Vaccine Affiliation Agreement Sample Contracts

AMENDMENT TO THE BCBSM VACCINE AFFILIATION AGREEMENT
Vaccine Affiliation Agreement • September 5th, 2020

This Amendment is made between Blue Care Network of Michigan, Blue Care of Michigan, Inc., and BCN Service Co. (collectively, “BCN”) and the Pharmacy identified on the Signature Document to the Agreement. It is effective on October 1, 2009, or when signed by the parties, whichever is later.

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Participation Signature Docume
Vaccine Affiliation Agreement • February 17th, 2022

IN WITNESS WHEREOF, the parties wishing to be bound by the terms and conditions of BCBSM's Vaccine Affiliation Agreement (WP 10857 OCT 09) have affixed their signatures to this Signature Document, which is incorporated by reference in the BCBSM Vaccine Affiliation Agreement. The effective date of this Agreement is the date of Provider's signature on this document or October 1, 2009, whichever is later.

Participation Signature Document
Vaccine Affiliation Agreement • February 17th, 2022

IN WITNESS WHEREOF, the parties wishing to be bound by the terms and conditions of BCN's Amendment (WP 10856 OCT 09) to BCBSM's Vaccine Affiliation Agreement (WP 10857 OCT 09) have affixed their signatures to this Signature Document, which is incorporated by reference into the BCN Amendment to the BCBSM Vaccine Affiliation Agreement. The effective date of this Agreement is the date of Provider's signature on this document or October 1, 2009, whichever is later.

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