Common use of Sub-Agreements Clause in Contracts

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.00

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Health Information Technology (HIT): Self-Management Programs: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue (at least quarterly) the Grantee a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date:

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Health Information Technology (HIT): Self-Management Programs: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue the Grantee a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date:

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Health Information Technology (HIT): Self-Management Programs: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue the Grantee (at least quarterly) a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date:

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Practice Facilitation: Practice Facilitation Milestones: Health Information Technology (HIT): Self-Management Programs: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue the Grantee a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date:

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Title Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion Tuition $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Health Information Technology (HIT): Self-Management Programs: Self-Management Master Trainer: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue (at least quarterly) the Grantee a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date:

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. .Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Practice Facilitation: Practice Facilitation Milestones: Health Information Technology (HIT): Self-Management Programs: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue the Grantee (at least quarterly) a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date:

Sub-Agreements. Party shall not assign, subcontract or subgrant the performance of his Agreement or any portion thereof to any other Party without the prior written approval of the State. Party also agrees to include in subcontract or subgrant agreements a tax certification in accordance with paragraph 13 above. Notwithstanding the foregoing, the State agrees that the Party may assign this agreement, including all of the Party's rights and obligations hereunder, to any successor in interest to the Party arising out of the sale of or reorganization of the Party. Last updated January 31, 2011 Vermont Blueprint for Health Travel and Flexible Funding Request Form (complete and obtain Blueprint Assistant Director approval in advance of expenditure) Health Service Area Name Description of Expense (attach supporting documentation such as meeting agenda for training expense; scope of work, work plan, timeline and budget for flexible spending expense) How does the flexible spending project or training relate to Blueprint work in your health service area? Project or Training Start Date Project or Training End Date Person Traveling (if applicable) Indicate Traveler's Role (check one): Project Manager Practice Faciliator CHT Staff Practice Staff SASH Staff Other (describe) First Name Last Name Degree/Certification Job Tit le Work Address Email Work Phone Cell Phone Fax Number Signature Date Signed Estimated Costs Flexible Spending Project Expense (attach budget) Type of Expense Brief Description of Expense Unit Expense Number of Units (days, miles, materials or other units) Total Expense Flexible Spending Project Expense (attach budget) Expense for Training Hosted by Health Service Area Speaker's Fees $0.00 $0.00 Room Rental $0.00 $0.00 Materials $0.00 $0.00 Miscellaneous $0.00 $0.00 Expense for Training Offered by Other Organizations Tuit ion $0.00 $0.00 Airfare $0.00 $0.00 Ground Transportation $0.00 $0.00 Mileage $0.565 0.560 $0.00 Lodging Per Night $0.00 $0.00 Meals and Tips $0.00 $0.00 Miscellaneous $0.00 $0.00 Grand Total $0.000.00 For allowable meals and mileage rates, please refer to Bulletin 3.4 - Reimbursement for Travel Related Expenses INVOICE Grantee: Grant #: Address: Invoice #: Date of invoice: Grantee Billing Contact: Phone #: Dates of Service Description of Deliverables/Work Performed (please include/list a narrative of activities) Amount Project Management: Project Management Milestone: Practice Facilitation: Practice Facilitation Milestones: Health Information Technology (HIT): Self-Management Programs: Self-Management Master Trainer: Tobacco Cessation Master Trainer: Self-Management Completers ($200 each): Training, Travel, and Flexible Funding: TOTAL: Remittance Address: Xxxx to Address: Xxxxxxx Xxxxxxx Department of Vermont Health Access 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, Xxxxxxx 00000-0000 Xxxxxxx.Xxxxxxx@xxxxx.xx.xx DVHA BO USE: *INVOICE PAYMENTS ARE NET00 TERMS, UNLESS STATED OTHERWISE* Upon Grantee signature of this invoice, the Grantee confirms that the following funds are inaccessible to the Grantee will be reverted back to the State, resulting in a reduction in the total amount of the grant award. Within 15 business days of receipt of the invoice, the State will issue the Grantee a confirmation letter of the reduction that will be executed upon signature of the Grantee and the State. Amount: Date: