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Supplemental Employment Services Contract and Forms

Employment Support Services

OK Library for the Blind and Physically Handicapped
300 N.E. 18th Street
Oklahoma City, OK 73105

Office: (405) 522-2123
Toll Free: (800) 523-0288
Fax: (405) 522-2139

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000c Sample FY 2025 Contracts.zip

Download: FY25 Final-Sample Contracts.zip

ESS-C-801 Authorization Request & Billing Form Rev 2024-08-01

Download: ESS-C-801 Authorization Request & Invoice Rev 2024-08-01

008f FY25 Supplemental Employment Services Contract SES PDF

Download: FY25 Supplemental Employment Services Contract Final-Sample

ESS-C-117 Travel Log and Invoice (Rev. 2024-03-06)

Download: ESS-C-117 Travel Log and Invoice (Rev 2024-3-06).pdf

ESS-C-133 DRS Counselor Monthly Update Form (Rev. 2021-08-11)

Download: ESS-C-133 DRS Counselor Monthly Update Form (Rev. 2021-08-11)

ESS-C-137 Plan of Career Exploration (Rev 2022-08-10)

Download: ESS-C-137 Plan of Career Exploration (Rev 2022-08-10)

ESS-C-141 Career Exploration Report (Rev. 2021-06-21)

Download: ESS-C-141 Career Exploration Report

ESS-C-145n DRS Counselor Response to ESS-C-137 Plan of Career Exploration

Download: ESS-C-145n DRS Counselor Response to Plan of Career Exploration

ESS-C-149n Contractor's Written Justification for completing less than three (3) different activities (Rev. 2022-08-12)

Download: ESS-C-149n Contractor's Written Justification for completing less than 3 different activities (Rev 2022-08-12)

ESS-C-153n DRS Counselor Written Approval for completing less then three (3) different activities (if needed) Rev 2022-08-12

Download: ESS-C-153n DRS Counselor Written Approval for completing less than three (3) different activities (if applicable)

ESS-C-157 Pre-Placement Information Form (Rev 2024-08-16)

Download: ESS-C-157 Pre-Placement Information Form (Rev 2023-11-27)

ESS-C-161 (1) Job Analysis (Rev 2022-09-22)

Download: ESS-C-161 Job Analysis (1) Rev 2022-09-22

ESS-C-165 Internship Placement Report (Rev 2022-09-14)

Download: ESS-C-165 Internship Placement Report (Rev 2022-09-14)

ESS-C-166 Job Development & Placement Report (Rev. 2023-12-08)

Download: ESS-C-166 Job Development & Placement Report (Rev 2023-12-08)

ESS-C-169 Internship Time Log

Download: ESS-C-169 Internship Time Log

ESS-C-173 Team Meeting Report (Rev. 2022-09-12)

Download: ESS-C-173 Team Meeting Report (Rev 2022-09-12)

ESS-C-177 Placement Report (Internship) (Rev. 2022-08-24)

Download: ESS-C-177 Placement Report (Permanent placement from Internship) (Rev 2022-08-24)

ESS-C-181 Termination & Re-Placement Report

Download: ESS-C-181 Termination & Re-Placement Report (Rev 2023-11-27)

ESS-C-185 Job Accommodation Form (Rev 2022-09-09)

Download: ESS-C-185 Job Accommodation Form (Rev 2022-09-09)

ESS-C-197n Internship Agreement Documentation (Rev 2022-08-12)

Download: ESS-C-197n Internship Agreement Documentation (Rev 2022-08-12)

ESS-C-213n O*NET median hourly wage documentation (for in-house placement only) (Rev. 2022-09-02)

Download: ESS-C-213n O*NET median hourly wage documentation (Rev 2022-09-02)

ESS-C-310 Assessment Report Rev. 2024-08-16

Download: ESS-C-310 Assessment Report Rev 2024-08-16

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