Government of the District of ColumbiaDistrict of Columbia • May 3rd, 2021
Jurisdiction FiledMay 3rd, 2021HUMAN CARE AGREEMENT Pag1 e of Pages 51 1. HCA NumberDoc562265 2. Date of AwardSee Block 13C 3. DateSolicitation Issued 5/3/2021 4. Issued by: JM0Office of Contracting and Procurement On Behalf ofDepartment on Disability Services 250 E Street, SW,Washington, DC 20024 5. Administered by:Department on Disability Services (DDS) Developmental Disabilities Administration (DDA) 250 E Street, SW,Washington, DC 20024Telephone: 202-730-1700 6. NAME AND ADDRESS OF PROVIDER/CONTRACTOR (No. Street, county, state and ZIP Code) Phone: Fax: Email: 7. PROVIDER/CONTRACTOR SHALL SUBMIT ALL INVOICES TO: See Section G.3.4 INVOICESUBMITTAL 8. DISTRICT SHALL SEND ALL PAYMENTS TO: Address in Block 6. 9. DESCRIPTION OF HUMAN CARE SERVICE AND RATE COST LINE ITEM NIGP CODE BRIEF DESCRIPTION OF HUMAN CARE SERVICE QUANTITY OF SERVICE REQUIRED TOTAL SERVICE UNITS SERVICE RATE TOTAL AMOUNT 0001thru 0006 952-92-65 Residential Habilitation, Supported Living, a nd Host Home Occupancy RelatedResidential Expenses for Di