Electronic Visit Verification ("EVV A. To ensure: 1. the EVV system is used to verify the provision of services governed under 40 TAC, Chapter 68 or its successor; 2. only authorized people access the Contractor's EVV account; 3. all data elements required by HHSC or HHSC's designee are uploaded or entered and maintained in the EVV system completely, accurately, and prior to submitting the claim; 4. that each time services governed by 40 TAC Chapter 68 or its successor are delivered to an individual, the Contractor's staff uses an HHSC-approved EVV system; and 5. service delivery documentation is immediately available for review by HHSC when requested. B. Equipment provided to Contractor by HHSC, HHSC’s designee, or an HHSC-approved EVV vendor, must be returned in good condition when the equipment is no longer needed under this Contract. In the context of this agreement, “good condition” means Contractor must not place any marks or identifying information on the equipment and may not alter information on the equipment including logos and serial numbers. If the equipment is lost, stolen, marked, altered or damaged by Contractor, Contractor may be required to pay the replacement cost for each piece of equipment that is lost, stolen, marked or damaged. Replacement costs for lost, stolen, marked or damaged equipment may be assessed periodically. If Contractor recovers previously lost or stolen equipment for which Contractor paid the replacement cost in the prior 12 months, Contractor may return the equipment and be reimbursed for the replacement costs within 12 months of the date HHSC, HHSC’s designee or an HHSC-approved EVV vendor (as applicable) received payment in full from the Contractor. This is provided the equipment is returned in good condition as specified above. C. HHSC may perform EVV compliance oversight reviews to determine if Contractor has complied with EVV compliance requirements as outlined in 40 TAC Chapter 68 or its successor, EVV Policy posted on the HHSC EVV website or EVV Policy Handbook. D. If the Contractor determines an electronic record in the EVV system needs to be adjusted at any time, the Contractor will make the adjustment in the EVV system using the most appropriate EVV reason code number(s), EVV reason code description(s) and enter any required free text when completing visit maintenance in the EVV system, if applicable. E. Contractor must begin using an HHSC-approved EVV system prior to submitting an EVV relevant claim. F. All claims for services required to use EVV (EVV claims) must match to an accepted EVV visit transaction in the EVV Aggregator (the state’s centralized EVV database) prior to reimbursement of an EVV claim. Without a matching accepted EVV visit transaction, the claim will be denied. G. Contractor must submit all EVV related claims through the Texas Medicaid Claims Administrator, or as otherwise described in the EVV Policy posted on the HHSC EVV website or in the EVV Policy Handbook. H. Contractor must complete all required EVV training as outlined in the EVV Policy posted on the HHSC EVV website or EVV Policy Handbook: • Prior to using either an EVV vendor system or an EVV proprietary system and • Yearly thereafter. I. Contractor and, if applicable, the Contractor’s appointed EVV system administrator, must complete, sign and date the EVV Onboarding Form as outlined in 40 TAC Chapter 68 or its successor, EVV Policy posted on the HHSC website or EVV Policy Handbook.
Instructions for Operators This agreement is intended to be provided to an Operator from a LEA. The Operator should fully read the agreement and is requested to complete the below areas of the agreement. Once the Operator accepts the terms of the agreement, the Operator should wet sign the agreement and return it to the LEA. Once the LEA signs the agreement, the LEA should provide a signed copy of the agreement to the Operator. Cover Page Box # 3 Official Name of Operator Cover Page Box # 4 Date Signed by Operator Recitals Box #5 Contract Title for Service Agreement Recitals Box #6 Date of Service Agreement Article 7 Boxes #7-10 Operator’s designated representative Signature Page Boxes #15-19 Authorized Operator’s representative signature Exhibit A Box #25 Description of services provided Exhibit B All Applicable Boxes Operator notates if data is collected to provide the described services. Defines the schedule of data required for the Operator to provide the services outlined in Exhibit A Exhibit D All Applicable Boxes (Optional Exhibit): Defines deletion or return of data expectations by LEA Exhibit E All Applicable Boxes (Optional Exhibit): Operator may, by signing the Form of General Offer of Privacy Terms (General Offer, attached as Exhibit E), be bound by the terms of this DPA to any other Subscribing LEA who signs the acceptance in said Exhibit. Exhibit F Boxes # 25-29 A list of all Subprocessors used by the Operator to perform functions pursuant to the Service Agreement, list security programs and measures, list Operator’s security measures
Requirements for E- Bidders 3.1. For Individual/ Joint E-Bidders, the following documents shall be uploaded during online registration; 3.1.1. Copy of Identification Documents (both sides) 3.1.2. Evidence of deposit payment 3.2. For Agent acting for Individual/ Joint Online Bidders, the following documents shall be uploaded during online registration; 3.2.1. Copy of Identification Documents (both sides) of Individual/ Joint Online Bidder 3.2.2. Copy of Identification Documents (both sides) of Agent 3.2.3. Copy of letter of authorization to bid 3.2.4. Evidence of deposit payment 3.3. For Company, the following documents shall be uploaded during online registration: 3.3.1. Copy of Identification Documents (both sides) of the representative. 3.3.2. Copy of letter of authorization to bid under the Company’s Letter Head 3.3.3. Form 24; Form 44; Form 49 (or their equivalent forms under the Companies Act 2016)
Drug-Free Workplace Certification As required by Executive Order No. 90-5 dated April 12, 1990, issued by the Governor of Indiana, the Company hereby covenants and agrees to make a good faith effort to provide and maintain a drug-free workplace at the Project Location. The Company will give written notice to the IEDC within ten (10) days after receiving actual notice that the Company, or an employee of the Company in the State of Indiana, has been convicted of a criminal drug violation occurring in the workplace. False certification or violation of this certification may result in sanctions including, but not limited to, suspension of payments under the Agreement, termination of the Agreement and/or debarment of contracting opportunities with the State for up to three (3) years. In addition to the provisions of the above paragraph, if the total amount set forth in the Agreement is in excess of $25,000.00, the Company agrees that it will provide a drug-free workplace by: A. Publishing and providing to all of its employees a statement notifying them that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Company’s workplace, and specifying the actions that will be taken against employees for violations of such prohibition;
Minimum Customer Support Requirements for TIPS Sales Vendor shall provide timely and commercially reasonable support for TIPS Sales or as agreed to in the applicable Supplemental Agreement.
Mail Order Catalog Warnings In the event that, the Settling Entity prints new catalogs and sells units of the Products via mail order through such catalogs to California consumers or through its customers, the Settling Entity shall provide a warning for each unit of such Product both on the label in accordance with subsection 2.4 above, and in the catalog in a manner that clearly associates the warning with the specific Product being purchased. Any warning provided in a mail order catalog shall be in the same type size or larger than other consumer information conveyed for such Product within the catalog and shall be located on the same display page of the item. The catalog warning may use the Short-Form Warning content described in subsection 2.3(b) if the language provided on the Product label also uses the Short-Form Warning.
Attachment C_ CONTRACT AFFIRMATIONS For purposes of these Contract Affirmations, HHS includes both the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). System Agency refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract Affirmations apply to all Contractors and Grantees (referred to as “Contractor”) regardless of their business form (e.g., individual, partnership, corporation). By entering into this Contract, Contractor affirms, without exception, understands, and agrees to comply with the following items through the life of the Contract:
CONDITIONS FOR EMERGENCY/HURRICANE OR DISASTER - TERM CONTRACTS It is hereby made a part of this Invitation for Bids that before, during and after a public emergency, disaster, hurricane, flood, or other acts of God that Orange County shall require a “first priority” basis for goods and services. It is vital and imperative that the majority of citizens are protected from any emergency situation which threatens public health and safety, as determined by the County. Contractor agrees to rent/sell/lease all goods and services to the County or other governmental entities as opposed to a private citizen, on a first priority basis. The County expects to pay contractual prices for all goods or services required during an emergency situation. Contractor shall furnish a twenty-four (24) hour phone number in the event of such an emergency.
Inspection Checklist (Check one)
Court Ordered Requests for Call Detail Records and Other Subscriber Information 7.1 To the extent technically feasible, BellSouth maintains call detail records for Mpower end users for limited time periods and can respond to subpoenas and court ordered requests for this information. BellSouth shall maintain such information for Mpower end users for the same length of time it maintains such information for its own end users. 7.2 Mpower agrees that BellSouth will respond to subpoenas and court ordered requests delivered directly to BellSouth for the purpose of providing call detail records when the targeted telephone numbers belong to Mpower end users. Billing for such requests will be generated by BellSouth and directed to the law enforcement agency initiating the request. 7.3 Where BellSouth is providing to Mpower telecommunications services for resale or providing to Mpower the local switching function, then Mpower agrees that in those cases where Mpower receives subpoenas or court ordered requests regarding targeted telephone numbers belonging to Mpower end users, if Mpower does not have the requested information, Mpower will advise the law enforcement agency initiating the request to redirect the subpoena or court ordered request to BellSouth. Where the request has been forwarded to BellSouth, billing for call detail information will be generated by BellSouth and directed to the law enforcement agency initiating the request. 7.4 In all other instances, Mpower will provide Mpower end user and/or other customer information that is available to Mpower in response to subpoenas and court orders for their own customer records. When BellSouth receives subpoenas or court ordered requests regarding targeted telephone numbers belonging to Mpower end users, BellSouth will advise the law enforcement agency initiating the request to redirect the subpoena or court ordered request to Mpower.
