Project Information

Bid Title

Request for Applications (RFA) Legal Assistant Developer (LAD) RFx# 3140004566

Issuing Agency

State Government of Mississippi

Location

Mississippi

Published Date

Jun 1, 2026

Closing Date

Jun 18, 2026

Government Level

State & Local

Status

Closed

Ref. #

1651-26-R-RFQF-00004-V02

Original Source

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Bid Documents

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Project Description

Procurement Details

Smart Number	1651-26-R-RFQF-00004-V02	Advertised Date	06/01/2026 8:20 AM
RFx #	3140004566	Submission Date	06/18/2026 4:00 PM
RFx Status	Open	Major Procurement Category	PERSONNEL SERVICES NON-IT
RFx Opening Date	06/18/2026 4:15 PM	Sub Procurement Category
RFx Type	RFQ - Formal
Agency	MS DEPT OF HUMAN SERVICES
RFx Description	The Mississippi State Unit on Aging (SUA) is seeking a Legal Assistance Developer (LAD) to oversee and strengthen the delivery of legal assistance services statewide in alignment with the Older Americans Act and Final Rule requirements.

Contact Information

Name	Kimbley Hendrix	Email	KIMBLEY.HENDRIX@MDHS.MS.GOV
Phone	6013547205	Fax

RFx Items

PRODUCT CATEGORY	PRODUCT DESCRIPTION
94620	Serv FinAuditing

Awarded

VENDOR NAME

VENDOR NUMBER

AWARD DATE

AWARD AMOUNT

FUNDING SOURCE

Bid Attachments

Attachments Application
Attachments RFA

Attachment Preview

STATE OF MISSISSIPPI APPLICATION

Return Completed Application to:

For Staff/Official Use Only

Kimbley Hendrix

Mississippi Department of Human Services

Received: __________________

Division of Procurement Services 200 South

Lamar Street Jackson, MS 39201

Important! Please Read Before you begin the application process:

Applicants must complete and attach the “Supplemental Questions” page when applicable. This page is located on the MSPB

website Job Openings screen. Scroll down to the bottom of the screen and click the preferred job; when the description is displayed,

click “Print Job Information.” Applications failing to include this page or lacking sufficient information will be returned to the applicant

as invalid. Please ensure your application is received by the closing date as indicated on the job posting.

POSITION #:

-TYPE OR PRINT IN BLACK INK-

JOB INFORMATION

POSITION TITLE:

FIRST NAME

ADDRESS

PERSONAL INFORMATION

MIDDLE INITIAL

LAST NAME

CITY

STATE

ZIP

HOME PHONE

ALTERNATE PHONE

MONTH AND DATE OF BIRTH

EMAIL ADDRESS

WHICH METHOD DO YOU PREFER TO BE NOTIFIED ABOUT YOUR

APPLICATION STATUS?

EMAIL OR

PAPER

EDUCATION

WHAT IS YOUR HIGHEST LEVEL OF EDUCATION:

Some High School

Some College

Associate’s Degree

High School

Technical College

Bachelor’s Degree

HIGH SCHOOL EDUCATION

DID YOU GRADUATE FROM HIGH SCHOOL/RECEIVE A G.E.D.? YES

NO

IF NO, WHAT WAS THE HIGHEST GRADE LEVEL COMPLETED? 7

8

9 10

11 12

Master’s Degree

Specialist’s Degree

SCHOOL NAME

COLLEGE/UNIVERSITY EDUCATION

DEGREE RECEIVED

DATES ATTENDED

SCHOOL LOCATION (CITY/STATE)

DID YOU GRADUATE?

YES

NO

MAJOR

SEMESTER

QUARTER

# OF UNITS COMPLETED:

Doctorate Degree

SCHOOL NAME

DATES ATTENDED

SCHOOL LOCATION (CITY/STATE)

DID YOU GRADUATE?

YES

NO

MAJOR

DEGREE RECEIVED

SEMESTER

QUARTER

# OF UNITS COMPLETED:

SCHOOL NAME

DATES ATTENDED

SCHOOL LOCATION (CITY/STATE)

Rev 2/2012

DID YOU GRADUATE?

YES

NO

MAJOR

DEGREE RECEIVED

SEMESTER

QUARTER

# OF UNITS COMPLETED:

TYPE

LICENSE NUMBER

TYPE

LICENSE NUMBER

TYPE

LICENSE NUMBER

DATES

From

To

ADDRESS, CITY, STATE

PHONE NUMBER

HOURS PER WEEK

DUTIES

CERTIFICATES & LICENSES

DATE ISSUED (MONTH/YEAR)

ISSUING AGENCY

DATE ISSUED (MONTH/YEAR)

ISSUING AGENCY

DATE ISSUED (MONTH/YEAR)

ISSUING AGENCY

WORK HISTORY

EMPLOYER

EXPIRATION DATE (MONTH/YEAR)

SPECIALIZATION

EXPIRATION DATE (MONTH/YEAR)

SPECIALIZATION

EXPIRATION DATE (MONTH/YEAR)

SPECIALIZATION

POSITION TITLE

SUPERVISOR (NAME & TITLE)

SALARY

MAY WE CONTACT THIS EMPLOYER?

YES

NO

DATES

From

To

ADDRESS, CITY, STATE

PHONE NUMBER

HOURS PER WEEK

DUTIES

EMPLOYER

SUPERVISOR (NAME & TITLE)

SALARY

POSITION TITLE

MAY WE CONTACT THIS EMPLOYER?

YES

NO

2

Rev 3/2012

DATES

From

To

ADDRESS, CITY, STATE

PHONE NUMBER

HOURS PER WEEK

DUTIES

WORK HISTORY

EMPLOYER

SUPERVISOR (NAME & TITLE)

SALARY

POSITION TITLE

MAY WE CONTACT THIS EMPLOYER?

YES

NO

DATES

From

To

ADDRESS, CITY, STATE

PHONE NUMBER

HOURS PER WEEK

DUTIES

EMPLOYER

SUPERVISOR (NAME & TITLE)

SALARY

POSITION TITLE

MAY WE CONTACT THIS EMPLOYER?

YES

NO

3

Rev 3/2012

AGENCY WIDE QUESTIONS

1. ARE YOU CURRENTLY EMPLOYED WITH THE STATE OF MS? YES

NO

2. IF YOU ANSWERED “YES” TO THE PREVIOUS QUESTION, INDICATE WHICH AGENCY AND YOUR CURRENT JOB TITLE. (IF YOU PREVIOUSLY INDICATED

“NO”, PROCEED TO THE NEXT QUESTION.)

___________________________________________________________ _____________________________________________________________

(AGENCY NAME)

(CURRENT JOB TITLE)

3. HAVE YOU BEEN SEPRATED WITHIN THE LAST 12 MONTHS FROM THE STATE OF MS DUE TO A REDUCTION IN FORCE (RIF)? YES

NO

4. IF YOU ANSWERED “YES” TO THE PREVIOUS QUESTION, INDICATE WHICH AGENCY, YOUR PREVIOUS JOB TITLE, AND THE DATE OF YOUR RIF

SEPARATION. (IF YOU PREVIOUSLY INDICATED “NO”, PROCEED TO THE NEXT QUESTION.)

_______________________________________________ ______________________________________ ___________________________________

(AGENCY NAME)

(PREVIOUS JOB TITLE)

(DATE OF RIF)

5. ARE YOU A VETERAN OF THE ARMED FORCES? YES NO

(IF YOU INDICATED “YES”, YOU MUST ATTACH A COPY OF YOUR DD214 OR OTHER PROOF OF SERVICES.)

6. IF YOU ARE A VETERAN, WERE YOU DECLARED DISABLED? YES NO

7. ARE YOU AN ADULT MALE BORN ON OR AFTER JANUARY 1, 1960 WHO REGISTERED FOR SELECTIVE SERVICE BETWEEN THE AGES OF 18 AND 25?

YES

NO

TO MEET THE REQUIREMENTS OF FEDERAL REGULATIONS, MSPB NEEDS TO COLLECT INFORMATION ON THE QUESTIONS BELOW FOR

REPORTING PURPOSES ONLY. THIS INFORMATION WILL NOT BE USED FOR MAKING EMPLOYMENT DECISIONS. (OPTIONAL)

8. INDICATE YOUR RACE

AMERICAN INDIAN

WHITE

HISPANIC

BLACK

ASIAN

Other

9. INDICATE YOUR GENDER

MALE

FEMALE

10. AGE GROUP:

UNDER 18

18-25

26-39

40-54

55-69

70+

ADDITIONAL INFORMATION

Additional Information (other schools or training; special qualifications; honors and awards; etc.):

APPLICANT DECLARATIONS

By signing this application, I certify that all statements made herein and on any attached documents are true and complete to the best of my knowledge. I

authorize the verification of this information by the Mississippi State Personnel Board and any agency considering me for employment. I know that any

misrepresentation herein may lead to rejection of my application, removal of my name from the list of eligibles, and/or dismissal from state service. I

understand that, as a condition of employment, I will be required to present documentation which verifies both my identity and my employment eligibility

pursuant to federal immigration law.

X_________________________________________________________________

SIGNATURE OF APPLICANT

_________________________________________________

DATE

4

Rev 3/2012

SUPPLEMENTAL QUESTIONS

Applicants must complete and attach the “Supplemental Questions” page when applicable. This page is located on the

MSPB website Job Openings screen. Scroll down to the bottom of the screen and click the preferred job; when the description is

displayed, click “Print Job Information.” Applications failing to include this page or lacking sufficient information will be returned to

the applicant as invalid. Please ensure your application is received by the closing date as indicated on the job posting.

JOB NUMBER:

SCHOOL NAME

DATES ATTENDED

SCHOOL LOCATION (CITY/STATE)

ADDITIONAL WORK HISTORY

JOB INFORMATION

POSITION TITLE:

COLLEGE/UNIVERSITY EDUCATION

DEGREE RECEIVED

DID YOU GRADUATE?

YES

NO

MAJOR

SEMESTER

QUARTER

# OF UNITS COMPLETED:

SCHOOL NAME

DATES ATTENDED

SCHOOL LOCATION (CITY/STATE)

TYPE

LICENSE NUMBER

TYPE

LICENSE NUMBER

DATES

From

To

ADDRESS

COMPANY WEBSITE

HOURS WORKED PER WEEK

DUTIES

DID YOU GRADUATE?

YES

NO

MAJOR

DEGREE RECEIVED

DATES ATTENDED

CERTIFICATES & LICENSES

DATE ISSUED (MONTH/YEAR)

ISSUING AGENCY

EXPIRATION DATE (MONTH/YEAR)

SPECIALIZATION

DATE ISSUED (MONTH/YEAR)

ISSUING AGENCY

WORK HISTORY

EMPLOYER

CITY

PHONE NUMBER

MONTHLY SALARY

EXPIRATION DATE (MONTH/YEAR)

SPECIALIZATION

POSITION TITLE

STATE

SUPERVISOR (NAME & TITLE)

MAY WE CONTACT THIS EMPLOYER?

YES

NO

5

Rev 3/2012

Commodity Codes

• NAICS 541110Offices of Lawyers
• NAICS 541511Custom Computer Programming Services
• NAICS 541512Computer Systems Design Services
• NAICS 541519Other Computer Related Services

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