Common use of Sponsoring Institution Clause in Contracts

Sponsoring Institution. UNIVERSITY OF MARYLAND MEDICAL CENTER Signature: ____________________________ Signature: ____________________________ By: By: Xxxx X. Xxxxx, M.D. Title: Program Director Title Designated Institutional Official Date: Date: Address: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ Signature: ____________________________ By: By: Xxxxxxx Xxxxxxxxxx, MD, MBA, FACP Title: Chairman Title: Senior Vice President and Chief Medical Officer Date: Date: Address: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ By: Xxxxxxx Xxxxx Title: Director, Graduate Medical Education Date: Address: 000 X. Xxxx Xxxxxx Xxxxxxxxx, Xxxxxxxx 00000 Participating Site: THE XXXXX XXXXXXX HOSPITAL Signature: Signature: By: By: Xxxxx X. Xxxx, M.D. Title: Program Director Title: Vice President, Medical Affairs Date: ________________________ Date: Address: ___________________________ Address: __________________________ Acknowledged and Agreed: Signature: By: Xxxxxxx X. Xxxxxxxxx, MD, MPH Title: Associate Xxxx for Graduate Medical Education/DIO Date: ______________________ Address: 000 Xxxxx Xxxxxxxx, Xxxx 000 Xxxxxxxxx, Xxxxxxxx 00000 ATTACHMENT A ROTATION GOALS AND OBJECTIVES FOR ______________________ ROTATION AT THE XXXXX XXXXXXX HOSPITAL PROGRAM DESCRIPTION: GOALS FOR ROTATION: ATTACHMENT B It is understood that if this is a multi-year Agreement, salary will be adjusted each academic period covered under the Agreement to reflect current UMMC approved salary the current academic year. Fringe benefits and administrative fees will be revised in accordance with the new salary level and will appear on subsequent invoices from UMMC, without the need for the parties to execute a new Attachment B. Payment for stipends includes vacation pay up to three weeks per Resident per year, and routine holiday, sick, and personal time off. UMMC will invoice The Xxxxx Xxxxxxx Hospital (JHH) at the beginning of the quarter. In response to UMMC invoices, JHH shall pay to UMMC 100% of the amount due for a quarter within 30 days of the invoice date. JHH shall pay all invoices minus any disputed amounts. Any billing disputes will be submitted in writing to UMMC as soon as reasonably possible. JHH and UMMC shall resolve any disputed amounts within 30 days of notification of dispute. For invoices that are not paid in accordance with these payment terms, JHH shall pay UMMC a late fee of 1.5% a month on the outstanding balance. PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL TOTAL REIMBURSEMENT BY PGY LEVEL

Sponsoring Institution. UNIVERSITY OF MARYLAND MEDICAL CENTER Signature: ____________________________ Signature: ____________________________ By: By: Xxxx X. Xxxxx, M.D. Title: Program Director Title Designated Institutional Official Date: Date: Address: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ Signature: ____________________________ By: By: Xxxxxxx XxxxxxxxxxXxxxx Xxxxxxx, MD, MBA, FACP MD Title: Chairman Title: Senior Vice President and Chief President, Medical Officer Date: Affairs Date: Address: Date: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ By: Xxxxxxx Xxxxx Title: Director, Graduate Medical Education Date: Address: 000 X. Xxxx Xxxxxx XxxxxxxxxBaltimore, Xxxxxxxx 00000 Maryland 21201 Participating Site: THE XXXXX XXXXXXX HOSPITAL Signature: Signature: By: By: Xxxxx X. Xxxx, M.D. Title: Program Director Title: Vice President, Medical Affairs Date: ________________________ Date: Address: ___________________________ Address: __________________________ Acknowledged and Agreed: Signature: By: Xxxxxxx X. Xxxxxxxxx, MD, MPH Title: Associate Xxxx for Graduate Medical Education/DIO Date: ______________________ Address: 000 Xxxxx Xxxxxxxx, Xxxx 000 XxxxxxxxxBaltimore, Xxxxxxxx 00000 Maryland 21205 ATTACHMENT A ROTATION GOALS AND OBJECTIVES FOR ______________________ ROTATION AT THE XXXXX XXXXXXX HOSPITAL PROGRAM DESCRIPTION: GOALS FOR ROTATION: ATTACHMENT B It is understood that if this is a multi-year Agreement, salary will be adjusted each academic period covered under the Agreement to reflect current UMMC approved salary the current academic year. Fringe benefits and administrative fees will be revised in accordance with the new salary level and will appear on subsequent invoices from UMMC, without the need for the parties to execute a new Attachment B. Payment for stipends includes vacation pay up to three weeks per Resident per year, and routine holiday, sick, and personal time off. UMMC will invoice The Xxxxx Xxxxxxx Hospital (JHH) at the beginning of the quarter. In response to UMMC invoices, JHH shall pay to UMMC 100% of the amount due for a quarter within 30 days of the invoice date. JHH shall pay all invoices minus any disputed amounts. Any billing disputes will be submitted in writing to UMMC as soon as reasonably possible. JHH and UMMC shall resolve any disputed amounts within 30 days of notification of dispute. For invoices that are not paid in accordance with these payment terms, JHH shall pay UMMC a late fee of 1.5% a month on the outstanding balance. PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL TOTAL REIMBURSEMENT BY PGY LEVELLEVEL 5 of 5

Sponsoring Institution. UNIVERSITY OF MARYLAND MEDICAL CENTER Signature: ____________________________ Signature: ____________________________ By: By: Xxxx X. Xxxxx, M.D. Title: Program Director Title Designated Institutional Official Date: Date: Address: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ Signature: ____________________________ By: By: Xxxxxxx XxxxxxxxxxXxxxxx Xxxxxx, MD, MBACPPS, FACP FACP, SFHM Title: Chairman Title: Senior Associate Chief Medical Officer, Date: Chief Quality Officer and Vice President and Chief Medical Officer DateAddress: Date: Address: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ By: Xxxxxxx Xxxxx Title: Director, Graduate Medical Education Date: Address: 000 X. Xxxx Xxxxxx Xxxxxxxxx, Xxxxxxxx 00000 Participating Site: THE XXXXX XXXXXXX HOSPITAL Signature: Signature: By: By: Xxxxx X. Xxxx, M.D. Title: Program Director Title: Vice President, Medical Affairs Date: ________________________ Date: Address: ___________________________ Address: __________________________ Acknowledged and Agreed: Signature: By: Xxxxxxx X. Xxxxxxxxx, MD, MPH Title: Associate Xxxx for Graduate Medical Education/DIO Date: ______________________ Address: 000 Xxxxx Xxxxxxxx, Xxxx 000 Xxxxxxxxx, Xxxxxxxx 00000 ATTACHMENT A ROTATION GOALS AND OBJECTIVES FOR ______________________ ROTATION AT THE XXXXX XXXXXXX HOSPITAL PROGRAM DESCRIPTION: GOALS FOR ROTATION: ATTACHMENT B It is understood that if this is a multi-year Agreement, salary will be adjusted each academic period covered under the Agreement to reflect current UMMC approved salary the current academic year. Fringe benefits and administrative fees will be revised in accordance with the new salary level and will appear on subsequent invoices from UMMC, without the need for the parties to execute a new Attachment B. Payment for stipends includes vacation pay up to three weeks per Resident per year, and routine holiday, sick, and personal time off. UMMC will invoice The Xxxxx Xxxxxxx Hospital (JHH) at the beginning of the quarter. In response to UMMC invoices, JHH shall pay to UMMC 100% of the amount due for a quarter within 30 days of the invoice date. JHH shall pay all invoices minus any disputed amounts. Any billing disputes will be submitted in writing to UMMC as soon as reasonably possible. JHH and UMMC shall resolve any disputed amounts within 30 days of notification of dispute. For invoices that are not paid in accordance with these payment terms, JHH shall pay UMMC a late fee of 1.5% a month on the outstanding balance. PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL TOTAL REIMBURSEMENT BY PGY LEVELLEVEL 5 of 5

Sponsoring Institution. UNIVERSITY OF MARYLAND MEDICAL CENTER Signature: ____________________________ Signature: ____________________________ By: By: Xxxx X. Xxxxx, M.D. Title: Program Director Title Designated Institutional Official Date: Date: Address: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ Signature: ____________________________ By: By: Xxxxxxx XxxxxxxxxxXxxxx Xxxxxxx, MD, MBA, FACP MD Title: Chairman Title: Senior Vice President and Chief President, Medical Officer Date: Affairs Date: Address: Date: Address: 00 X. Xxxxxx Street Baltimore, Maryland 21201 Signature: ____________________________ By: Xxxxxxx Xxxxx Title: Director, Graduate Medical Education Date: Address: 000 X. Xxxx Xxxxxx XxxxxxxxxBaltimore, Xxxxxxxx 00000 Maryland 21201 Participating Site: THE XXXXX XXXXXXX HOSPITAL Signature: Signature: By: By: Xxxxx X. Xxxx, M.D. Title: Program Director Title: Vice President, Medical Affairs Date: ________________________ Date: Address: ___________________________ Address: __________________________ Acknowledged and Agreed: Signature: By: Xxxxxxx X. Xxxxxxxxx, MD, MPH Title: Associate Xxxx for Graduate Medical Education/DIO Date: ______________________ Address: 000 Xxxxx Xxxxxxxx, Xxxx 000 XxxxxxxxxBaltimore, Xxxxxxxx 00000 Maryland 21205 ATTACHMENT A ROTATION GOALS AND OBJECTIVES FOR ______________________ ROTATION AT THE XXXXX XXXXXXX HOSPITAL PROGRAM DESCRIPTION: (Competency-Based) GOALS FOR ROTATION: ATTACHMENT B It is understood that if this is a multi-year Agreement, salary will be adjusted each academic period covered under the Agreement to reflect current UMMC approved salary the current academic year. Fringe benefits and administrative fees will be revised in accordance with the new salary level and will appear on subsequent invoices from UMMC, without the need for the parties to execute a new Attachment B. Payment for stipends includes vacation pay up to three weeks per Resident per year, and routine holiday, sick, and personal time off. UMMC will invoice The Xxxxx Xxxxxxx Hospital (JHH) at the beginning of the quarter. In response to UMMC invoices, JHH shall pay to UMMC 100% of the amount due for a quarter within 30 days of the invoice date. JHH shall pay all invoices minus any disputed amounts. Any billing disputes will be submitted in writing to UMMC as soon as reasonably possible. JHH and UMMC shall resolve any disputed amounts within 30 days of notification of dispute. For invoices that are not paid in accordance with these payment terms, JHH shall pay UMMC a late fee of 1.5% a month on the outstanding balance. PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL PGY _____ Salary Fringe Benefits (25% of salary) Total Salary and Fringe by PGY Level Administrative Fee Total Salary, Fringe and Administrative Fee by PGY Level FTE Equivalency TOTAL REIMBURSEMENT BY PGY LEVEL TOTAL REIMBURSEMENT BY PGY LEVELLEVEL 5 of 5