OMB No.: 0915-0285. Expiration Date: 9/30/2016Health Center Agreements • April 1st, 2016
Contract Type FiledApril 1st, 2016DEPARTMENT OF HEALTH AND HUMAN SERVICESHealth Resources and Services Administration Form 8: HEALTH CENTER AGREEMENTS FOR HRSA USE ONLY Grant Number Application Tracking Number Note: When a health center grantee wishes to establish an agreement/arrangement in the future that will either (1) result in another organization carrying out a substantial portion of the approved scope of project or (2) impact the governing board’s composition, authorities, functions, or responsibilities, a Prior Approval request must be submitted in EHB and approved by HRSA before the agreement/arrangement can be formalized and implemented. PART I Health Center Agreements 1. Does your organization have a parent, affiliate, or subsidiary organization? [_]Yes [_] No 2. Do you have, or propose to make as part of this application, any subawards to subrecipients and/or will you contract with another organization to carry out a substantial portion of the proposed scope of project? Contracts for a substantial por