Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this ~~Contract~~ Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this ~~Contract~~ Amendment to the State of Indiana. I understand that my signing and submitting this ~~Contract~~ Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted ~~Contract~~ Amendment and this affirmation. I understand and agree that by electronically signing and submitting this ~~Contract~~ Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this ~~Contract~~ Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ~~xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST~~ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Contractor and the State have, through their duly authorized representatives, entered into this ~~Contract~~Amendment. The parties, having read and understood the foregoing terms of this ~~Contract~~Amendment, do by their respective signatures dated below agree to the terms thereof. ~~[Contractor] [~~Title:\t1P\resident, Indiana ~~Agency]~~ Market Title:\t2M\edicaid director Date:\d51/\12/2021 | 14:39 EDT Date:\d52/\12/2021 | 22:51 EDT Electronically Approved by: Indiana Office of Technology By: ~~By: Title: Title: Date: Date:~~ (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved by: State Budget Agency By: (for) ~~Xxxxx X.Xxxxxx~~Xxxxxxx X. Xxxxxxx, Director ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved as to Form and ~~Legality~~Legality by: Office of the Attorney General By: (for) ~~Xxxxxx~~ Xxxxxxxx X. ~~Xxxx, Xx.~~Xxxxxx, Attorney General ~~Refer~~ 1.0 Background 11 2.0 Managed Care Entity- Contractor Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Administrative and Organizational Structure 13 2.4 Staffing 14 2.4.1 Key Staff 14 2.4.2 Staff Positions 20 2.4.3 Training 22 2.4.4 Debarred Individuals 23 2.5 FSSA/OMPP Meeting Requirements 24 2.6 Financial Stability 24 2.6.1 Solvency 24 2.6.2 Insurance 25 2.6.3 Reinsurance 25 2.6.4 Financial Accounting Requirements 26 2.6.5 Reporting Transactions with Parties of Interest 28 2.6.6 Medical Loss Ratio 29 2.6.7 Health Insurance Providers Fee 30 2.7 Subcontracts 31 2.8 Confidentiality of Member Medical Records and Other Information 34 2.9 Internet Quorum (IQ) Inquires 34 2.10 Material Change 34 2.11 Future Program Guidance 34 2.12 Conflict of Interest 35 2.13 Capitation Related to ~~Electronic Approval History found after the final page of the Executed Contract for details.~~a Vacated Program 35 3.0 HIP Plan Design and Member Eligibility 35 3.1 HIP Plus 35

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Contract

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ Indiana Department of ~~this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency]~~ Administration By: CARGILL INCORPORATED By: Title: Customer Care Representative II Title: Vendor Manager Date: 8/9/2022 | 17:03 EDT Date: 8/10/2022 | 07:23 EDT Electronically Approved by: Department of Administration By: (for) ~~Xxxxxx X. Xxxxx~~Xxxxxxx Xxxx erda, Commissioner ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved by: State Budget Agency By: (for) ~~Xxxxx X.Xxxxxx~~Xxxxxxx X. Xxxxxxx, Director ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved as to Form and ~~Legality~~Legality by: Office of the Attorney General By: (for) ~~Xxxxxx X. Xxxx, Xx.~~Xxxxxxxx X Xxxxxx, Attorney General ~~Refer~~ This document is an exhibit to ~~Electronic Approval History found after~~ the ~~final page~~ Contract, and is deemed to be attached to and incorporated within the Contract by reference. Any inconsistency, conflict, or ambiguity between this exhibit and the Contract shall be resolved by giving precedence and effect to the Contract. INDOT District Salt Type INDOT Early Fill Requested Quantity (Ton) Price Per Ton (Delivered) Price Per Ton (Delivered & Loaded) Price Per Ton (Pick Up) 10 - Crawfordsville Untreated Salt INDOT 2,000 $82.35 $90.35 $81.00 INDOT District Salt Type INDOT Seasonal Requested Quantity (Ton) Price Per Ton (Delivered) Price Per Ton (Delivered & Loaded) Price Per Ton (Pick Up) 10 - Crawfordsville Untreated Salt INDOT 46,000 $82.35 $90.35 $81.00 20 - Fort Xxxxx Untreated Salt INDOT 65,000 $65.12 $73.12 $60.00 30 - Greenfield Untreated Salt INDOT 71,459 $72.49 $80.49 $72.00 INDOT District Salt Type INDOT Seasonal Requested Quantity (Ton) Price Per Ton (Delivered) Price Per Ton (Delivered & Loaded) Price Per Ton (Pick Up) 10 - Crawfordsville Treated Salt INDOT 3,242 $93.11 $101.11 $93.00 20 - Fort Xxxxx Treated Salt INDOT 20 $97.88 $105.88 $97.00 30 - Greenfield Treated Salt INDOT 175 $93.58 $101.58 $93.00 50 - Seymour Treated Salt INDOT 200 $89.94 $97.94 $89.00 60 - Vincennes Treated Salt INDOT 70 $107.76 $115.76 $107.00 INDOT District Salt Type Other State Agencies Requested Quantity (Ton) Price Per Ton (Delivered) Price Per Ton (Pick Up) 10 - Crawfordsville Treated Salt DOC-Indiana Women's Prison 40 $93.11 $93.00 10 - Crawfordsville Treated Salt DOC-Plainfield Complex 120 $93.11 $93.00 10 - Crawfordsville Treated Salt DOC-Putnamville Correctional Facility 60 $93.11 $93.00 10 - Crawfordsville Treated Salt DOC-Rockville Correctional Facility 22 $93.11 $93.00 20 - Fort Xxxxx Treated Salt DOC - Miami Correctional Facility 20 $97.88 $97.00 30 - Greenfield Treated Salt Richmond State Hospital 75 $93.58 $93.00 30 - Greenfield Treated Salt Indiana State Fair Commission 40 $93.58 $93.00 30 - Greenfield Treated Salt DOC - New Castle Correctional Facility 60 $93.58 $93.00 30 - Greenfield Untreated Salt DOC-Correctional Industrial Facility / IR 80 $72.49 $72.00 50 - Seymour Treated Salt Camp Xxxxxxxxx 200 $89.94 $89.00 60 - Vincennes Treated Salt DOC-Branchville Correctional Facility 40 $107.76 $107.00 60 - Vincennes Treated Salt DOC-Wabash Valley Correctional Facility 30 $107.76 $107.00 INDOT District Salt Type Customer Name Requested Quantity (Ton) Price Per Ton (Delivered) Price Per Ton (Pick Up) 10 - Crawfordsville Treated Salt Boone County - OneIndiana 1000 $89.51 $89.00 10 - Crawfordsville Treated Salt City of ~~the Executed Contract for details.~~Greencastle Public Works - OneIndiana 450 $89.51 $89.00 10 - Crawfordsville Treated Salt City of Lebanon - OneIndiana 900 $89.51 $89.00 10 - Crawfordsville Treated Salt City of Terre Haute - OneIndiana 700 $89.51 $89.00 10 - Crawfordsville Treated Salt Clay County - OneIndiana 150 $89.51 $89.00 10 - Crawfordsville Treated Salt Clinton County Government - OneIndiana 1000 $89.51 $89.00 10 - Crawfordsville Treated Salt Fountain Co. Highway - OneIndiana 300 $89.51 $89.00 10 - Crawfordsville Treated Salt Hendricks County - OneIndiana 2800 $89.51 $89.00 10 - Crawfordsville Treated Salt Indiana State University - K12Indiana 100 $89.51 $89.00 10 - Crawfordsville Treated Salt Lebanon Comm School Corp - K12Indiana 120 $89.51 $89.00 10 - Crawfordsville Treated Salt Purdue University - OneIndiana 500 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Avon - OneIndiana 1500 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Brownsburg - OneIndiana 1600 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Danville - OneIndiana 400 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Fairview Park - OneIndiana 25 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Otterbein - OneIndiana 80 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Oxford - OneIndiana 20 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Plainfield - OneIndiana 1200 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Shadeland 240 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Veedersburg - OneIndiana 20 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Waynetown - OneIndiana 40 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Whitestown - OneIndiana 1000 $89.51 $89.00 10 - Crawfordsville Treated Salt Town of Williamsport 60 $89.51 $89.00 10 - Crawfordsville Treated Salt Vermillion County - OneIndiana 100 $89.51 $89.00 10 - Crawfordsville Treated Salt Vermillion County - OneIndiana 100 $89.51 $89.00 10 - Crawfordsville Treated Salt Vermillion County - OneIndiana 100 $89.51 $89.00 10 - Crawfordsville Treated Salt Zionsville Community Schools - K12Indiana 230 $89.51 $89.00 20 - Fort Xxxxx Treated Salt City of Angola Clerk - OneIndiana 100 $93.10 $93.00 20 - Fort Xxxxx Treated Salt City of Bluffton - OneIndiana 500 $93.10 $93.00 20 - Fort Xxxxx Treated Salt City of Xxxxxx - OneIndiana 100 $93.10 $93.00 20 - Fort Xxxxx Treated Salt City of Dunkirk - OneIndiana 80 $93.10 $93.00 20 - Fort Xxxxx Treated Salt City of East Chicago - OneIndiana 3000 $93.10 $93.00 20 - Fort Xxxxx Treated Salt City of Xxxxxxx - OneIndiana 300 $93.10 $93.00 20 - Fort Xxxxx Treated Salt City of Ligonier - OneIndiana 100 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Dekalb County Central Schools - K12Indiana 60 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of Xxxxxxxx 100 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of Millersburg - OneIndiana 80 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of North Manchester - OneIndiana 120 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of Ossian - OneIndiana 60 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of St. Xxx - OneIndiana 22 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of Topeka - OneIndiana 100 $93.10 $93.00 20 - Fort Xxxxx Treated Salt Town of Winona Lake - OneIndiana 350 $93.10 $93.00 30 - Greenfield Treated Salt City of Alexandria - OneIndiana 175 $89.38 $89.00 30 - Greenfield Treated Salt City of Xxxxxxxx Street - OneIndiana 2400 $89.38 $89.00 30 - Greenfield Treated Salt City of Beech Grove - OneIndiana 800 $89.38 $89.00 30 - Greenfield Treated Salt City of Xxxxxx - OneIndiana 50 $89.38 $89.00 30 - Greenfield Treated Salt City of Greenfield Street - OneIndiana 1000 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 3000 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 8000 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 7500 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 3000 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 3000 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 3000 $89.38 $89.00 30 - Greenfield Treated Salt City of Indianapolis 7500 $89.38 $89.00 30 - Greenfield Treated Salt City of Xxxxxxxx - OneIndiana 1800 $89.38 $89.00 30 - Greenfield Treated Salt City of New Castle - OneIndiana 1300 $89.38 $89.00 30 - Greenfield Treated Salt City of Richmond Street Dept 1100 $89.38 $89.00 30 - Greenfield Treated Salt City of Shelbyville Street - OneIndiana 590 $89.38 $89.00 30 - Greenfield Treated Salt Hancock County Highway - OneIndiana 1500 $89.38 $89.00 30 - Greenfield Treated Salt Henry County Highway - OneIndiana 800 $89.38 $89.00 30 - Greenfield Treated Salt IUPUI - OneIndiana 650 $89.38 $89.00 30 - Greenfield Treated Salt Jay County Highway - OneIndiana 500 $89.38 $89.00 30 - Greenfield Treated Salt MSD of Decatur Township - K12Indiana 100 $89.38 $89.00 30 - Greenfield Treated Salt MSD of Xxxxxx Township - OneIndiana 180 $89.38 $89.00 30 - Greenfield Treated Salt MSD of Xxxxx Township - K12Indiana 100 $89.38 $89.00 30 - Greenfield Treated Salt MSD of Xxxxx Township - K12Indiana 100 $89.38 $89.00 30 - Greenfield Treated Salt MSD Washington Township - OneIndiana 450 $89.38 $89.00 30 - Greenfield Treated Salt Rush County Schools - K12Indiana 40 $89.38 $89.00 30 - Greenfield Treated Salt Shelby County Government - OneIndiana 600 $89.38 $89.00 30 - Greenfield Treated Salt Town of Cambridge City - OneIndiana 80 $89.38 $89.00 30 - Greenfield Treated Salt Town of Chesterfield - OneIndiana 80 $89.38 $89.00 30 - Greenfield Treated Salt Town of Xxxxx - OneIndiana 120 $89.38 $89.00 30 - Greenfield Treated Salt Town of Fortville - OneIndiana 160 $89.38 $89.00 30 - Greenfield Treated Salt Town of Fountain City - OneIndiana 50 $89.38 $89.00 30 - Greenfield Treated Salt Town of Frankton - OneIndiana 60 $89.38 $89.00 30 - Greenfield Treated Salt Town of Hagerstown - OneIndiana 80 $89.38 $89.00 30 - Greenfield Treated Salt Town of Xxxxxxx - OneIndiana 120 $89.38 $89.00 30 - Greenfield Treated Salt Town of Lapel - OneIndiana 100 $89.38 $89.00 30 - Greenfield Treated Salt Town of McCordsville - OneIndiana 240 $89.38 $89.00 30 - Greenfield Treated Salt Town of Morristown - OneIndiana 100 $89.38 $89.00 30 - Greenfield Treated Salt Town of New Palestine 80 $89.38 $89.00 30 - Greenfield Treated Salt Town of Xxxxxxx - OneIndiana 50 $89.38 $89.00 30 - Greenfield Treated Salt Town of Speedway - OneIndiana 400 $89.38 $89.00 30 - Greenfield Treated Salt Town of Summitville - OneIndiana 60 $89.38 $89.00 30 - Greenfield Treated Salt Town of Yorktown - OneIndiana 600 $89.38 $89.00 40 - La Porte Treated Salt Carroll County Highway - OneIndiana 900 $79.46 $79.00 40 - La Porte Treated Salt City of Xxxx - OneIndiana 5000 $79.46 $79.00 40 - La Porte Treated Salt City of Xxxxxxx - OneIndiana 6700 $79.46 $79.00 40 - La Porte Treated Salt City of Lake Station - OneIndiana 800 $79.46 $79.00 40 - La Porte Treated Salt City of XxXxxxx - OneIndiana 1800 $79.46 $79.00 40 - La Porte Treated Salt City of Mishawaka - OneIndiana 2200 $79.46 $79.00 40 - La Porte Treated Salt City of Monticello - OneIndiana 350 $79.46 $79.00 40 - La Porte Treated Salt City of Rensselaer - OneIndiana 160 $79.46 $79.00 40 - La Porte Treated Salt City of Rochester - OneIndiana 75 $79.46 $79.00 40 - La Porte Treated Salt City of Xxxxxxx - OneIndiana 525 $79.46 $79.00 40 - La Porte Treated Salt Fulton County Highway - OneIndiana 650 $79.46 $79.00 40 - La Porte Treated Salt Merrillville Community Schools - K12Indiana 150 $79.46 $79.00 40 - La Porte Treated Salt Newton County - OneIndiana 500 $79.46 $79.00 40 - La Porte Treated Salt Purdue University Northwest 130 $79.46 $79.00 40 - La Porte Treated Salt Town of Bremen - OneIndiana 300 $79.46 $79.00 40 - La Porte Treated Salt Town of Camden - OneIndiana 25 $79.46 $79.00 40 - La Porte Treated Salt Town of Cedar Lake Public Works - OneIndiana 100 $79.46 $79.00 40 - La Porte Treated Salt Town of Xxxx - OneIndiana 1000 $79.46 $79.00 40 - La Porte Treated Salt Town of Kouts - OneIndiana 50 $79.46 $79.00 40 - La Porte Treated Salt Town Of Long Beach - OneIndiana 500 $79.46 $79.00 40 - La Porte Treated Salt Town of Munster - OneIndiana 3000 $79.46 $79.00 40 - La Porte Treated Salt Town of St Xxxx - OneIndiana 2700 $79.46 $79.00 40 - La Porte Treated Salt Town of Trail Creek - OneIndiana 150 $79.46 $79.00 40 - La Porte Treated Salt Town of Westville - OneIndiana 100 $79.46 $79.00 40 - La Porte Treated Salt Town of Winamac - OneIndiana 80 $79.46 $79.00 40 - La Porte Treated Salt Town of Winfield - OneIndiana 850 $79.46 $79.00 40 - La Porte Treated Salt Tri-Creek School Corporation - K12Indiana 120 $79.46 $79.00 40 - La Porte Treated Salt Twin Lakes School Corporation - K12Indiana 75 $79.46 $79.00 50 - Seymour Treated Salt Brown County Government - OneIndiana 800 $91.68 $91.00 50 - Seymour Treated Salt City of Batesville - OneIndiana 150 $91.68 $91.00 50 - Seymour Treated Salt City of Greendale - OneIndiana 350 $91.68 $91.00 50 - Seymour Treated Salt City of Lawrenceburg - OneIndiana 600 $91.68 $91.00 50 - Seymour Treated Salt City of New Albany - OneIndiana 1200 $91.68 $91.00 50 - Seymour Treated Salt City of Rising Sun Government - OneIndiana 200 $91.68 $91.00 50 - Xxxxxxx Treated Salt City of Salem - OneIndiana 150 $91.68 $91.00 50 - Xxxxxxx Treated Salt City of Seymour - OneIndiana 400 $91.68 $91.00 50 - Seymour Treated Salt Xxxxxx-Sweetwater Conservancy District 150 $91.68 $91.00 50 - Seymour Treated Salt Decatur County Highway - OneIndiana 200 $91.68 $91.00 50 - Seymour Treated Salt Floyd County Road - OneIndiana 2000 $91.68 $91.00 50 - Seymour Treated Salt Franklin County Highway - OneIndiana 1800 $91.68 $91.00 50 - Seymour Treated Salt Harrison County Highway - OneIndiana 2000 $91.68 $91.00 50 - Seymour Treated Salt Jennings County Highway - OneIndiana 800 $91.68 $91.00 50 - Seymour Treated Salt Johnson County Highway Department - OneIndiana 2700 $91.68 $91.00

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Consulting Agreement

Appears in 1 contract

Samples: Master Services Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Consulting Contract

Appears in 1 contract

Samples: Contract Amendment

Appears in 1 contract

Samples: Broadband Access Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Contract #0000000000000000000018310

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Professional Services

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this ~~Contract~~ Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this ~~Contract~~ Amendment to the State of Indiana. I understand that my signing and submitting this ~~Contract~~ Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted ~~Contract~~ Amendment and this affirmation. I understand and agree that by electronically signing and submitting this ~~Contract~~ Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this ~~Contract~~ Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ~~xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, Contractor~~ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\tP1r\ esident and ~~the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms~~ CEO Date:5\d/11\3/2021 | 11:43 EDT Title:\Mt2e\dicaid director By:\s2\ Date5:\d/21\3/2021 | 12:09 EDT Electronically Approved by: Indiana Office of ~~this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency]~~ Technology By: ~~By: Title: Title: Date: Date:~~ (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved by: State Budget Agency By: (for) ~~Xxxxx X.Xxxxxx~~Xxxxxxx X. Xxxxxxx, Director ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved as to Form and ~~Legality~~Legality by: Office of the Attorney General By: (for) ~~Xxxxxx~~ Xxxxxxxx X. ~~Xxxx, Xx.~~Xxxxxx, Attorney General ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~1.0 Background 10 2.0 Managed Care Entity- Contractor Requirements 11

Appears in 1 contract

Samples: Contract Amendment

Appears in 1 contract

Samples: Consulting Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Master Services Agreement

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this ~~Contract~~ Grant Agreement by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this ~~Contract~~ Grant Agreement to the State of Indiana. I understand that my signing and submitting this ~~Contract~~ Grant Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted ~~Contract~~ Grant Agreement and this affirmation. I understand and agree that by electronically signing and submitting this ~~Contract~~ Grant Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this ~~Contract~~ Grant Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency] VANDERBURGH COUNTY HEALTH INDIANA STATE DEPARTMENT OF HEALTH DEPARTMENT By: By: Title: Title: Date: Date: Electronically Approved by: Department of Administration By: (for) ~~Xxxxxx X. Xxxxx~~Xxxxxxx Xxxxxxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxx X.Xxxxxx, Director Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved as to Form and Legality: Office of the Attorney General By: (for) Xxxxxx X. Xxxx, Xx., Attorney General Refer to Electronic Approval History found after the final page of the Executed Contract for details.

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Contract Amendment

Appears in 1 contract

Samples: Contract #0000000000000000000024457

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Master Services Agreement

Appears in 1 contract

Samples: Consulting Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Contract for Providing Risk Based Managed Care Services

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Contract

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this ~~Contract~~ Grant by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this ~~Contract~~ Grant to the State of Indiana. I understand that my signing and submitting this ~~Contract~~ Grant in this fashion is the legal equivalent of having placed my handwritten signature on the submitted ~~Contract~~ Grant and this affirmation. I understand and agree that by electronically signing and submitting this ~~Contract~~ Grant in this fashion I am affirming to the truth of the information contained therein. I understand that this ~~Contract~~ Grant will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST ~~In Witness Whereof, Contractor and the~~ VANDERBURGH COUNTY Indiana State ~~have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms~~ Department of ~~this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency]~~ Health By: By: Title: Title: Date: Date: ~~Electronically~~ Approved by: Department of Administration By: (for) ~~Xxxxxx X. Xxxxx~~Xxxxxxx Xxxxxxxxx, Commissioner ~~Refer~~ This document will be reviewed and approved electronically. Please refer to ~~Electronic Approval History found after~~ the final page of the Executed Contract for details. ~~Electronically~~ Approved by: State Budget Agency By: (for) Xxxxx ~~X.Xxxxxx~~X. Xxxxxx, Director ~~Refer~~ This document will be reviewed and approved electronically. Please refer to ~~Electronic Approval History found after~~ the final page of the Executed Contract for details. ~~Electronically~~ Approved as to Form and Legality: Office of the Attorney General By: (for) ~~Xxxxxx~~ Xxxxxxx X. ~~Xxxx, Xx.~~Xxxxxxx, Attorney General ~~Refer~~ This document will be reviewed and approved electronically. Please refer to ~~Electronic Approval History found after~~ the final page of the Executed Contract for details. The Public Health Preparedness and Emergency Response (PHPER) Division within the Indiana State Department of Health (ISDH) is the entity responsible for administering Public Health Emergency Preparedness funding (PHEP) received from the Centers for Disease Control and Prevention (CDC), and administering Healthcare Preparedness Program (HPP) funding received from the Assistant Secretary for Preparedness and Response (ASPR). The ISDH administers these funds through sub-awardee agreements which require various activities aimed at enhancing state and local preparedness in order to better respond to public health and healthcare emergencies. During Budget Period (BP) 5, the ISDH will administer funding to Local Health Departments through this grant agreement with the intent of further developing capabilities of Healthcare Coalitions and Public Health Districts through three primary projects. This Attachment A contains the guidance and requirements related to this grant for the Local Health Departments.

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Master Services Agreement

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Office Lease Agreement

Appears in 1 contract

Samples: Quantity Purchase Agreement

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Broadband Corridor Access Agreement

Appears in 1 contract

Samples: Grant Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Consulting Contract

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Consulting Agreement

Appears in 1 contract

Samples: Contract #0000000000000000000018225

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Quantity Purchase Agreement for Managed Services Provider (Msp)

Appears in 1 contract

Samples: Contract Amendment

Appears in 1 contract

Samples: Contract for Providing Risk Based Managed Care Services

Appears in 1 contract

Samples: Master Services Agreement

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Professional Services

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts ~~Database~~Databas e: xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency] xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL By: By: Title: President & CEO Title: Vendor Manager Date: 12/22/2021 | 13:30 EST Date: 12/22/2021 | 13:33 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) ~~Xxxxxx X. Xxxxx~~Xxxxxxx Xxxxxxxx, Commissioner ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved by: State Budget Agency By: (for) ~~Xxxxx X.Xxxxxx~~Xxxxxxx X. Xxxxxxx, Director ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved as to Form and ~~Legality~~Legality by: Office of the Attorney General By: (for) ~~Xxxxxx~~ Xxxxxxxx X. ~~Xxxx, Xx.~~Xxxxxx, Attorney General ~~Refer~~ This document is an exhibit to ~~Electronic Approval History found after~~ the ~~final page of~~ Contract, and is deemed to be attached to and incorporated within the ~~Executed~~ Contract by reference. Any inconsistency, conflict, or ambiguity between this exhibit and the Contract shall be resolved by giving precedence and effect to the Contract. This document is an exhibit to the Contract, and is deemed to be attached to and incorporated within the Contract by reference. Any inconsistency, conflict, or ambiguity between this exhibit and the Contract shall be resolved by giving precedence and effect to the Contract. Model Description Retail - MSRP Contract Price B/W CPC Color CPC ESTUDIO478S 50ppm Mono MFP 550 Sheet Drawer - Input Tray 250 Sheet Drawer - Input Tray 550 Sheet Lockable Drawer - Input Tray Inline Stapler $3,861 $274 $178 $343 $343 $1,262$118$88$249$225 $0.0040 KD1061 KD1060 KD1062 MJ1044 GN1170 GB2080LXK GB2090LXK GB2100LXK GB2110LXK GB2120LXK GR1350 GR1360 GB2130LXK GB2140LXK GB2150LXK Mark Net N8372 Wireless Module Forms and Barcode Card PRESCRIBE Card IPDS Card Serial ISP+ SP/BB sidecover Fiber ISP+ CoAtl sp/bb sidecover Keyboard - English - Same as LE Color 508 Keyboard + Voice Guidance Kit Security Module Contact front solutions modules Contactless front solutions module $63 $469 $246 $698 $172 $616 $411 $718 $107 $69 $232 $53$379$199$574$129$498$332$587$87$56$188 GC 1420 256MB User Flash Memory $81 $46 CASTERBASE479CS STAND479CS PWRFLTR-S1 3.5" Caster Base for ~~details~~ES478S, ES389CS/479CS (for taller configurations) 13.5" stand for ES478S, ES389CS/479CS Compact Power Filter, 120V/15A, 1 Reptacle, Non-Networked $299 $399 $112 $248$129$36 ESTUDIO3018A ESTUDIO4518A ESTUDIO5018A 30 PPM DIGITAL MONOCHROME MFP 45 PPM DIGITAL MONOCHROME MFP 50 PPM DIGITAL MONOCHROME MFP 100-Sheet RADF 300-Sheet DSDF (e2018A/2518A/3018A require GC 1410) Platen Cover Inner Finisher Console Finisher w/ Stapling Finisher - Saddle Stitch Bridge Kit (Required with MJ1109B/1110B) Job Separator (eS2018A-3018A) Job Separator (eS3518A-5018A) Hole Punch for MJ1042B Hole Punch (for MJ1109B & MJ1110B) 550 Sheet Paper Feed Pedestal 550-Sheet Drawer Envelope Drawer Module 2000 Sheet Large Capacity Feeder Work Tray Manual Pocket Accessible Arm Next Gen PCS Power Filter, 120V-15 AMPS ESP enVision diagnostic power conditioning system 120/15A power filter & network (2 RECEPT.) Surge 120/15 Standalone Interface Cable for all ESP XG-PCS and EV series Power FiltersStand $11,502 $14,870 $16,522 $1,809 $2,445$51$1,901$2,467$3,667$287$313$313$918$918$1,059$594$594$1,323$60$60$97$1,253$1,298$1,129$893$108$299 $675$775$1,300$198$529$32$190$300$1,107$127$158$158$160$199$127$166$166$125$31$35$56$153$210$113$94$35$85 $0.0032$0.0024$0.002 MR3031B MR4000B KA 5005PC MJ1042B MJ1109B MJ1110B KN5005 MJ5014 MJ5015 MJ6011 MJ6105 KD1058B MY1048B MY1049B KD1059B KK5005 KK5008 KK2550 PWRFLTR-XGPCS15D PWRFLTR-EV12015 PWRFLTR-D5133NT PWRFLTR-D113Z6T PWRFLTR-XGPCSIC1 STAND5005 GN4020 GR9000 GR1330 Wireless LAN/Bluetooth Module (requires GR1310 for e2018A/2518A/30 Bluetooth Keyboard (requires GN4020) Accessory Tray (Keyboard Shelf) $680 $107 $107 $356$55$55 Model Description Retail - MSRP ContractPrice B/W CPC Color CPC GS10 10 GQ12 80 GS10 80 GS10 90 GS10 95 GS10 07 GP10 80 Meta Scan Enabler for e- CONNECT Harness Kit for Coin Controller Embedded OCR Enabler 1 License (requires GC1410 on e2018A/2518A/3 Multi-Station Print Enabler 1 License (requires GC1410 on e2018A/2518A Multi Station Print Enabler 5 LicensesUnicode Font Enabler IPSEC Enabler $566 $90 $837 $211 $751 $729 $863 $316$55$295$91$350$326$578 GB1550N ODE GB1560N ODE GB1590N ODE GB1610N ODE GB2300N ODE GB2310N ODE GB2320NODE e-BRIDGE Replicator eX (Node License) e-BRIDGE Job Point eX (Node License) e-BRIDGE Job Separator eX (Node License) e-BRIDGE Job Build eX (Node License) e-BRIDGE Plus for OneDrive for Business v3.0 e-BRIDGE Plus for Sharepoint Online v3.0e-BRIDGE Plus for Exchange Online v3.0 $99 $99 $99 $99 $99 $99 $99 $42$42$42$42$0$69$69 GD1370N GS1100NODE Fax Unit / 2nd Line Fax Unit Fax Over IP Enabler $1,107$863 $403 $385 ELEVATE2 Elevate Custom Configuration (Per Device) $995 $0 ESTUDIO6518A ESTUDIO751 8A ESTUDIO851 8A 65 PPM Digital Copier w/ DSDF 75 PPM Digital Copier w/ DSDF 85 PPM Digital Copier w/ DSDF 2500 Sheet Large Capacity Feeder 50 Sheet Stapling Finisher Saddle Stitch FinisherHole Punch Unit for MJ1111B& MJ1112B Side Exit Tray Finisher Rail $31,727$37,967$46,680$1,926$3,458$5,289$876$63$91 $2,150$2,600$3,100$266$450$1,353$80$30$55 $0.002$0.002$0.002 MP250 2B MJ111 1B MJ111 2B MJ610 6N KA65 51 KN11 03 GN40 20 GR13 20 GR13 30 GR13 40 GR90 00 GP10 80 T4DT- FB4BTH-P GE1230 GS10 10 GS10 07 GS10 80 GS10 90 GS10 95 Wireless LAN/Bluetooth Module Card Reader Holder Accessory Tray (Keyboard Shelf) Panel 10 Key Option Bluetooth Keyboard (requiresGN4020) IPSEC EnablerElatec TWN4 Mifare NFC-P Card Reader USB Black FIPS HDD Meta Scan Enabler for e- CONNECT Unicode Font EnablerEmbedded OCR Enabler 1 License Multi-Station Print Enabler 1 License Multi- Station Print Enabler 5 Licenses $680 $107 $107 $107 $107 $863 $325 $427 $566 $729 $837 $211 $751 $356$55$55$55$55$578$162$283$316$326$295$91$350 GB1550N ODE GB1560N ODE GB1590N ODE GB1610N ODE GB2300N ODE GB2310N ODE GB2320NODE e-BRIDGE Replicator eX (Node License) e-BRIDGE Job Point eX (Node License) e-BRIDGE Job Separator eX (Node License) e-BRIDGE Job Build eX (Node License) e-BRIDGE Plus for OneDrive forBusiness v3.0 e-BRIDGE Plus for Sharepoint Online v3.0 e-BRIDGE Plus for Exchange Online v3.0 $99 $99 $99 $99 $99 $99 $99 $42$42$42$42$0$69$69 GQ12 80 KK50 08 KK25 50 PWRFLTR- XGPCS20D PWRFLTR- EV12020 PWRFLTR- D5143NT PWRFLTR- D114Z6T PWRFLTR- XGPCSIC1 Coin Controller Harness Kit Manual Pocket Accessible ArmNext Gen PCS Power Filter, 120V-20 AMPSESP enVision Adv Diagnostic 120/20 AMP power filter (2 RECEPT.) Surge 120/20 StandaloneInterface Cable for all ESP XG-PCS and EV series Power Filters $90$60$97$1,267$1,334$1,264$1,017$108 $55$35$56$148$213$116$102$35 FAX OPTIONS Model Description Retail - MSRP ContractPrice B/W CPC Color CPC GD1370N GS1100NODE Fax Unit / 2nd Line Fax UnitFax Over IP Enabler $1,107$863 $403 $385 ELEVATE2 Elevate Custom Configuration (Per Device) $995 $0 ESTUDIO908 90 PPM Digital Copier Bypass Tray For Main Unit A4 LCC A3 LCCRelay Unit For LCT A3 LCT Bypass Tray ForA3 LCT Curl Correction Unit Inserter Relay UnitPaper Folding Unit 100 Staple Finisher 100 Staple Saddle Stitch Finisher Punch Unit For MX-FN21/22 Connection Kit For LCT Status IndicatorPunch Unit For MX- FN24/25 Trimmer Unit For MX-FN22 Stacker Paper Cart for StackerFax Kit (90PPM ONLY) ESP enVision Adv DiagnosticNext GEN PCS Power Filter, 208V/20A, 1 pigtail + 2receptacles, networ Power Filter 208V-20 AMPS Interface Cable for all ESP XG-PCS and EV series Power Filters $38,340$1,588$1,696$3,294$378$7,236$1,588$1,232$4,169$1,232$16,956$8,154$11,578$1,021$2,160$729$935$7,236$25,380$1,944$1,360$1,683$1,637$1,682$108 $8,750$409$823$1,666$134$3,383$1,029$500$2,506$140$10,111$2,800$3,500$650$958$323$554$3,837$17,347$1,323$588$259$199$148$35 $0.002 MX- MFX1 MX- LC12 MX- LCX3N MX- RB16 MX- LC13_N MX- MF11 MX- RB18 MX- CF11 MX- RB13 MX- FD10 MX- FN21 MX- FN22 MX- PN13B MX- RB17 MX- SL10N MX- PNX4B MX- TM10 MX- ST10 MX- CA10 MX- FX15 PWRFLTR- EV20820 PWRFLTR- XGPCS20820D PWRFLTR- E524ZNT PWRFLTR- XGPCSIC1 DIGITAL - COLOR ESTUDIO330AC MY1050 KD1071 MJ1047 PWRFLT R-S1 GR1380 GR1390 STAND4 00 35PPM COLOR MFPPAPER FEED UNIT, 550 SHEETS LARGE CAPACITY FEEDER, 2000 SHEETS OFFLINE STAPLERPOWER FILTER, 120V/15A, COMPACT, 1 RECEPTACLE STAND SPACERCASTER BASE COPIER STAND $4,195 $464 $699 $299 $112 $125 $299 $199 $1,532$234$664$245$36$112$245$129 $0.004 $0.036 GE1230 HARD DISK DRIVE 320GB FIPS $427 $283 GD1370N FAX UNIT / SECOND LINE FAX UNIT $1,107 $403 GB1550N ODE GB1560N ODE GB1590N ODE GB1610N ODE GB2300N ODE GB2310N ODE GB2320NODE E-BRIDGE REPLICATOR EXE- BRIDGE JOB POINT EX E-BRIDGE JOBSEPARATOR EXE- BRIDGE JOB BUILD EX e-BRIDGE Plus for OneDrive for Business v3.0E-BRIDGE PLUS FOR SHAREPOINT ONLINE V3.0E- BRIDGE PLUS FOR EXCHANGE ONLINE V3.0 $99 $99 $99 $99 $99 $99 $99 $42$42$42$42$0$69$69 Model Description B/W CPC Color CPC Retail - MSRP ContractPrice GB2380NO DE GB2390NO DE GB2430NO DE ECTRANS LATE- E-BRIDGE PLUS FOR GMAIL X-X XXXXX PLUS FOR GOOGLE DRIVE E- BRIDGE PLUS FOR DOCUWARE E-C ONNECT TRANSLATE $99 $99 $99 $495 $69$69$69$0 ELEVATE2 ELEVATE CUSTOM CONFIGURATION (PERDEVICE) $995 $0 ESTUDIO301 5AC ESTUDIO451 5AC ESTUDIO5015AC 30 PPM ColorCopier 45 PPMColor Copier 50 PPM Color Copier 100- Sheet RADF 300-Sheet DSDF Platen Cover Inner FinisherConsole Finisher w/ Stapling Finisher - Saddle Stitch Bridge Kit (Required with MJ1109B/1110B) Hole Punch for MJ1042B Hole Punch (for MJ1109B & MJ1110B) Job Separator Work Tray Manual Pocket Accessible Arm 550 Sheet Paper Feed Pedestal 550-Sheet Drawer Envelope Drawer Module2000 Sheet Large Capacity FeederNext Gen PCS Power Filter, 120V-15 AMPS ESP enVision diagnostic power conditioning system 120/15A power filter & network (2 RECEPT.) Surge 120/15 Standalone Interface Cable for all ESP XG-PCS and EV series Power Filters Stand $17,580$27,196$28,341$1,809$2,445$51$1,901$2,467$3,667$287$918$918$313$60$60$97$1,059$594$594$1,323$1,253$1,298$1,129$893$108$299 $1,400$1,900$2,500$198$529$32$190$300$1,107$127$160$199$158$31$35$56$127$166$166$125$153$210$113$94$35$85 $0.0024$0.0024$0.0024 $0.028$0.028$0.028 MR303 1B MR400 0B KA5005 PC MJ1042 B MJ1109 B MJ1110 B KN5005 MJ6011 MJ6105 MJ5015 KK5005 KK5008 KK2550 KD1058 B MY104 8B MY104 9B KD1059 B PWRFLTR- XGPCS15D PWRFLTR- EV12015 PWRFLTR- D5133NT PWRFLTR- D113Z6T PWRFLTR- XGPCSIC1 STAND5005 GN40 20 GR90 00 GR13 30 GR13 40 GR13 10 GR13 20 T4DT- FB4BTH-P XX0000 XX00 00 XX00 00 XX00 80 GS10 90 GS10 95 GS10 07 GP10 80 Wireless LAN/Bluetooth Module Bluetooth Keyboard (requires GN4020) Accessory Tray (Keyboard Shelf) Panel 10 Key Option USB Hub Card Reader HolderElatec TWN4 Mifare NFC-P Card Reader USB Black FIPS HDD Meta Scan Enabler for e- CONNECT Harness Kit for Coin Controller Embedded OCR Enabler 1 License Multi-Station Print Enabler 1 License Multi-Station Print Enabler 5 Licenses Unicode Font Enabler IPSEC Enabler $680 $107 $107 $107 $118 $107 $325 $427 $566 $90 $837 $211 $751 $729 $863 $356$55$55$55$64$55$162$283$316$55$295$91$350$326$578 GB1550N ODE GB1560N ODE GB1590N ODE GB1610N ODE GB2300N ODE GB2310N ODE GB2320N ODE e-BRIDGE Replicator eX (Node License) e-BRIDGE Job Point eX (Node License) e-BRIDGE Job Separator eX (Node License) e-BRIDGE Job Build eX (Node License) e-BRIDGE Plus for OneDrive for Business v3.0 e-BRIDGE Plus for Sharepoint Online v3.0e-BRIDGE Plus for Exchange Online v3.0 $99 $99 $99 $99 $99 $99 $99 $42$42$42$42$0$69$69 GD1370N GS1100NODE Fax Unit / 2nd Line Fax UnitFax Over IP Enabler $1,107$863 $403 $385 ELEVATE2 Elevate Custom Configuration (Per Device) $995 $0 Model Description Retail - MSRP ContractPrice B/W CPC Color CPC ESTUDIO6516 AC ESTUDIO6516 ACT 65PPM Color 75 BK MFP with DSDF 4 Drawer 65PPM Color 75 BK MFP with $42,056 $42,056 $1,926 $4,500$4,500$266 $0.0024$0.0024 $0.028$0.028 MP250 2B MJ111 1B MJ111 2B MJ610 6N KA655 1 KK255 0 KN1103 DSDF Tandem Drawer 2500 Sheet Large Capacity Feeder 50 Sheet StaplingFinisher Saddle Stitch Finisher Hole Punch Unit for MJ1111B& MJ1112B Side Exit Tray Accessible Arm Finisher Rail $3,458$5,289$876$63$97$91 $450$1,353$80$30$56$55 GQ12 80 KK50 08 PWRFLTR- XGPCS20D PWRFLTR- EV12020 PWRFLTR- D5143NT PWRFLTR- D114Z6T PWRFLTR- XGPCSIC1 Coin Controller Harness Kit Manual Pocket Next Gen PCS Power Filter, 120V-20 AMPSESP enVision Adv Diagnostic 120/20 AMP power filter (2RECEPT.) Surge 120/20StandaloneInterface Cable for all ESP XG-PCS and EV series Power Filters $90$60$1,267$1,334$1,264$1,017$108 $55$35$148$213$116$102$35 GN40 20 GR13 20 GR13 30 GR13 40 GR90 00 GP10 80 T4DT- FB4BTH-P GE1230 GS10 10 GS10 07 GS10 80 GS10 90 GS10 95 Wireless LAN/Bluetooth Module Card Reader Holder Accessory Tray (Keyboard Shelf) Panel 10 Key Option Bluetooth Keyboard (requires GN4020) IPSEC Enabler Elatec TWN4 Mifare NFC-P Card Reader USB Black FIPS HDD Meta Scan Enabler for e- CONNECT Unicode Font EnablerEmbedded OCR Enabler 1 License Multi-Station Print Enabler 1 License Multi- Station Print Enabler 5 Licenses $680 $107 $107 $107 $107 $863 $325 $427 $566 $729 $837 $211 $751 $356$55$55$55$55$578$162$283$316$326$295$91$350 GB1550N ODE GB1560N ODE GB1590N ODE GB1610N ODE GB2300N e-BRIDGE Replicator eX (Node License) e-BRIDGE Job Point eX (Node License) e-BRIDGE Job Separator eX (Node License) e-BRIDGE Job Build eX (Node License) e-BRIDGE Plus for OneDrive forBusiness v3.0 e-BRIDGE Plus for Sharepoint Online v3.0 $99 $99 $99 $99 $99 $99 $99 $42$42$42$42$0$69$69 ODE GB2310N ODE GB2320NODE e-BRIDGE Plus for Exchange Online v3.0

Appears in 1 contract

Samples: Professional Services

Appears in 1 contract

Samples: Consulting Contract

Appears in 1 contract

Samples: Broadband Corridor Access Agreement

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Grant Agreement

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this ~~Contract~~ Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this ~~Contract~~ Amendment to the State of Indiana. I understand that my signing and submitting this ~~Contract~~ Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted ~~Contract~~ Amendment and this affirmation. I understand and agree that by electronically signing and submitting this ~~Contract~~ Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this ~~Contract~~ Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ~~xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST~~ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Contractor and the State have, through their duly authorized representatives, entered into this ~~Contract~~Amendment. The parties, having read and understood the foregoing terms of this ~~Contract~~Amendment, do by their respective signatures dated below agree to the terms thereof. ~~[Contractor] [~~By:\s1\ Title:\t1P\resident, Anthem IN Medicaid Title:\t2Me\ dicaid director Date:\d51/\14/2021 | 12:58 EDT Date:\d52/\14/2021 | 13:21 EDT Electronically Approved by: Indiana ~~Agency]~~ Office of Technology By: ~~By: Title: Title: Date: Date:~~ (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved by: State Budget Agency By: (for) ~~Xxxxx X.Xxxxxx~~Xxxxxxx X. Xxxxxxx, Director ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved as to Form and ~~Legality~~Legality by: Office of the Attorney General By: (for) ~~Xxxxxx~~ Xxxxxxxx X. ~~Xxxx, Xx.~~Xxxxxx, Attorney General ~~Refer to Electronic Approval History found after the final page of the Executed Contract~~ 1.0 Background 12 2.0 Managed Care Entity- Contractor Requirements 14 2.1 State Licensure 14 2.2 National Committee for ~~details.~~Quality Assurance (NCQA) Accreditation 14 2.3 Administrative and Organizational Structure 14 2.4 Staffing 15 2.4.1 Key Staff 15 2.4.2 Staff Positions 21 2.4.3 Training 23 2.4.4 Debarred Individuals 24 2.5 FSSA/OMPP Meeting Requirements 25 2.6 Financial Stability 25 2.6.1 Solvency 25 2.6.2 Insurance 26 2.6.3 Reinsurance 26 2.6.4 Financial Accounting Requirements 27

Appears in 1 contract

Samples: Contract

Appears in 1 contract

Samples: Joint Funding Agreement

Appears in 1 contract

Samples: Consulting Agreement

Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this ~~Contract~~ Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this ~~Contract~~ Amendment to the State of Indiana. I understand that my signing and submitting this ~~Contract~~ Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted ~~Contract~~ Amendment and this affirmation. I understand and agree that by electronically signing and submitting this ~~Contract~~ Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this ~~Contract~~ Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: ~~xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof~~xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL By:\s1\ Title:\t1P\resident, ~~Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms~~ Anthem IN Medicaid Title:\t2M\edicaid director Date:\d51/\14/2021 | 12:56 EDT Date:\d52/\14/2021 | 13:22 EDT Electronically Approved by: Indiana Office of ~~this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency]~~ Technology By: ~~By: Title: Title: Date: Date:~~ (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved by: State Budget Agency By: (for) ~~Xxxxx X.Xxxxxx~~Xxxxxxx X. Xxxxxxx, Director ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~ Electronically Approved as to Form and ~~Legality~~Legality by: Office of the Attorney General By: (for) ~~Xxxxxx~~ Xxxxxxxx X. ~~Xxxx, Xx.~~Xxxxxx, Attorney General ~~Refer to Electronic Approval History found after the final page of the Executed Contract for details.~~1.0 Background 10 2.0 Managed Care Entity- Contractor Requirements 11