DEPARTMENT OF HEALTH AND HUMAN SERVICES Agreement to Purchase ServicesDHHS Agreement Number • May 5th, 2014 • Maine
Contract Type FiledMay 5th, 2014 JurisdictionTHIS AGREEMENT, made this _________ day of __________, ______, is by and between the State of Maine, ________________, hereinafter called “Department,” and _____________________, located at _____________________________________ , telephone number __________________, hereinafter called “Provider”, for the period of _______________ to _______________________.