Participant Information My address is: My Social Security Number is:
Sharing of Participant Information 20 7.4 REPORTING AND DISCLOSURE AND COMMUNICATIONS TO PARTICIPANTS..................................................20 7.5 NON-TERMINATION OF EMPLOYMENT; NO THIRD-PARTY BENEFICIARIES.................................................20 7.6
Grant Information The attached Budget contains the Grant Information. PEI may use a Notice of Award to announce, modify, or clarify the annual Grant budget, source of funding, Performance Measures, Quality Incentive Project (QIP) terms, or other Grant requirements.
Tenant Information Every Tenant who shall pay rent in exchange for the right to access and occupy the premises through this agreement must be identified with an entry of each one’s name and formal mailing address. II. Lease Type [Choose Option 4 Or Option 5] (4) Fixed Lease Option. Many written leases will be in effect for one year or longer and carry the condition of terminating only upon a certain date. If this agreement will operate under such conditions then, xxxx the checkbox “Fixed Lease.” After choosing this checkbox, the statement attached to it must be supplied with the first calendar date when the Tenant may occupy the premises as well as the final calendar date of his or her occupancy. If neither Party wishes to commit to the terms of this agreement for a predetermined period of time then, continue to review the next option.
APPLICANT INFORMATION We are a child safe and equal opportunity employer. Applications from Aboriginal and Xxxxxx Xxxxxx Islander people, people with a disability and people from culturally and linguistically diverse backgrounds are encouraged. In addition, applications for positions that work with children must provide referees who can comment on their experience working with children. These roles also require a valid
Other Important Information Collection costs
Other Relevant Information This information shall always be in writing and shall address other relevant information as required by the contract or requested by the RFP. For example, in accordance with Section H, H106, Avoidance of Organizational Conflicts of Interest, identifying any situation in which the potential for a conflict of interest exists. If travel is specified in the TO PWS or statement of work, air fare and/or local mileage, per diem rates by total days, number of trips and number of contractor employees traveling shall be included in the cost proposal (see clause H047).
Disclosure of Account Information to Third Parties We will disclose information to third parties about your account or the transfers you make:
Compensation for Providing Information The Party requesting Information agrees to reimburse the other Party for the reasonable out-of-pocket costs, if any, of creating, gathering and copying such Information, to the extent that such costs are incurred for the benefit of the requesting Party.
ADDITIONAL GRANT INFORMATION DSHS Data Universal Numbering System (DUNS) Number: 807391511 Federal Award Identification Number (XXXX): NU50CK000501 Catalog of Federal Domestic Assistance (CFDA) Name and Number (list all that apply): Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) – 93.323 Federal Award Date: April 23, 2020 Name of Federal Awarding Agency: Centers for Disease Control and Prevention Awarding Official Contact Information: Xxxxxxx Xxxxxxxx-Xxxx, Grants Management Officer 0000 Xxxxxxx Xxxx – Mailstop TV2 Atlanta, GA 00000-0000 Phone: 000-000-0000 SIGNATURE PAGE FOLLOWS SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT NO. HHS000812700039 SYSTEM AGENCY GRANTEE Signature Printed Name: Xxxxxxxx Xxxx Printed Name: Signature Emi1y Everekke Title: _Deputy Commissioner Program Direckor Date of Execution: September 3, 2020 Date of Execution: Augusk 31, 2020 THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT NO. HHS000812700039 ARE INCORPORATED BY REFERENCE: ATTACHMENT A - STATEMENT OF WORK ATTACHMENT B - BUDGET ATTACHMENT C - UNIFORM TERMS AND CONDITIONS - GRANT ATTACHMENT D - SUPPLEMENTAL AND SPECIAL CONDITIONS ATTACHMENT E - FEDERAL ASSURANCES NON-CONSTRUCTION ATTACHMENT F - CERTIFICATION REGARDING LOBBYING ATTACHMENT G - FFATA ATTACHMENT H - HHS DATA USE AGREEMENT ATTACHMENT I - SECURITY AND PRIVACY INQUIRY (SPI) ATTACHMENTS FOLLOW I. GRANTEE RESPONSIBILITIES Grantee will: A. Enhance laboratory testing and reporting capacity: 1. Establish or expand capacity to test all symptomatic individuals, and secondarily expand capacity to achieve community-based surveillance. This capacity would entail increasing testing capabilities above the current number of specimens that can be tested at the jurisdiction’s public health laboratory or by establishing new testing capabilities at the jurisdiction’s laboratory. 2. Screen for past infection (e.g., serology) for health care workers, employees of high-risk facilities, critical infrastructure workforce, and childcare providers. 3. Obtain all jurisdictional laboratory test data electronically, including from new, non-traditional testing settings, and using alternative file formats (e.g., .csv or .xls) to help automate. In addition to other reportable results, this should include all COVID-19 – related testing data, including all tests to detect severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2) and serology testing. 4. Report all COVID-19 – related line level testing data (negatives, positives, indeterminants, serology) daily to DSHS. Data must meet new federal Coronavirus AID, Relief, and Economic Security (CARES) Act laboratory guidance. All public health data must be reported electronically to DSHS in compliance with the Texas Administrative Code and within appropriate reporting timeframes. B. Submit a monthly report on the report template to be provided by the DSHS. Monthly reports are due on or before the 15th of each month. Each report must contain a summary of activities that occurred during the preceding month for each activity listed above in Section I A, 1-4. Submit monthly reports by electronic mail to XXXXX.Xxxxxxxxx@xxxx.xxxxx.xxx. The email “Subject Line” and the name of the attached file for all reports should be clearly identified with the Grantee’s Name, Contract Number, IDCU/COVID and the month the report covers. C. May use funds to pay pre-award costs which date back to January 20, 2020, that are directly related to the COVID-19 outbreak response. All pre-award costs must be approved in writing by DSHS. D. Not use funds for research, clinical care, fund raising activities, construction or major renovations, to supplant existing state or federal funds for activities, or funding an award to another party or provider who is ineligible. Other than normal and recognized executive-legislative relationships, no funds may be used for: 1. Publicity or propaganda purposes, for the preparation, distribution, or use of any material designed to support or defeat the enactment of legislation before any legislative body; 2. The salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative act or Executive order proposed or pending before any legislative body.
