Provider Telephone Number. Street Address Fax Number City, State, Zip code E-mail Address Tax Identification or Social Security Number License Number (if applicable)
Provider Telephone Number. Street Address Fax Number City, State, Zip code E-mail Address Tax Identification or Social Security Number License Number (if applicable) Type of Business Individual Sole Proprietorship Partnership Corporation Other
Provider Telephone Number. 2.1.1.9 Plan ID Card The plan ID card must include the following: (1) The Contractor’s name; (2) The Contractor’s address; and (3) The Contractor’s member services telephone number.
Provider Telephone Number. E.The contractor shall assure that appropriate non-English language versions of all materials are developed and available to members and potential members. The contractor shall provide interpreter services in person where practical, but otherwise by telephone, for applicants or members whose primary language is not English. Non-English versions of materials are required if, as provided annually by the Agency, the population speaking a non-English language in a county is greater than five (5) percent.
Provider Telephone Number. Mailing Address Fax Number City, State, Zip code E-mail Address Tax Identification or Social Security Number Business License Number (if applicable) Definitions. For this Agreement, the following definitions apply:
Provider Telephone Number. Provider Email Address Contact Details (optional) If you complete this section, it authorises South Gloucestershire to publish your contact details on our website. This will help parents identify providers in their local area. Please x if you agree to any of them being displayed. Address ☐ Phone Number ☐ Email Address ☐ Type of Establishment (please indicate) Provider Sector (please put a cross on one only) Childminder Agency Registered Charity (Charity Commission Registration Number): Private Provider Committee led, not for profit Organisation (Name of Organisation): Voluntary Managed Committee Partnership (Name of Partners): Maintained School Nursery Other (Please Describe) Governor Run Independent School Academy Provision Offered 2022/23 academic year (Optional). If you complete this section it authorises South Gloucestershire to publish the details of the provision you are offering on our website. This will help parents identify providers that will meet there needs. Provision Offered 2022/23 academic year (Compulsory). Providers will also be responsible for keeping their information in compulsory fields on the Portal up to date as further releases of the Portal become available. Please put a cross against each type of provision offered 2 Year Old Free Childcare 15 Hours 3 Year Old Universal Childcare 15 Hours 3 Year Old Extended Childcare 15 Hours Tax Free Childcare Day Care Type (e.g. Day Nursery) Please provide your OFSTED Registration Number (URN): If applicable. This does not apply to childcare providers who are exempt from registration Please complete and return Section 22 pages 26 and 27 of the Provider Agreement to the NEF Central Finance Team: South Gloucestershire Council Chief Executive and Corporate Resources Finance & Customer Services Nursery Education Funding PO Box 1953 Bristol BS37 0DB Or print and scan to: xxxxxxxxxxxxxx@xxxxxxxxx.xxx.xx The person authorised to sign for your establishment must sign the following declaration: • I certify that this provision conforms to all the conditions of eligibility for registration for 2022/23 and that this provider will ensure all elements are met • I have read carefully the various documents referred to in this Agreement • I agree to the terms and conditions in the Provider Agreement 2022/23 • I understand that, as a provider, if we fail to meet the conditions set, the Council will withdraw funding and require the repayment of the whole or part of any funding we have been paid in respect of the p...
Provider Telephone Number. The provider directory must list the providers sorted by individual counties and by services.
