ContractPersonal Service Contract • January 22nd, 2018 • Washington
Contract Type FiledJanuary 22nd, 2018 JurisdictionPERSONAL SERVICE CONTRACT DSHS Contract Number: Resulting From Procurement Number: This Contract is between the state of Washington Department of Socialand Health Services (DSHS) and the Contractor identified below, and is governed by chapter 39.26 RCW. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) DSHS INDEX NUMBER CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE1000PC-35 DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBER(S) CONTRACT START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A - Washington State Foundation