Attachment G. References Must be completed (all references must be verifiable), signed/dated and submitted in ProcureAZ.
Attachment G. Contract Coverage Attachment Contractors under the Master Agreement that results from this contract will submit quarterly Attachment G to the Lead State. This attachment is intended to encapsulate the plans, services and offerings of the contractor. This would include any legacy and current offerings, including the plans entered on Attachment C. (anything that would be covered by the Master Agreement). For Award Category 1, all legacy plans that have a discount under the Current Nevada Master Agreement must continue the discount to be covered by the Master Agreement that results from this solicitation. All legacy plans that do not have a discount under the Current Nevada Master Agreement may continue to have no discount under the Master Agreement that results from this solicitation
Attachment G. 1. Navigator and Navigator Organization Conduct
Attachment G. Addendum to ENS Agreement for Patient Asserted Notifications
Attachment G. Special Grant Conditions
Attachment G. Contractor Named Claim Fiduciary County hereby delegates to Contractor fiduciary responsibility and discretion to determine all matters relating to the interpretation and operation of the dental plan as it relates to the administration and payment of disputed benefit claims in accordance with the terms of the dental plan, the Agreement and to the extent provided in this Attachment G. Notwithstanding any provision in this Agreement to the contrary, the parties agree that Contractor shall provide claim appeal fiduciary services subject to the terms and conditions set forth below, and any other applicable federal and state law or regulation, with regards to denied claims and appeals of denied claims under dental plan. The parties acknowledge that Contractor has received and accepted additional fees/compensation from the County, under this Agreement, for the specific purpose of acting as claims fiduciary for the Plan. Fiduciary Claims Appeal Services Contractor shall act as the claims fiduciary under the dental plan(s) for the appeal of disputed claims under the dental plan. For purposes of this Agreement, a disputed claim is a claimant’s written request for review and reconsideration of a claim for benefits initially denied in whole or in part by Contractor. As claims fiduciary, Contractor shall take all actions and retain all experts and outside resources, at its own cost and expense that it deems necessary and appropriate to act in the capacity of claims fiduciary. Contractor shall ensure that the content of each written claim denial and/or appeal denial notice shall include all information required to be included in such notice to be compliant with applicable federal and state law or regulation, with regards to denied claims and appeals for denied claims. The content of such written notices shall specifically include information regarding how the participant can seek a first and independent second level appeal of the denied claim or appeal and Contractor shall ensure that each notice is provided in a culturally and linguistically appropriate manner. In the event a claimant files any court action seeking payment on any claim, whether appealed to Contractor or otherwise, Contractor shall take immediately notify County and await instructions and/or direction from County with respect to any further actions to be taken by Contractor. Contractor shall, at reasonable intervals, provide County with information on the status of such litigation. In no event may Cont...
Attachment G. T/R Systems Training and Consulting Rates Effective June 20, 1997 Trainer: $ * per day Engineer: $ * per day Sr. Engineer: $ * per day Managing Engineer: $ * per day Chief Technology Officer: $ * All rates are in US dollars. A day represents a normal eight hour working day. Rates are subject to change with * (*) days notice. Daily rates do not include travel and living expenses which will be billed separately. * Confidential information has been omitted and filed separately with the Commission.
Attachment G. Maryland Living Wage Requirements for Service Contracts and Affidavit of Agreement If required, Attachment G-1 Living Wage Affidavit of Agreement must be completed and submitted with the Technical Proposal. ATTACHMENT H – Federal Funds Attachment If required (see Section 1.35), these Attachments must be completed and submitted with the Technical Proposal as instructed in the Attachments. ATTACHMENT I – Conflict of Interest Affidavit and Disclosure If required (see Section 1.36), this Attachment must be completed and submitted with the Technical Proposal. ATTACHMENT J – Non-Disclosure Agreement If required (see Section 1.37), this Attachment must be completed and submitted within five (5) Business Days of receiving notification of recommendation for award. However, to expedite processing, it is suggested that this document be completed and submitted with the Technical Proposal. ATTACHMENT K –Form TD-3 These Attachments must be completed and submitted with the Technical Proposal as instructed in the Attachments. ATTACHMENT L – Mercury Affidavit If required (see Section 1.40), this Attachment must be completed and submitted with the Technical Proposal. ATTACHMENT M – Veteran-Owned Small Business Enterprise Forms If required (see Section 1.41), these Attachments include the VSBE Attachments M-1 through M-4. Attachment M-1 must be completed and submitted with the Technical Proposal. Attachment M-2 is required to be submitted within ten (10) Business Days of receiving notification of recommendation for award. ATTACHMENT N – Location of the Performance of Services Disclosure If required (see Section 1.42), this Attachment must be completed and submitted with the Technical Proposal.
Attachment G. First Revised and Restated Required Standard Provisions for PHP and Provider Contracts is revised and restated in its entirety as set forth in Xxxxxxxxxx 0, Xxxxxxxxxx X. Second Revised and Restated Required Standard Provisions for PHP and Provider Contracts, to this Amendment.
Attachment G. Queensland Linehaul Agreement
