum 73 77995 YOAKUM TOTALS 285 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 13-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes North Regional Support Center Atlanta 26 75551 Brownwood 17 76802 Dallas 59 75150 Fort Worth 67 76133 Paris 13 75460 Tyler 23 75702 Waco 24 76704 Wichita Falls 24 76302 North Regional Support Center Total 253 South Regional Support Center San Antonio 52 78229 Austin 30 78753 Corpus Christi 26 78416 Laredo 17 78043 Pharr 21 78577 Yoakum 28 77995 South Regional Support Center Total 174 East Regional Support Center Beaumont 25 77708 Bryan 20 77803 Houston 108 77007 Lufkin 20 75901 East Regional Support Center Total 173 THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 14-15

SCHEDULE 5 RESPONDENT INFORMATION WORKSHEET SPECIFICATION NO. RESPONDENT NAME District Work Site Locations and Employees In Each Zip Codes Affiliated Offices Office Number of SAPs Licensed Masters Level Counselors and Other Counselors Counselor Counselor to Employee Ratio Comments and Notes West Regional Support Center Abilene 27 79601 Amarillo 20 79110 Childress 16 79201 El Paso 35 79928 Lubbock 49 79404 Odessa 19 79761 San Angelo 18 76904 West Regional Support Center Total 184 Regional Support Center Total 784 DMV Austin 513 78701 DMV TOTALS 513 AUSTIN DIVISIONS AND OFFICES 2,124 78701 AUSTIN DIVISIONS AND OFFICES TOTALS 2,124 REGIONAL SUPPORT CENTER TOTALS 784 DMV TOTALS 513 DISTRICTS 9,298 TOTAL OF ALL DISTRICTS, DIVISIONS, OFFICES, 12,719 REGIONS, AND DMV THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. 15-15

SCHEDULE 6 RESPONDENT PERSONNEL QUALIFICATIONS AND REFERENCES SOLICITATION NO. QXXXXXXXXXXXXXXXX RESPONDENT NAME: The respondent shall complete a minimum of three references for each respondent personnel to be assigned to the purchase order. TxDOT reserves the right to reject the proposed Respondent Personnel if references or past working performance are questionable or unfavorable (Ref. Para. 19.2.7.). RESPONDENT PERSONNEL INFORMATION FULL NAME: NUMBER OF YEARS EMPLOYED BY RESPONDENT: TITLE: Reference: # NAME OF ORGANIZATION: BUSINESS ADDRESS: BUSINESS CITY: BUSINESS STATE: CONTACT PERSON NAME: CONTACT PERSON TITLE: PHONE NUMBER: E-MAIL ADDRESS: ZIP FAX RESPONSE DESCRIBE THE TYPE OF COUNSELING OR SERVICE PERFORMED: SERVICE START DATE: CLIENT COMMENTS: SERVICE END DATE This page may be reproduced as needed to document each reference. THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. ANY NEGATIVE RESPONSE(S) MAY RESULT IN DISQUALIFICATION OF THE RESPONSE. 1-1

SCHEDULE 7 RESPONDENT REFERENCES SOLICITATION NO. QXXXXXXXXXXXXXXXX SPECIFICATION NO. RESPONDENT NAME Page 1 of Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Point of Contact: Date Services Performed: Reference Response (to be filled in by TxDOT): Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Point of Contact: Date Services Performed: Reference Response (to be filled in by TxDOT): Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Point of Contact: Date Services Performed: Reference Response (to be filled in by TxDOT): Company Name: Address: City: State: Zip Code: Phone Number: Fax Number: Point of Contact: Date Services Performed: Reference Response (to be filled in by TxDOT): THIS PAGE OR A REASONABLE FACSIMILE SHALL BE RETURNED WITH THE RESPONSE. FAILURE TO RETURN THIS PAGE OR A REASONABLE FACSIMILE WILL RESULT IN THE RESPONSE BEING CONSIDERED NON-RESPONSIVE. ANY NEGATIVE RESPONSE(S) MAY RESULT IN DISQUALIFICATION OF THE RESPONSE. 1-1