Common use of Annual Reporting Template Clause in Contracts

Annual Reporting Template. The following document is the template that must be used for the submission of your Facility's Annual Report. The information requested in the template below pertains only to the insured Services provided in your Facility under contract with AHS from July 1, 2019 until June 30, 2024. Name of Facility: Facility Address: Surgical Specialty Number of procedures performed [year], by category Enhanced Medical Goods & Services Please provide a list and statement of revenues for all enhanced medical goods and services provided by your Facility.

Annual Reporting Template. The following document is the template that must be used for the submission of your Facility's Annual Report. The information requested in the template below pertains only to the insured Services provided in your Facility under contract with AHS from July 1, 2019 until June 30, 2024. Name of Facility: Facility Address: Surgical Specialty Number of procedures performed [year], by category Enhanced Medical Goods & Services Please provide a list and statement of revenues for all enhanced medical goods and services provided by your FacilityApril 1st 2012 to March 31st 2017.

Annual Reporting Template. The following document is the template that must be used for the submission of your Facility's Annual Report. The information requested in the template below pertains only to the insured Services provided in your Facility under contract with AHS from July January 1, 2019 2020 until June 30, 2024. Name of Facility: Facility Address: Surgical Specialty Number of procedures performed [year], by category Enhanced Medical Goods & Services Please provide a list and statement of revenues for all enhanced medical goods and services provided by your Facility.

Annual Reporting Template. The following document is the template that must be used for the submission of your Facility's Annual Report. The information requested in the template below pertains only to the insured Services provided in your Facility under contract with AHS from July 1, 2019 until June 30, 20242013. Name of Facility: Facility Address: Surgical Specialty Number of procedures performed [year], by category Enhanced Medical Goods & Services Please provide a list and statement of revenues for all enhanced medical goods and services provided by your Facility.