CONTACT FOR NOTIFICATION. All notices required or desired to be sent by either Party shall be sent to the persons listed below. DHS CONTACT PROVIDER CONTACT Name: Name: Title: Title: Address: Address: Phone: Phone: TTY#: TTY #: Fax#: Fax #: E-mail Address: E-mail Address: Agreement No. EXHIBIT E PERFORMANCE MEASURES Agreement No. EXHIBIT F PERFORMANCE STANDARDS Agreement No. EXHIBIT G STATE AGENCY CONTRACTS For each contract or other agreement to which Provider is a party with any other State agency, state:
Appears in 3 contracts
Samples: Community Services Agreement, Community Services Agreement, Community Services Agreement
CONTACT FOR NOTIFICATION. All notices required or desired to be sent by either Party shall be sent to the persons listed below. DHS CONTACT PROVIDER CONTACT Name: Name: _ Title: Title: Address: Address: Phone: Phone: _ TTY#: TTY #: Fax#: _ Fax #: _ E-mail Address: _ _ E-mail Address: _ Agreement No. EXHIBIT E PERFORMANCE MEASURES Agreement No. EXHIBIT F PERFORMANCE STANDARDS Agreement No. EXHIBIT G STATE AGENCY CONTRACTS For each contract or other agreement to which Provider is a party with any other State agency, state:
Appears in 1 contract
Samples: Community Services Agreement
CONTACT FOR NOTIFICATION. All notices required or desired to be sent by either Party shall be sent to the persons listed below. DHS CONTACT PROVIDER CONTACT Name: Name: Title: Title: Address: Address: Phone: Phone: TTY#: TTY #: Fax#: Fax #: E-mail E‐mail Address: E-mail E‐mail Address: Agreement No. EXHIBIT E PERFORMANCE MEASURES Agreement No. EXHIBIT F PERFORMANCE STANDARDS Agreement No. EXHIBIT G STATE AGENCY CONTRACTS For each contract or other agreement to which Provider is a party with any other State agency, state:
Appears in 1 contract
Samples: Community Services Agreement
CONTACT FOR NOTIFICATION. All notices required or desired to be sent by either Party shall be sent to the persons listed below. DHS CONTACT PROVIDER CONTACT Name: Title: Address: Phone: Name: Title: Title: Address: Address: Phone: Phone: TTY#: TTY #: Fax#: Fax #: E-mail Address: Fax #: E-mail Address: Agreement No. EXHIBIT E PERFORMANCE MEASURES Agreement No. EXHIBIT F PERFORMANCE STANDARDS Agreement No. EXHIBIT G STATE AGENCY CONTRACTS For each contract or other agreement to which Provider is a party with any other State agency, state:
Appears in 1 contract
Samples: Community Services Agreement