Appendix 2 Sample Contracts

Medicare Opt Out Agreement
Appendix 2 • July 14th, 2014

This agreement (“ Agreement”) is entered into by and between Stahl Primary Care, LLC, a Georgia professional corporation, owned and operated by Dr Stahl, (the “Physician ”), whose principal medical office is located at 5925 Iron Gate Trace, Cumming, GA 30040, and

Sample 1
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YOUTH WORKSITE AGREEMENT
Appendix 2 • April 12th, 2017 • Ohio

This Worksite Agreement is entered into between the INSERT WIOA YOUTH PROVIDER NAME (hereinafter “Youth Provider”) having its principal place of business located at INSERT WIOA YOUTH PROVIDER ADDRESS and INSERT WORKSITE NAME HERE (hereinafter “Employer of Record”) having its principal place of business located at INSERT WORKSITE ADDRESS HERE who is a Employer of Record participating in the 2016 Year-round Workforce Innovation Opportunities Act (WIOA) Work Experience Program.

Sample 1
DIOCESAN HOUSE OCCUPANCY AGREEMENT
Appendix 2 • January 9th, 2019

This Agreement provides residential accommodation as part of the clergy stipend package and is dependent on the Occupant continuing their position with the Diocese and the Parish/Organisation.

Sample 1
Partnership Agreement
Appendix 2 • August 17th, 2021
Sample 1
Medicare Opt Out Agreement
Appendix 2 • September 5th, 2018

This agreement (“Agreement”) is entered into by and between New South Family Medicine, LLC, a South Carolina professional corporation, owned and operated by Dr. Jessica Kaiser Mendelsohn (the “Physician”), whose principal medical office is located at 1365 Broadcloth Street, Suite 203 Fort Mill, SC 29715 and

Sample 1
APPENDIX 2
Appendix 2 • November 14th, 2003 • Valence Technology Inc • Miscellaneous electrical machinery, equipment & supplies • California
Sample 1
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