Payment (Electronic Funds Transfer. County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e-mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract.
Payment (Electronic Funds Transfer. (EFT): The County of Orange offers contractors the option of receiving payment directly to their bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT will also receive an Electronic Remittance Advice with the payment details via e-mail. An e-mail address will need to be provided to the County of Orange via an EFT Authorization Form. To request a form, please contact the agency/department represetative listed in the contract. Upon completion of the form, please mail, fax or email to the address of phone listed on the form.
Payment (Electronic Funds Transfer. County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e- mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract. Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form- LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
Payment (Electronic Funds Transfer. INVOICING INSTRUCTIONS County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e-mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract.
1. Invoices and all supporting documentation shall be submitted to County’s Project Manager as follows: County of Orange Health Care Agency/Accounts Payable PO Box 689 Santa Ana, CA 92702 2 Contractor shall provide a two-part invoice on Contractor’s letterhead for services rendered. Each invoice shall have a number and shall include the following information:
a. Contractor’s name and address, and remittance address (if different)
b. Contractor’s Tax Identification Number or Employer’s Identification Number
c. County agency name and service address
Payment (Electronic Funds Transfer. INVOICING INSTRUCTIONS County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e-mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract.
1. Invoices for HCA-PG and all supporting documentation shall be submitted as follows: County of Orange Health Care Agency Attn: Accounts Payable PO Box 689 Santa Ana, CA 92702 County of Orange Health Care Agency Page 31 Contract MA-042-17011420 Invoice for DA-PA and all supporting documentation shall be submitted as follows: County of Orange Office of the District Attorney Attn: Accounts Payable PO Box 808 Santa Ana, CA 92702
2. Contractor shall provide a two-part invoice on Contractor’s letterhead for services rendered. Each invoice shall have a number and shall include the following information:
Payment (Electronic Funds Transfer. INVOICING INSTRUCTIONS County offers contractors the option of receiving payment directly to their bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT will also receive an Electronic Remittance Advice with the payment details via e-mail. An e-mail address will need to be provided to County via an EFT Authorization Form. To request a form, please contact the agency/department representative listed in the Contract.
1. Invoices and all supporting documentation shall be submitted to: HEALTH CARE AGENCY: ACCOUNTS PAYABLE X.X. XXX 000 XXXXX XXX, XX 00000-0000 2 Contractor shall provide a two-part invoice on Contractor’s letterhead for goods delivered and/or services rendered. In the case of goods, Contractor shall leave an invoice with each delivery. Each invoice shall have a number and shall include the following information:
a. Contractor’s Name and Address
b. Contractor’s Remittance Address, if different from a, above
c. Contractor’s Tax Identification Number(TIN) or Employer’s Identification Number (EIN)
d. Name of County Agency
e. Delivery/Service Address
f. Master Agreement Number MA-042-18010431 g. Description of Services;
Payment (Electronic Funds Transfer. County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e- mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in County of Orange MA-042-21011330 Health Care Agency Page 34 of 49 Folder No. C032752 Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form- LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each s...
Payment (Electronic Funds Transfer. County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e- mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract. ATTACHMENT C C-1 C-2 New Provider (on-boarding) $225/ Each Established Providers (Maintenance & Recredentialing) $135/ Each Background Checks (as needed and mutually agreed upon within the scope of the fixed price) Not to Exceed $40/each and an associated processing fee not to exceed $10 Description of Service Fees Aug. 15, 2022 – Aug. 14. 2023 Aug. 15, 2023 – Aug. 14. 2024 New Provider (on-boarding) $233/each $241/each Established Providers (Maintenance and credentialing) $12/provider/monthly $13/provider/monthly Background Checks (as needed and mutually agreed upon with the scope of the fixed price) Not to exceed $40/each and an associated processing fee not to exceed $10 Per the Scope of work as defined in this agreement and for the volume of approximately 2,000 credentialed providers.
Payment (Electronic Funds Transfer. County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e- mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract. County of Orange MA-042-20012181 Health Care Agency Page 42 of 65 Folder No. C025988 Contract execution provisional payment Provision of environment, delivery of access (including user names and passwords) to the baseline product with CA specific configurations for state ordinance and mandated programs (ie: food, HazMat) $170,550 September 2020 - JAD sessions (onsite, unless prohibited by federal, state or local travel restrictions related to COVID-19), County specific data requirements and configuration work complete and delivered to County for sign off Deliverable package to include data fields map and elements, workflows, and initial business logic requirements for (Food, Public Pools, Hazardous Materials program, Ocean Water Quality, Massage program Solid Waste program) that come out of the JAD sessions with County SME’s and department heads. Upon signoff, HealthSpace (HS) will proceed to make the modifications to HS Cloud Suite $28,425 November 2020 - Configurations made- per workflow and configuration Specific changes and configurations to product as result of specifications from prior deliverable, meetings in product and delivered for testing to County. $47,375 December 2020 – Initial data conversion performed and delivered to County for testing Data converted from legacy data source Envision Connect and available in HS Cloud Suite for the programs included in this Contract. HS will provide UAT (user acceptance testing) scripts for data validation, user testing, and verification in HS Cloud Suite for signoff. $37,900 January 2021 – Final configuration changes, if required and requested by County Any additional configuration changes, including modifications to data fields and workflows, as a result of the previous deliverable testing. All changes will be available in production environment for testing in HS Cloud Suite $18,950 February/March 2021 – User Acceptance testing complete HS will deliver full UAT scripts and scenario testing for users to use to validate system ready for go-live $37,900 March/April 2...
Payment (Electronic Funds Transfer. County offers Contractor the option of receiving payment directly to its bank account via an Electronic Fund Transfer (EFT) process in lieu of a check payment. Payment made via EFT shall also receive an Electronic Remittance Advice with the payment details via e- mail. An e-mail address shall need to be provided to County via an EFT Authorization Form. Contractor may request a form from the agency/department representative listed in the Contract. County of Orange MA-042-21010747 Health Care Agency Page 30 of 42 Folder No. C029259 Declaration of Restrictive Covenant RECORDED AT REQUEST OF, AND RETURN TO: County of Orange/OC Health Care Agency Office of Care Coordination 000 X. 0xx Xx. Xxxxx 000 Xxxxx Xxx, XX 00000 Attention: Program Manager EXEMPT RECORDING REQUEST _
