Common Contracts

FISCAL INTERMEDIARY SERVICES AGREEMENT

Fiscal Intermediary Services Agreement • June 21st, 2019 • Michigan

• Contract Type
  Fiscal Intermediary Services Agreement
• Filed
  June 21st, 2019
• Jurisdiction
  Michigan

THIS AGREEMENT, made and entered into this [[_______day of ________________]] by and between [[name of CMHSP]], whose administrative offices are located at [[address of CMHSP]] (hereinafter referred to as the “CMHSP” or "Payor"), and [[name of Fiscal Intermediary]], whose principal place of business is located at [[address of Fiscal Intermediary]] (hereinafter referred to as the "FI").