Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Contractor (rev. 8/08) ATTACHMENT I Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, as Amended The undersigned (hereinafter called the "Contractor(s)") hereby agrees that it will comply with Section 504 of the Rehabilitation Act of 1973, as amended, all requirements imposed by the applicable DHHS regulation, and all guidelines and interpretations issued pursuant thereto. The Contractor(s) gives/give this assurance in consideration of for the purpose of obtaining contracts after the date of this assurance. The Contractor(s) recognizes/recognize and agrees/agree that contracts will be extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the Contractor(s), its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this assurance on behalf of the Contractor(s). The Contractor(s): (Check a or b)
Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Contractor
Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Contractor Attachment I (Required only from Contractors who provide services directly to the Public on County's behalf.) Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, as Amended The undersigned (hereinafter called the "Contractor(s)") hereby agrees that it will comply with Section 504 of the Rehabilitation Act of 1973, as amended, all requirements imposed by the applicable DHHS regulation, and all guidelines and interpretations issued pursuant thereto. The Contractor(s) gives/give this assurance in consideration of and for the purpose of obtaining contracts after the date of this assurance. The Contractor(s) recognizes/recognize and agrees/agree that contracts will be extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the Contractor(s), its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this assurance on behalf of the Contractor(s). The Contractor(s): (Check a or b) a. ( ) employs fewer than 15 persons. b. ( ) employs 15 or more persons and, pursuant to Section 84.7 (a) of the regulation (45 C.F.R. 84.7 (a)), has designated the following person(s) to coordinate its efforts to comply with the DHHS regulation. Name of 504 Person - Type or Print AIDS Community Research Consortium 0000 Xx Xxxxxx Xxxx, Xxxxx X Name of Contractor(s) - Type or Print Street Address or XX Xxx Xxxxxxx Xxxx XX 00000 Xxxx Xxxxx Zip Code I certify that the above information is complete and correct to the best of my knowledge. Date Signature and Title of Authorized Official *Exception: DHHS regulations state that: "If a recipient with fewer than 15 employees finds that, after consultation with a handicapped person seeking its services, there is no method of complying with (the facility accessibility regulations)...other than making a significant alteration in its existing facilities, the recipient may, as an alternative, refer the handicapped person to other providers of those services that are accessible."
Reservation of Right to Monitor Activities. Covered Entity reserves the right to monitor the security policies and procedures of Business Associate. Specific Provisions for Use and Disclosures by Business Associate of PHI Subject to 42 CFR Part 2.
Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Contractor Attachment III County of San Mateo Contractor’s Declaration Form I. CONTRACTOR INFORMATION Contractor Name: El Xxxxxxxx of San Mateo County Phone: (000) 000-0000 Contact Person: Xxxxxxxx Xxxxx, Executive Director Fax: (000)000-0000 Address: 1798 – X Xxx Xxxx Xxxx Xxxx Xxxx, XX 00000
Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Business Associate. ATTACHMENT I Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, as Amended The undersigned (hereinafter called "Contractor(s)") hereby agrees that it will comply with Section 504 of the Rehabilitation Act of 1973, as amended, all requirements imposed by the applicable DHHS regulation, and all guidelines and interpretations issued pursuant thereto. The Contractor(s) gives/give this assurance in consideration of for the purpose of obtaining contracts after the date of this assurance. The Contractor(s) recognizes/recognize and agrees/agree that contracts will be extended in reliance on the representations and agreements made in this assurance. This assurance is binding on the Contractor(s), its successors, transferees, and assignees, and the person or persons whose signatures appear below are authorized to sign this assurance on behalf of the Contractor(s). The Contractor(s): (Check a or b) ☐ a. Employs fewer than 15 persons. ☐ b. Employs 15 or more persons and, pursuant to section 84.7 (a) of the regulation (45 C.F.R.
Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Xxxxxxxxxx XXXX XX XXXX XXXX Exhibit “A” In consideration of the payments set forth in Exhibit “B”, Contractor shall provide the following services:
Reservation of Right to Monitor Activities. HPSM reserves the right to monitor the security policies and procedures of BHRS
Reservation of Right to Monitor Activities. HPSM reserves the right to monitor the security policies and procedures of BHRS BHRS's Signature Date BHRS's Name (Please Print) REQUIREMENTS FOR DELEGATED ENTITIES BHRS Note: All references to the Medicare Advantage Organization (MAO) apply to the delegated entities with whom HPSM has contracted for services MARKETING/MEMBER MATERIALS Applicable to Contract? Notes
Reservation of Right to Monitor Activities. County reserves the right to monitor the security policies and procedures of Contractor Attachment III FINGERPRINTING CERTIFICATION FORM For the Agreement with Youth Leadership Institute Tobacco Prevention Services July 1, 2006 through June 30, 2007 Funded by Tobacco Master Settlement Agreement Funds And Proposition 99 Contractor agrees that its employees and/or its subcontractors, assignees and volunteers who, during the course of performing services under this agreement, have contact with children will be fingerprinted in order to determine whether they have a criminal history which would compromise the safety of children with whom contractors employees, assignees and subcontractors or volunteers have contact. Name Title Signature
