Purchase Order Social Worker in United States Chicago –Free Word Template Download with AI

Purchase Order No.: PO-2025-04872
Date of Issue: June 12, 2025
Valid Until: September 12, 2025 Vendor / Service Provider: Lakeside Behavioral Health Group, LLC
Address: 845 N. Franklin Street, Chicago, IL 60610
Contact: Margaret Ellison, Director of Clinical Services
Phone: (312) 555-0342 Department: Human Services & Community Outreach
Cost Center: CC-2025-SW-0114
Priority: Standard

This Purchase Order is issued by Chicago Community Services Agency, Inc. (hereinafter referred to as the "Purchasing Entity") to Lakeside Behavioral Health Group, LLC (hereinafter referred to as the "Service Provider") for the professional engagement of a licensed Social Worker to deliver comprehensive case management, family intervention, and community-based support services within the United States Chicago metropolitan area. The Social Worker shall operate under the supervision of the Purchasing Entity's Program Director and shall comply with all applicable Illinois Department of Children and Family Services (IDCF) regulations, the Chicago Municipal Code, and the National Association of Social Workers (NASW) Code of Ethics.

Item #	Description	Quantity	Unit	Unit Rate (USD)	Extended Price (USD)
1	Licensed Clinical Social Worker (LCSW) – Full-time case management services for at-risk families in the South Side of United States Chicago. Includes weekly home visits, family therapy sessions, and resource coordination.	1	Position / 12 months	$78,400.00	$78,400.00
2	Social Worker – Part-time crisis intervention support at the Chicago Family Shelter Network. Includes on-call availability (24/7 rotation), emergency response within 4 hours, and documentation of all interventions.	1	Position / 12 months	$42,600.00	$42,600.00
3	Supervisory Social Worker – Program oversight, staff mentoring, quality assurance audits, and compliance reporting to the City of Chicago Department of Health and the Illinois State Board of Social Work.	1	Position / 12 months	$94,200.00	$94,200.00
4	Professional liability insurance coverage for all Social Worker personnel engaged under this Purchase Order, minimum $2,000,000 per occurrence, compliant with Illinois Insurance Code.	1	Policy / 12 months	$6,850.00	$6,850.00
5	Background check, fingerprinting, and credential verification services for all Social Worker candidates as required by the Chicago Police Department and the Illinois State Police.	3	Individual	$185.00	$555.00
6	Continuing education and professional development stipend for Social Worker staff (minimum 40 CEU hours annually per Illinois licensure requirements).	3	Individual / Year	$1,200.00	$3,600.00
SUBTOTAL					$226,205.00
Illinois State Sales & Use Tax (Exempt – Nonprofit 501(c)(3))					$0.00
Chicago Municipal Business License Fee (Applicable)					$1,131.00
TOTAL PURCHASE ORDER AMOUNT					$227,336.00

The Social Worker(s) engaged under this Purchase Order shall perform the following duties within the United States Chicago service area, which encompasses Cook County and the immediate suburban corridors of the Chicago metropolitan region:

Conduct comprehensive psychosocial assessments for all referred families and individuals within 72 hours of initial contact.
Develop and implement individualized service plans in coordination with the Chicago Public Schools, Cook County Circuit Court, and the Illinois Department of Human Services.
Provide in-home visits no fewer than twice per week for each active case, with all visits documented in the agency's electronic case management system.
Facilitate group counseling sessions at the agency's Chicago office and at partner community centers in the Englewood, Pilsen, and Uptown neighborhoods.
Coordinate with law enforcement, the Chicago Police Department's Community Policing Division, and the Office of the City Attorney for cases involving domestic violence, child protective services, or juvenile justice referrals.
Submit monthly progress reports to the Purchasing Entity's Program Director and quarterly compliance reports to the Illinois State Board of Social Work.
Maintain strict confidentiality in accordance with the Illinois Freedom of Information Act, HIPAA regulations, and the NASW Code of Ethics.

Payment Terms: Net 30 days from receipt of an approved invoice. Payment shall be made via electronic funds transfer (EFT) to the Service Provider's designated account. Invoices must reference this Purchase Order number (PO-2025-04872) and the applicable Cost Center (CC-2025-SW-0114).
Performance Period: This Purchase Order is valid for a period of twelve (12) months commencing July 1, 2025, and expiring June 30, 2026, unless terminated earlier in accordance with Section 7.
Compliance: The Service Provider warrants that all Social Worker personnel shall hold current, unexpired licensure issued by the Illinois State Board of Social Work and shall maintain professional liability insurance throughout the performance period.
Chicago-Specific Requirements: All Social Worker services delivered within the City of Chicago limits shall comply with the Chicago Municipal Code, Title 4 (Public Health and Safety), and any applicable ordinances of the Chicago City Council. The Service Provider shall register with the City of Chicago Department of Business Affairs and Consumer Protection.
Indemnification: The Service Provider shall indemnify and hold harmless the Purchasing Entity, its officers, directors, and employees from any and all claims, damages, or liabilities arising from the negligent or willful acts of the Social Worker(s) engaged under this Purchase Order.
Termination: Either party may terminate this Purchase Order with thirty (30) days' written notice. The Purchasing Entity reserves the right to terminate immediately for material breach, loss of licensure, or violation of any applicable Illinois or Chicago law.
Governing Law: This Purchase Order shall be governed by and construed in accordance with the laws of the State of Illinois, with venue in the Circuit Court of Cook County, United States Chicago.
Non-Discrimination: The Service Provider shall comply with all federal, state, and local non-discrimination laws, including the Illinois Human Rights Act and the Chicago Fair Employment Practices Ordinance, in the recruitment, placement, and supervision of Social Worker personnel.

This Purchase Order constitutes a binding commitment upon signature by the authorized representatives of both parties. By signing below, the Service Provider acknowledges receipt of this Purchase Order and agrees to furnish the Social Worker services described herein in full compliance with all stated terms, conditions, and applicable regulations of the United States Chicago jurisdiction.

For the Purchasing Entity:

Chicago Community Services Agency, Inc.

David R. Thompson
Chief Financial Officer
Date: ______________________

For the Service Provider:

Lakeside Behavioral Health Group, LLC

Margaret Ellison
Director of Clinical Services
Date: ______________________ ⬇️ Download as DOCX Edit online as DOCX

Create your own Word template with our GoGPT AI prompt:

GoGPT