PAYMENT DUE WITH CONTRACT FOR SERVICEAdoption Services Fee Agreement • October 30th, 2020
Contract Type FiledOctober 30th, 2020I/We understand that all Post Placement/Post Adoption reports required to be written by a Social Worker* must be pre- paid with submission of this application OR if adopting through a CHI placement program, paid at referral acceptance.
PAYMENT DUE WITH CONTRACT FOR SERVICEAdoption Services Fee Agreement • October 30th, 2020
Contract Type FiledOctober 30th, 2020 Post-Adoption/Post-Placement Reports written by a SW @ $325.00 each Sibling Post-Adoption/Post-Placement (same date) @ $125.00 each TRAVEL EXPENSES when overnight stay is required SW Office to PAP home $ $ $ Hotel, meals, tolls, mileage PER NIGHT $175.00 x nights (additional transportation if required is not included – airfare, trains, etc) Apostilles $ 100.00 ICPC (Interstate Compact on the Placement of Children) assistance $ 800.00 Other services (description): $
PAYMENT DUE WITH CONTRACT FOR SERVICEAdoption Services Fee Agreement • October 29th, 2020
Contract Type FiledOctober 29th, 2020 Post-Adoption/Post-Placement Reports written by a SW @ $375.00 each Sibling Post-Adoption/Post-Placement (same date) @ $125.00 each TRAVEL EXPENSES when overnight stay is required SW Office to PAP home $ $ $ Hotel, meals, tolls, mileage PER NIGHT $175.00 x nights (additional transportation if required is not included – airfare, trains, etc) CHI processing of UT Background check @ $75/person $ Apostilles $ 100.00 ICPC (Interstate Compact on the Placement of Children) assistance $ 800.00 Other services (description): $ TOTAL PAID TO CHI: $
PAYMENT DUE WITH CONTRACT FOR SERVICEAdoption Services Fee Agreement • October 29th, 2020
Contract Type FiledOctober 29th, 2020 Post-Adoption/Post-Placement Reports written by a SW @ $425.00 each Sibling Post-Adoption/Post-Placement (same date) @ $125.00 each TRAVEL EXPENSES when overnight stay is required SW Office to PAP home $ $ $ Hotel, meals, tolls, mileage PER NIGHT $175.00 x nights (additional transportation if required is not included – airfare, trains, etc) Apostilles $ 100.00 ICPC (Interstate Compact on the Placement of Children) assistance $ 800.00 Other services (description): $
PAYMENT DUE WITH CONTRACT FOR SERVICEAdoption Services Fee Agreement • September 2nd, 2020
Contract Type FiledSeptember 2nd, 2020 Post-Adoption/Post-Placement Reports written by a SW @ $300.00 each Sibling Post-Adoption/Post-Placement (same date) @ $125.00 each $ $ Apostilles $ 100.00 ICPC (Interstate Compact on the Placement of Children) assistance $ 800.00 TRAVEL EXPENSES from SW Office to PAP homeo Driving – round trip (current IRS allowable rate) cents per mile $ o Hotel when overnight stay is required $96/night $ o Meals when overnight stay is required (using USA GSA CONUS rates for Meals & IE) Breakfast $13 x Lunch $14 x Dinner $23 x $ o Other (Ferry, Tolls, Trains, Subway, etc.) $ Other services (description): $