Common Contracts
1 similar Human Care Agreement contracts
DISTRICT OF COLUMBIA GOVERNMENTHuman Care Agreement • November 1st, 2017 • District of Columbia
Human Care Agreement PAGE OF PAGES 1 49 1. HUMAN CARE AGREEMENT NUMBER 2. REQUISITION/PURCHASE REQUEST NO./SOLICITATION NO. 3. DATE OF AWARD RM-17-HCA-MHRS-XXX-BY4-RDS 4. ISSUED BY 5. ADMINISTERED BY (If other than Item No. 4): OFFICE OF CONTRACTING AND PROCUREMENT OBO/DEPARTMENT OF BEHAVIORAL HEALTH64 New York Avenue NE, 2nd Floor (west) Washington, DC 20002 Department of Behavioral HealthHuman Care Agreement/Contract Administrator – TBD 64 New York Avenue NE, 2nd Floor (west) Washington, DC 20002 6. NAME AND ADDRESS OF PROVIDER/CONTRACTOR (No. street, county, state and ZIP Code) 7. PROVIDER/CONTRACTOR SHALL SUBMIT ALL CLAIMS/ INVOICES TO: 8. DISTRICT SHALL SEND ALL PAYMENTS TO: Department of Behavioral Health (Reference Section G) 9. DESCRIPTION OF HUMAN CARE SERVICE AND RATE COST ITEM/LINE NO. NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANTITY OFSERVICE REQUIRED TOTALSERVICE UNITS SERVICE RATE TOTAL AMOUNT XXX-XX- XX See section B Total $
