ContractClient Service Contract • September 22nd, 2021 • Washington
Contract Type FiledSeptember 22nd, 2021 JurisdictionCLIENT SERVICE CONTRACTKidney Disease Program Previous HCA Contract Number: K HCA Contract Number: K THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred to as "HCA" and “Authority” and the party whose name appears below, hereinafter referred to as "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2021 CONTRACT END DATE 07/01/2023 TOTAL MAXIMUM CONTRACT AMOUNT PURPOSE OF CONTRACT:To assist persons who meet
ContractClient Service Contract • July 1st, 2020 • Washington
Contract Type FiledJuly 1st, 2020 JurisdictionCLIENT SERVICE CONTRACTKidney Disease Program Previous HCA Contract Number: HCA Contract Number: THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred toas "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 7/01/2020 CONTRACT END DATE 6/30/2022 TOTAL MAXIMUM CONTRACTAMOUNT$ PURPOSE OF CONTRACT:To assist persons who meet the Kidney Disease Program (KDP) Eligibility Requirements to gain access to End Stage Renal Disease (ESRD) t
ContractClient Service Contract • May 5th, 2020 • Washington
Contract Type FiledMay 5th, 2020 JurisdictionCLIENT SERVICE CONTRACTKidney Disease Program HCA Contract Number: THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred toas "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2018 CONTRACT END DATE 06/30/2020 TOTAL MAXIMUM CONTRACT AMOUNT PURPOSE OF CONTRACT:To assist persons who meet the Kidney Disease Program (KDP) Eligibility
ContractClient Service Contract • May 5th, 2020 • Washington
Contract Type FiledMay 5th, 2020 JurisdictionCLIENT SERVICE CONTRACTKidney Disease Program HCA Contract Number: THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred toas "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2017 CONTRACT END DATE 06/30/2019 TOTAL MAXIMUM CONTRACT AMOUNT PURPOSE OF CONTRACT:To assist persons who meet the Kidney Disease Program (KDP) Eligibility
ContractClient Service Contract • May 5th, 2020 • Washington
Contract Type FiledMay 5th, 2020 JurisdictionCLIENT SERVICE CONTRACT HCA Contract Number: THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred to as"HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program H A DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2016 CONTRA T END DATE 06/30/2018 TOTAL MAXIMUM ONTRACT AMO NT$ PURPOSE OF CO TRACT:To assist perso s who meet the Kidney Disease Program (KD ) Eligibility Requirements to gain
ContractClient Service Contract • July 15th, 2019 • Washington
Contract Type FiledJuly 15th, 2019 JurisdictionCLIENT SERVICE CONTRACTKidney Disease Program HCA Contract Number: THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred toas "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2019 CONTRACT END DATE 06/30/2021 TOTAL MAXIMUM CONTRACT AMOUNT PURPOSE OF CONTRACT:To assist persons who meet the Kidney Disease Program (KDP) Eligibility
ContractClient Service Contract • September 3rd, 2014 • Washington
Contract Type FiledSeptember 3rd, 2014 JurisdictionCLIENT SERVICE CONTRACT HCA Contract Number: «New_Contract_» THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred to as"HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME «Organization» CONTRACTOR doing business as (DBA) «DBA» CONTRACTOR ADDRESS «MailingAddress1»«Mailing_City», «State» «Zip» WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) «UBI» CONTRACTOR CONTACT «Kcont_Name» CONTRACTOR TELEPHONE«Phone» CONTRACTOR E-MAIL ADDRESS «Email_Address» HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE HCA CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2014 CONTRACT END DATE 06/30/2016 TOTAL MAXIMUM CONTRACT AMOUNT$«New ».00 PURPOSE OF CONTRACT:To assist perso