Common Contracts

This Contract is entered into between the Department of Human Services and the Contractor named below:

Business Associate Agreement • April 13th, 2018 • Georgia

• Contract Type
  Business Associate Agreement
• Filed
  April 13th, 2018
• Jurisdiction
  Georgia

State Entity’s Name: Department of Human Services, through its Division of Family and Children (hereinafter the “Department” or “DHS”)

DEPARTMENT OF HUMAN SERVICES CONTRACT FORM

Business Associate Agreement • August 22nd, 2016 • Georgia

• Contract Type
  Business Associate Agreement
• Filed
  August 22nd, 2016
• Jurisdiction
  Georgia

Contractor’s Name (hereinafter the “Contractor”):Family Support Council, Inc. Healthy Families - Murray/WhitfieldPSSF ID#: 573-2655 SoN#: 9168 Model: FSS/HVS Contractor’s Address:1529 Waring RoadDalton, GA 30721 Contractor’s FEI#:58-1667920 Contractor’s Year End Date: December 31 Contractor’s Entity Type: Non-Profit ORI/GAPS#: GAP232375 E-Verify#: 343257