INDIVIDUAL SERVICE CONTRACT FOR CARE HOME SERVICESIndividual Service Contract • January 15th, 2021
Name of Program AddressIndividual Service Contract • February 1st, 2024
This notice accompanies a disclosure of information concerning a court alcohol and drug program client that is made to you with the client’s consent. This information has been disclosed to you from records that are protected by Federal confidentiality rules (42 C.F.R. Part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 C.F.R. Part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse client.
INDIVIDUAL SERVICE CONTRACT BETWEEN:Individual Service Contract • January 11th, 2016
CRV USER SUPPLIER NAME Name of the State/Administration/Organization: in quality of: 🗆 Asia Pacific State/Administration 🗆 ICAO Member of other ICAO region 🗆 Other organization Name of the common supplier for CRV Services:
INDIVIDUAL SERVICE CONTRACT FORMAT Contract No.___________Individual Service Contract • January 21st, 2004
This Contract, made and entered into this_____day of_______, 20__, by and between ____________________________ (a nonappropriated fund instrumentality hereinafter called NAFI) and__________________________ (hereinafter called Contractor), is for a period of_________ subject to the provisions set forth hereunder.
Individual Service Contract (ISC) between States and CRV SupplierIndividual Service Contract • January 19th, 2016
– Terms and Conditions will generally be used during the contracting and execution stages. In this case the Individual Service contract will be signed between the Supplier and the CRV User.
