Department of Justice Xxxx X. Xxxxxxx Student Loan Repayment Program (JRJSLRP) Service Agreement – Secondary Term of Service NAME: In consideration of the student loan repayment incentive for which I may qualify under 34 U.S.C. §10671, such incentive having been offered above and beyond the incentive(s) from which I have already benefitted from in exchange for a term of service that I have fulfilled, I hereby agree as follows:
Office of Justice Programs The Provider must report suspected fraud, waste and abuse to the OAG’s Office of the Inspector General at 000-000-0000.
COMMISSIONER OF ADMINISTRATION As delegated to Office of State Procurement Print Name: Xxxxxxxxx Xxxx Signature: Original signed Title: Contracts Specialist Date: 7/7/2017 Attachment A – Work Plan Contractor shall hire, train, and make available qualified personnel to perform and administer vocational rehabilitation services. Contractor shall conduct background checks using primary sources on all personnel authorized to provide direct services or transport persons served under this contract. When transportation is provided for persons served under this contract, Contractor shall maintain current records of driving licenses and satisfactory driving history of drivers. Contractor shall provide for the integrity and security of its information assets including, but not limited to, each automated system, electronic file, database or paper file, by establishing appropriate internal policies and procedures for preserving the integrity and security of the personal information of individuals served. Contractor shall work collaboratively as part of the team with VRS staff in providing services that are part of the person’s served Employment Plan. Contractor shall develop and share detailed written information outlining the procedure for notifying VRS and the person or their guardian regarding their acceptance for services listed in Attachment B, Fee-for-Service Rate Schedule. The written information, at a minimum, should include: (a) start date notification, (b) intake process and location, (c) orientation to the Contractor, (d) service planning and delivery, (e) monitoring of service provided, (f) communication and progress reports, (g) service exit or termination. Contractor shall provide the most effective mode(s) of communication to all populations without charge to VRS or persons served. Contractor shall provide Interpreter services for all services in Attachment B, Fee-for-Service Rate Schedule, and Performance Based Agreement (PBA) for Placement and Retention Services as referenced at xxxxx://xx.xxx/deed/job- seekers/disabilities/partners/. Contractor is responsible for all necessary interpreting costs. Contractors need to notify VRS on the same day that the scheduled service(s) is cancelled in order to receive the cancellation fee. Documentation (phone calls, emails, report writing, case notes) time is built into the fee structure and rates, therefore is not billable. VRS expects all documentation be provided in accessible format whenever possible. Attachment B – Fee-for-Service Rate Schedule Contractor: Northern Opportunity Works SWIFT #:0000000000 Referral Contact(s) and phone number(s): Xxxxxx Xxxxx 218-326-5114 Effective Date: 7/7/2017 Service Title Fee Unit Placement and Retention Services under a Performance Based Agreement (PBA) See Performance Based Agreement (PBA) for Placement and Retention Services as referenced at xxxxx://xx.xxx/deed/job- seekers/disabilities/partners/ Yes No Benefits Counseling/Benefits Analysis $72/$850 Hour/Each Intake (Not Applicable to PBA) $85 Each Job Shadowing $72 Hour Job Tryout $72 Hour Attachment C Security and Data Protection Contractor is responsible for the security and protection of State data subject to and related to Cloud Services in this Contract. The terms, conditions, and provisions of this Security and Data Protection section take precedence and will prevail over any other terms, conditions, and provisions of the Contract, if in conflict. This Security and Data Protection section, including its sub-sections, survives the completion, termination, expiration, or cancellation of the Contract. For the purposes of this Security and Data Protection section, the following terms have the following meanings:
REGISTRATION WITH DEPARTMENT OF REVENUE The CONTRACTOR shall complete registration with the Washington State Department of Revenue and be responsible for payment of all taxes due on payments made under this contract.
Department of Health and Human Services An employee notified of a positive controlled substance or alcohol test result may request an independent test of their split sample at the employee’s expense. If the test result is negative, the Employer will reimburse the employee for the cost of the split sample test. An employee who has a positive alcohol test and/or a positive controlled substance test may be subject to disciplinary action, up to and including dismissal, based on the incident that prompted the testing, including a violation of the drug and alcohol free work place rules.
