ContractClient Service Contract • October 20th, 2022 • Washington
CLIENT SERVICE CONTRACT Adult Family Home (AFH)Meaningful Day - HCS DSHS Contract Number:2212-60170Program Contract Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. ProviderOne ID and Location Number: CONTRACTOR NAME John J. Smith CONTRACTOR Doing Business As (DBA) Johns Place AFH CONTRACTOR MAILING ADDRESS 1234 12th Ave NEJunction City WA 98333-3333 ADULT FAMILY HOME (AFH) STREET ADDRESS 3421 Main StreetSuite 40-11Aberdeen Junction WA 98333-3333 CONTRACTOR Uniform Business Identifier (UBI) 600-123-123 CONTRACTOR DSHS INDEX NUMBER 146175 AFH LICENSE NUMBER CONTRACTOR CONTACTJohn Smith CONTRACTOR TELEPHONE(360) 555-1212 CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS john@someemail.com DSHS ADMINISTRATION Aging & Long Term Support Admin DSHS DIVISION Division of Home And Community Services DSHS CONTRACT CODE 1080XS-12 DSHS CONTACT NAME AND TITLE Student One Contracts Manager DSHS CONTACT ADDRESS 4500
ContractClient Service Contract • September 22nd, 2021 • Washington
CLIENT SERVICE CONTRACTKidney Disease Program Previous HCA Contract Number: K HCA Contract Number: K THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred to as "HCA" and “Authority” and the party whose name appears below, hereinafter referred to as "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program HCA DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2021 CONTRACT END DATE 07/01/2023 TOTAL MAXIMUM CONTRACT AMOUNT PURPOSE OF CONTRACT:To assist persons who meet
CLIENT SERVICE CONTRACT BETWEEN STATE OF WASHINGTONClient Service Contract • February 16th, 2022 • Washington
This Contract is made and entered into by and between the state of Washington, , hereinafter referred to as the "DEPARTMENT", and the below named firm, hereinafter referred to as “CONTRACTOR.”
ContractClient Service Contract • July 17th, 2024 • Washington
CLIENT SERVICE CONTRACT Pre-Employment Transition Services DSHS Contract Number:2412-60190Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 8504XS-12 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? No ASSISTANCE LISTING NUMBER(S) CONTRACT START DATE 10/01/2024 CONTRACT END DATE 09/30/2025 CONTRACT MAXIMUM AMOUNT $0.00 EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhib
ContractClient Service Contract • July 13th, 2023 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 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 - Data Security Requirements Exhibit B: InsuranceRequirements; Exhibit- C
ContractClient Service Contract • March 15th, 2023 • Washington
CLIENT SERVICE CONTRACT Job Service and IL Service Contract DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 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? ASSISTANCE LISTING 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 Data Security Requirements
ContractClient Service Contract • May 20th, 2020 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number: RFP 0913-343 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 Medicaid Purchasing Administration DSHS DIVISION Division of Healthcare Services DSHS CONTRACT CODE 7054XS-13 DSHS CONTACT NAME AND TITLE RosaMaria Espinoza Program Manager DSHS CONTACT ADDRESS PO Box 45530626 - 8th Ave.Olympia, WA 98504-5530 DSHS CONTACT TELEPHONE (360) 725-1721 Ext: DSHS CONTACT FAX (360) 664-0261 DSHS CONTACT E-MAIL ADDRESS rosamaria.espinoza@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? No CFDA NUMBER(S) 93.778 CONTRACT START
Client Service Contract withClient Service Contract • July 8th, 2019 • Washington
CLIENT SERVICE CONTRACT BETWEEN STATE OF WASHINGTON DEPARTMENT OF VETERANS AFFAIRS ANDClient Service Contract • September 17th, 2020 • Washington
This Contract is made and entered into by and between the state of Washington, Department of Veterans Affairs, hereinafter referred to as the "DEPARTMENT", and the below named firm, hereinafter referred to as “CONTRACTOR.”
RAGING POINT OUTFITTERS, LLCClient Service Contract • March 6th, 2023
CLIENT SERVICE CONTRACT BETWEEN CO-SIGNER.COM AND IMAGINE MEDIA GROUP, LLC. This Exclusive Technical Consulting and Services Agreement (the "Agreement") is entered into as of July 1,Client Service Contract • August 15th, 2013 • Co-Signer, Inc. • Household audio & video equipment • California
WHEREAS, CONTRACTOR shall be the provider of technical consulting and related services to CLIENT, and CLIENT hereby agrees to accept such technical consulting and services;
ContractClient Service Contract • November 7th, 2014 • Washington
CLIENT SERVICE CONTRACTCommunity Residential Services DSHS Contract Number:SAMPLE CONTRACTResulting From Solicitation Number:1413-516 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 Developmental Disabilities Administration DSHS DIVISION DSHS CONTRACT CODE 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 01/01/2015 CONTRACT END DATE 06/30/2015 CONTRACT MAXIMUM AMOUNT $0.00 EXHIBITS. The following Exhibits are attached and are incorporated into this Contr
ContractClient Service Contract • July 28th, 2022 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number:2213-811 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 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 - Data Security Requirements ; See Special Terms and Conditions Sect
CLIENT SERVICE CONTRACT NURSING FACILITY SERVICESClient Service Contract • October 19th, 2007 • Ensign Group, Inc • Services-skilled nursing care facilities • Washington
This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below
CLIENT SERVICE CONTRACTClient Service Contract • January 13th, 2011
ContractClient Service Contract • July 22nd, 2021 • Washington
CLIENT SERVICE CONTRACT Staffed LRA Residence DSHS Contract Number: Resulting From Solicitation Number:2313-837 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 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? ASSISTANCE LISTING NUMBER(S) CONTRACT START DATE 11/01/2023 CONTRACT END DATE 10/31/2026 CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A - Data S
CLIENT SERVICE CONTRACT BETWEEN STATE OF WASHINGTON DEPARTMENT OF SERVICES FOR THE BLIND AND VENDORClient Service Contract • January 10th, 2024
This Contract is made and entered into by and between the state of Washington, Department of Services for the Blind, hereinafter referred to as the "AGENCY" or “DEPARTMENT” or “DSB”, and the below named firm, hereinafter referred to as “CONTRACTOR.”
ATTACHMENT A SAMPLE CONTRACT RFQ 1813-695Client Service Contract • May 5th, 2020 • Washington
CLIENT SERVICE CONTRACT Regional Client Advocacy Services DSHS Contract Number:1813-60196Resulting From Solicitation Number: 1813-695 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME John J. Smith CONTRACTOR doing business as (DBA) Johns Place AFH CONTRACTOR ADDRESS 1234 12th Ave NEJunction City, WA 98333-3333 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) 600-123-123 DSHS INDEX NUMBER 146175 CONTRACTOR CONTACT Fred Jones CONTRACTOR TELEPHONE (360) 555-1212 CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS fred@someemail.com DSHS ADMINISTRATION Services and Enterprise Support Administration DSHS DIVISION Central Contracts & Legal Services DSHS CONTRACT CODE 8404XS-12 DSHS CONTACT NAME AND TITLE Maria Rogers Contracts Consultant DSHS CONTACT ADDRESS1115 Washington St SE Olympia, WA 98504-5811 DSHS CONTACT TELEPHONE (360)664-6034 DSHS CONTACT FAX
ContractClient Service Contract • July 10th, 2017 • Washington
CLIENT SERVICE CONTRACT Access & Visitation DSHS Contract Number:Click here to enter text. Resulting From Solicitation Number: Click here to enter text. This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Click here to enter text. Contractor Contract Number: CONTRACTOR NAME Click here to enter text. CONTRACTOR doing business as (DBA) Click here to enter text. CONTRACTOR ADDRESS Click here to enter text.Click here to enter text., Click here to enter text. Click here to enter text. WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) Click here to enter text. DSHS INDEX NUMBER Click here to enter text. CONTRACTOR CONTACT Click here to enter text. CONTRACTOR TELEPHONE Click here to enter text. CONTRACTOR FAX Click here to enter text. CONTRACTOR E-MAIL ADDRESS Click here to enter text. DSHS ADMINISTRATION Click here to enter text. DSHS DIVISION Click here to enter text. DSHS CONTRACT CODE C
ContractClient Service Contract • March 6th, 2024 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number:Click here to enter text. Resulting From Solicitation Number: Click here to enter text. This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Click here to enter text. Contractor Contract Number: CONTRACTOR NAME Click here to enter text. CONTRACTOR doing business as (DBA) Click here to enter text. CONTRACTOR ADDRESS Click here to enter text.Click here to enter text., Click here to enter text. Click here to enter text. WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) Click here to enter text. DSHS INDEX NUMBER Click here to enter text. CONTRACTOR CONTACT Click here to enter text. CONTRACTOR TELEPHONE Click here to enter text. CONTRACTOR FAX Click here to enter text. CONTRACTOR E-MAIL ADDRESS Click here to enter text. DSHS ADMINISTRATION Click here to enter text. DSHS DIVISION Click here to enter text. DSHS CONTRACT CODE Click here to enter t
ContractClient Service Contract • July 5th, 2019 • Washington
CLIENT SERVICE CONTRACT Supportive Housing DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 Aging & Long Term Support Admin DSHS DIVISION Division of Home And Community Services DSHS CONTRACT CODE 1070XP-12 DSHS CONTACT NAME AND TITLE Suemary Trobaugh Program Manager DSHS CONTACT ADDRESS 4450 10th AVE SE P O Box 45600Lacey, WA 98504-5600 DSHS CONTACT TELEPHONE (360)725-2557 DSHS CONTACT FAX Click here to enter text. DSHS CONTACT E-MAIL ADDRESS trobas@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? No CFDA NUMBER(S) CONTRACT START DATE
DSHS Administration: ESA DSHS Division: Region 5 DSHS Contract Code: 3003 DSHS Contact name and title: Margaret A. Gonzales DSHS Contact address: 2121 South State Street, MS: N27-1, Tacoma, WA 98405 Contract start date: 07/01/00 Contract end date:...Client Service Contract • November 13th, 2000 • L L Brown International Inc • Washington
ContractClient Service Contract • November 16th, 2022 • Washington
CLIENT SERVICE CONTRACTTemporary Contract Nurse Staffing Services DSHS Contract Number:xxxx-xxxxx Resulting From Solicitation Number: 2213-820 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 Aging & Long Term Support Admin DSHS DIVISION DSHS CONTRACT CODE DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS , Click here to enter text. DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? ASSISTANCE LISTING NUMBER(S) CONTRACT START DATE 02/01/2023 CONTRACT END DATE 06/30/2025 CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached a
Client Service ContractClient Service Contract • March 17th, 2015
CLIENT SERVICE CONTRACT DVPA Activities DSHS Contract Number: Resulting From Solicitation Number: 2013-757Client Service Contract • November 13th, 2020 • Washington
This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number:
Vonna J Lovett PLLC MAMFTClient Service Contract • August 8th, 2019
This document is important to you and/or your child as a consumer of services with this therapist. This Agreement contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and client rights with regard to the use and disclosure of Protected Health Information (PHI) for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Policies and Practices to Protect the Privacy of Your Health Information for use and disclosure of PHI for treatment payment, and health care operations. This Notice, which is included with this Agreement, explains HIPAA and its application to your personal health information in greater detail. The law requires that we obtain your signature acknowledging that we have provided you with this information. Although these documents ar
CLIENT SERVICE CONTRACTClient Service Contract • February 27th, 2024 • Washington
● The following Snohomish County Agencies, current and participating members of the Washington State Firefighters Joint-Apprenticeship Training Committee, hereinafter referred to as “PARTICIPATING AGENCIES”
ContractClient Service Contract • August 31st, 2021 • Washington
CLIENT SERVICE CONTRACT LRA Services DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE 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): No Data Security ExhibitNo Exhibits. The terms and conditions of this Contract are an integra
Client Service Contract withClient Service Contract • September 24th, 2012 • Washington
Administering the WA State 2013 Low-Income Home Energy Assistance Program (Oct 1, 2012 - Sept 30, 2013), per the specific and general terms & conditions of this contract, and the program policies & procedures established by Commerce.
ContractClient Service Contract • June 1st, 2022 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number:2213-811 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 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 - Data Security Requirements ; See Special Terms and Conditions Sect
ATTACHMENT A – SAMPLE CONTRACT RFQ 1735-660Client Service Contract • October 18th, 2017 • Washington
CLIENT SERVICE CONTRACT CANS-F Training DSHS Contract Number:1812-60155Resulting From Solicitation Number:1735-660 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAMEJohn J. Smith CONTRACTOR doing business as (DBA)Johns Place AFH CONTRACTOR ADDRESS3421 Main StreetSuite 40-11Aberdeen Junction, WA 98333-3333 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) 600-123-123 DSHS INDEX NUMBER146175 CONTRACTOR CONTACTJohn Smith CONTRACTOR TELEPHONE(360) 555-1212 CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESSjohn@someemail.com DSHS ADMINISTRATIONExecutive Administration DSHS DIVISIONOperation Support and Services Division DSHS CONTRACT CODE2000XC-12 DSHS CONTACT NAME AND TITLEMaria Rogers Contracts Consultant DSHS CONTACT ADDRESS1115 Washington St SE Olympia, WA 98504-5811 DSHS CONTACT TELEPHONE(360)664-6034 DSHS CONTACT FAX(360)664-6184 DSHS CONTACT E-MAI
ATTACHEMENT A SAMPLE CONTRACT DSHS RFQ 1713-649Client Service Contract • December 5th, 2017 • Washington
CLIENT SERVICE CONTRACT Family Mentoring Program DSHS Contract Number:1713-60203Resulting From Solicitation Number:1713-649 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME Smith Enterprises, LLC CONTRACTOR doing business as (DBA) Smith Cabin CONTRACTOR ADDRESS 8765 Main Street South Unit 231Tacoma, WA 98444-4444 WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) 600-123-456 DSHS INDEX NUMBER 146178 CONTRACTOR CONTACT Jennie Franklin CONTRACTOR TELEPHONE (253) 555-1216 CONTRACTOR FAX (253) 555-1214 CONTRACTOR E-MAIL ADDRESS jennie@smiths DSHS ADMINISTRATION Executive Administration DSHS DIVISION Operation Support and Services Division DSHS CONTRACT CODE 8000XC-13 DSHS CONTACT NAME AND TITLE Maria Rogers Contracts Consultant DSHS CONTACT ADDRESS1115 Washington St SE Olympia, WA 98504-5811 DSHS CONTACT TELEPHONE (360)664-6034 DSHS CONTACT FAX
ContractClient Service Contract • December 9th, 2015
SOUTH PUGET SOUND COMMUNITY COLLEGE CLIENT SERVICE CONTRACTClient Service Contract • October 10th, 2020 • Washington
This CLIENT SERVICE CONTRACT is made and entered into between South Puget Sound Community College, State of Washington, hereinafter referred to as the “COLLEGE” and:
ContractClient Service Contract • August 4th, 2017 • Washington
CLIENT SERVICE CONTRACTGang Repression, Intervention, and Prevention (GRIP) Services DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. 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 CODE 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: Statement of
