Workforce Innovation and Opportunity Act Completion Form

WORKFORCE INNOVATION AND OPPORTUNITY ACT COMPLETION FORM

RECITALS

WHEREAS, Program Participant Name: was enrolled in a Workforce Innovation and Opportunity Act (WIOA) funded program administered by Training Provider: to receive occupational training and support services; and

WHEREAS, the parties have completed the agreed training and related services described below, and the Training Provider seeks final completion certification and payment as permitted by applicable WIOA funding and local policies.

PROGRAM IDENTIFICATION

SCOPE OF WORK

The Training Provider certifies that the scope of services delivered to the Participant included occupational instruction, supportive services where applicable, and other activities necessary for successful completion. Describe the services and deliverables provided:

COMPLETION DETAILS & OUTCOMES

Completion Date:    Credential Awarded (if any):

Total Training Hours Completed:    Skills Attainment Outcome:

PAYMENT TERMS

Total Approved Cost for Training Services: $

Late Payment Fee: — Payments not received within the agreed terms shall accrue the stated late fee on outstanding balances.

Final payment will be made upon receipt of this completed form, any required supporting documentation, and verification of satisfactory completion in accordance with WIOA funding and local policy.

TERM AND TERMINATION

Agreement Start Date:    Agreement End Date:

Either party may terminate this agreement for cause upon written notice to the other party. Standard notice period: . Termination for convenience requires prior written approval by the WIOA funding authority and may affect final payment.

CONFIDENTIALITY

The parties acknowledge that participant records and related documentation constitute confidential information subject to applicable privacy and confidentiality laws and WIOA program rules. The Training Provider agrees not to disclose personally identifiable information without prior written consent except as required by law or by authorized program administration. Use of participant data for reporting purposes must be limited to aggregate or de-identified information unless explicit consent is obtained.

COMPLIANCE

The Training Provider certifies that all services were delivered in compliance with applicable WIOA statutes, regulations, and local policies, and that records substantiating program delivery are retained and available for review by authorized program administrators for the period required by law.

GOVERNING LAW

This Completion Form and any dispute arising from it shall be governed by and construed in accordance with the laws of the state where the Training Provider is administratively located, without regard to conflict of law principles. Venue for any action shall be the state or federal courts having jurisdiction in that state.

ENTIRE AGREEMENT

This document, together with any incorporated attachments, invoices, and approved program documents, constitutes the entire agreement between the parties regarding completion certification and final payment for the described training services. No amendment is effective unless in writing and signed by authorized representatives of both parties.

CERTIFICATIONS

CASE MANAGER / CONTACT INFORMATION

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