CONTRACT NAME The name of this contract is Prepaid Mental Health Plan - Four Corners Community Behavioral Health Inc.
Scope of Supply 12.1 The Goods and Related Services to be supplied shall be as specified in the Schedule of Requirements.
Purchase Order Contact Name Purchase Order Contact Name. This person is responsible for receiving Purchase Orders from TIPS. Xxxxx Xxxxxx Purchase Order Contact Email Purchase Order Contact Email xxxxx@xxxxxxxxxx.xxx 2 3
Name of Xxxxx(s) 2. The named person's role in the firm, and
Contractor Name Business License #: Address: City, State, Zip Code: Telephone: Facsimile: Email: * If you are an independent contractor you are required to obtain a business license with the City of Thousand Oaks. Contractor certifies under penalty of perjury that Contractor is a Sole Proprietor Corporation Limited Liability Company Partnership Nonprofit Corporation Other [describe: ]
Project Name Register ASIC
COMPANY NAME The Members may change the name of the Company or operate under different names, provided a majority of the Members agree and the name complies with Section 00-00-000 of the Act.
Purchase Order and Sales Contact Name Please identify the individual who will be responsible for receiving and processing purchase orders and sales under the TIPS Contract.
Contract Number All purchase orders issued by purchasing entities within the jurisdiction of this Addendum shall include the Participating State Addendum Number: 46151504-NASPO-17-ACS. This Addendum and Master Agreement number RFP-NK-15-001 (administered by the State of Colorado) together with its exhibits, set forth the entire agreement between the Parties with respect to the subject matter of all previous communications, representations or agreements, whether oral or written, with respect to the subject matter hereof. Terms and conditions inconsistent with, contrary or in addition to the terms and conditions of this Addendum and the Contract, together with its exhibits, shall not be added to or incorporated into this Addendum or the Contract and its exhibits, by any subsequent purchase order or otherwise, and any such attempts to add or incorporate such terms and conditions are hereby rejected. The terms and conditions of this Addendum and the Contract and its exhibits shall prevail and govern in the case of any such inconsistent or additional terms within the Participating State.
FULL NAME OF AGREEMENT The full name of this Agreement is the PDL NPDL/PFLG Slot Charter Agreement ("Agreement").