Automatic Amendment and Interpretation. If there is (i) a change in any law, regulation or rule, state or federal, applicable to HIPPA and/or Confidential Information, or (ii) any change in the judicial or administrative interpretation of any such law, regulation or rule,, upon the effective date of such change, this DUA shall be deemed to have been automatically amended, interpreted and read so that the obligations imposed on HHS and/or CONTRACTOR remain in compliance with such changes. Any ambiguity in this DUA will be resolved in favor of a meaning that permits HHS and CONTRACTOR to comply with HIPAA or any other law applicable to Confidential Information. Envelope Id: 8005CDCD06544FFDA073D09D6B8D2A08 Status: Completed Subject: Please DocuSign: HHS001193700012, Grayson County, Base Confinement Contract Source Envelope: Document Pages: 78 Signatures: 9 Envelope Originator: Certificate Pages: 5 Initials: 0 CMS Internal Routing Mailbox AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ #▇▇▇ Reston, VA 20190 ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ IP Address: 167.137.1.18 Status: Original 1/6/2023 3:31:37 PM Holder: CMS Internal Routing Mailbox ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Location: DocuSign ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇@▇▇.▇▇▇▇▇▇▇.tx.us County Judge Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 24.117.89.66 Sent: 1/6/2023 3:38:46 PM Resent: 1/25/2023 11:28:48 AM Viewed: 1/25/2023 3:47:07 PM Signed: 2/21/2023 3:51:40 PM Accepted: 1/25/2023 3:47:07 PM ID: ce3fb937-f6b9-440d-b319-fb4ac0d356c7 ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ CTCM, Unit Director DSHS Security Level: Email, Account Authentication (None) Accepted: 2/23/2023 10:09:46 AM ID: aee06a18-0950-48d5-824c-cd597753a6a9 ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Director, DSHS CMS Security Level: Email, Account Authentication (None) Accepted: 5/5/2022 12:43:08 PM ID: f01589da-43a7-481e-996a-7c50409e5d48 ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Associate Commissioner Texas Health and Human Services Commission Security Level: Email, Account Authentication (None) Using IP Address: 72.178.217.9 Using IP Address: 167.137.1.16 Signature Adoption: Pre-selected Style Using IP Address: 167.137.1.13 Sent: 2/21/2023 3:51:44 PM Viewed: 2/23/2023 10:09:46 AM Signed: 2/23/2023 10:11:56 AM Sent: 2/23/2023 10:12:00 AM Viewed: 2/23/2023 3:18:39 PM Signed: 2/23/2023 3:19:00 PM Sent: 2/23/2023 3:19:06 PM Viewed: 3/7/2023 1:03:20 PM Signed: 3/7/2023 1:03:36 PM Accepted: 7/6/2021 8:08:45 AM ID: 1a6909aa-b026-45a9-be9f-4240c2e32ff9 ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇@▇▇.▇▇▇▇▇▇▇.▇▇.us Health Department Director Grasyon County Health Department Security Level: Email, Account Authentication (None) Accepted: 12/7/2022 10:33:50 AM ID: fea7b990-a14a-4006-aa80-a5d1e5e7f94e CMS Internal Routing Mailbox ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ DSHS Contract Management Section Security Level: Email, Account Authentication (None) Not Offered via DocuSign ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Contract Administration Ma Security Level: Email, Account Authentication (None) Not Offered via DocuSign Sent: 1/6/2023 3:38:45 PM Viewed: 1/9/2023 10:00:10 AM Sent: 3/7/2023 1:03:40 PM Resent: 3/7/2023 1:03:43 PM Sent: 3/7/2023 1:03:40 PM Viewed: 3/8/2023 12:14:18 PM Envelope Sent Hashed/Encrypted 1/6/2023 3:38:45 PM Envelope Updated Security Checked 1/25/2023 11:28:47 AM Envelope Updated Security Checked 1/25/2023 11:28:47 AM Certified Delivered Security Checked 3/7/2023 1:03:20 PM Signing Complete Security Checked 3/7/2023 1:03:36 PM Completed Security Checked 3/7/2023 1:03:40 PM Electronic Record and Signature Disclosure created on: 9/14/2020 7:10:18 PM Parties agreed to: ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇ From time to time, DSHS Contract Management Section (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system. At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below. If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to: ▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at ▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address. If you created a DocuSign account, you may update it with your new email address through your account preferences. To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to ▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any. To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
Appears in 1 contract
Sources: Grant Agreement
Automatic Amendment and Interpretation. If there is (i) a change in any law, regulation or rule, state or federal, applicable to HIPPA and/or Confidential Information, or (ii) any change in the judicial or administrative interpretation of any such law, regulation or rule,, upon the effective date of such change, this DUA shall be deemed to have been automatically amended, interpreted and read so that the obligations imposed on HHS and/or CONTRACTOR remain in compliance with such changes. Any ambiguity in this DUA will be resolved in favor of a meaning that permits HHS and CONTRACTOR to comply with HIPAA or any other law applicable to Confidential Information. Envelope Id: 8005CDCD06544FFDA073D09D6B8D2A08 086451041F814FD3857A9B2430FA643B Status: Completed Subject: Please DocuSign: HHS001193700012, Grayson County, Base Confinement Contract HHS001182200015; Fort Bend; Base; TB STATE Signature Packet Source Envelope: Document Pages: 78 66 Signatures: 9 3 Envelope Originator: Certificate Pages: 5 6 Initials: 0 CMS Internal Routing Mailbox AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ #▇▇▇ Reston, VA 20190 ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ IP Address: 167.137.1.18 167.137.1.16 Status: Original 1/6/2023 3:31:37 4/12/2022 3:45:26 PM Holder: CMS Internal Routing Mailbox ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Location: DocuSign ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇@▇▇.▇▇▇▇▇▇▇.tx.us ▇.▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ County Judge Fort Bend County Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Signed by link sent to ▇▇▇▇▇▇.▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ Using IP Address: 24.117.89.66 209.184.91.105 Sent: 1/6/2023 3:38:46 PM 6/2/2022 11:35:29 AM Resent: 1/25/2023 11:28:48 6/2/2022 11:35:40 AM Viewed: 1/25/2023 3:47:07 PM 6/8/2022 9:29:34 AM Signed: 2/21/2023 3:51:40 PM 6/8/2022 10:29:07 AM Accepted: 1/25/2023 3:47:07 8/2/2021 3:59:58 PM ID: ce3fb937474773d2-f6b99ba5-440d441a-b319-fb4ac0d356c7 b77e-59bd9f48590f ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ .▇▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ CTCM, Unit Director DSHS Security Level: Email, Account Authentication (None) Signed by ▇▇▇▇ sent to ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Using IP Address: 167.137.1.17 Sent: 6/8/2022 10:29:12 AM Viewed: 6/8/2022 10:30:15 AM Signed: 6/8/2022 10:36:43 AM Accepted: 2/23/2023 10:09:46 6/8/2022 10:30:15 AM ID: aee06a18b7171ce4-0950882c-4727-48d5b505-824c-cd597753a6a9 2d27360e1f7a ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Director, DSHS CMS Security Level: Email, Account Authentication (None) Accepted: 5/5/2022 12:43:08 PM ID: f01589da-43a7-481e-996a-7c50409e5d48 ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇Signed by link sent to ▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Associate Using IP Address: 167.137.1.17 Sent: 6/8/2022 10:36:48 AM Viewed: 6/8/2022 11:17:43 AM Signed: 6/8/2022 11:18:13 AM Accepted: 5/5/2022 12:43:08 PM ID: f01589da-43a7-481e-996a-7c50409e5d48 Kirk Cole ▇▇▇▇.▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Deputy Commissioner Texas Health and Human Services Commission Security Level: Email, Account Authentication (None) Using IP Address: 72.178.217.9 Using IP Address: 167.137.1.16 Signature Adoption: Pre-selected Style Using IP Address: 167.137.1.13 Sent: 2/21/2023 3:51:44 PM Viewed: 2/23/2023 10:09:46 AM Signed: 2/23/2023 10:11:56 AM Sent: 2/23/2023 10:12:00 AM Viewed: 2/23/2023 3:18:39 PM Signed: 2/23/2023 3:19:00 PM Sent: 2/23/2023 3:19:06 PM Viewed: 3/7/2023 1:03:20 PM Signed: 3/7/2023 1:03:36 PM Accepted: 7/6/2021 8:08:45 AM ID: 1a6909aa-b026-45a9-be9f-4240c2e32ff9 Signed by link sent to ▇▇▇▇.▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Using IP Address: 160.42.85.12 Sent: 6/8/2022 11:18:19 AM Viewed: 6/8/2022 5:40:07 PM Signed: 6/8/2022 5:40:53 PM Accepted: 6/8/2022 5:40:07 PM ID: e6836a90-762d-4c06-84ff-ff40d7594480 Lacy Alexander ▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Security Level: Email, Account Authentication (None) Not Offered via DocuSign ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇@▇▇ ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇.us Health Department Director Grasyon County Health Department ▇ Security Level: Email, Account Authentication (None) Accepted: 12/7/2022 10:33:50 5/24/2022 11:20:00 AM ID: fea7b9908a965aaa-a14a-4006a5d5-aa8042a1-a5d1e5e7f94e aa1e-6b4854f8ffcd CMS Internal Routing Mailbox ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ DSHS Contract Management Section Security Level: Email, Account Authentication (None) Not Offered via DocuSign ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Contract Administration Ma Security Level: Email, Account Authentication (None) Not Offered via DocuSign Sent: 1/6/2023 3:38:45 4/12/2022 3:50:30 PM Viewed: 1/9/2023 10:00:10 4/12/2022 3:51:32 PM Sent: 4/12/2022 3:50:29 PM Resent: 4/19/2022 3:55:26 PM Resent: 5/2/2022 11:52:38 AM Resent: 5/4/2022 2:39:20 PM Resent: 5/24/2022 10:54:56 AM Resent: 6/2/2022 11:35:28 AM Sent: 3/7/2023 1:03:40 PM Resent: 3/7/2023 1:03:43 PM Sent: 3/7/2023 1:03:40 PM Viewed: 3/8/2023 12:14:18 6/8/2022 5:40:59 PM Envelope Sent Hashed/Encrypted 1/6/2023 3:38:45 4/12/2022 3:50:30 PM Envelope Updated Security Checked 1/25/2023 11:28:47 AM Envelope Updated Security Checked 1/25/2023 11:28:47 AM Certified Delivered Security Checked 3/7/2023 1:03:20 6/8/2022 5:40:07 PM Signing Complete Security Checked 3/7/2023 1:03:36 6/8/2022 5:40:53 PM Completed Security Checked 3/7/2023 1:03:40 6/8/2022 5:40:59 PM Electronic Record and Signature Disclosure created on: 9/14/2020 7:10:18 PM Parties agreed to: ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇ ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ From time to time, DSHS Contract Management Section (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system. At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below. If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to: ▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at ▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address. If you created a DocuSign account, you may update it with your new email address through your account preferences. To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to ▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇.▇▇ and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any. To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
Appears in 1 contract
Sources: Interlocal Cooperation Contract
Automatic Amendment and Interpretation. If there is (i) a change in any law, regulation or rule, state or federal, applicable to HIPPA and/or Confidential Information, or (ii) any change in the judicial or administrative interpretation of any such law, regulation or rule,, upon the effective date of such change, this DUA shall be deemed to have been automatically amended, interpreted and read so that the obligations imposed on HHS and/or CONTRACTOR remain in compliance with such changes. Any ambiguity in this DUA will be resolved in favor of a meaning that permits HHS and CONTRACTOR to comply with HIPAA or any other law applicable to Confidential Information. Envelope Id: 8005CDCD06544FFDA073D09D6B8D2A08 086451041F814FD3857A9B2430FA643B Status: Completed Sent Subject: Please DocuSign: HHS001193700012, Grayson County, Base Confinement Contract HHS001182200015; Fort Bend; Base; TB STATE Signature Packet Source Envelope: Document Pages: 78 66 Signatures: 9 0 Envelope Originator: Certificate Pages: 5 Initials: 0 CMS Internal Routing Mailbox AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇ #▇▇▇ Reston, VA 20190 ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ IP Address: 167.137.1.18 167.137.1.16 Status: Original 1/6/2023 3:31:37 4/12/2022 3:45:26 PM Holder: CMS Internal Routing Mailbox ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Location: DocuSign ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇@▇▇.▇▇▇▇▇▇▇.tx.us County Judge ▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 24.117.89.66 Sent: 1/6/2023 3:38:46 PM Resent: 1/25/2023 11:28:48 AM Viewed: 1/25/2023 3:47:07 PM Signed: 2/21/2023 3:51:40 PM Accepted: 1/25/2023 3:47:07 PM ID: ce3fb937-f6b9-440d-b319-fb4ac0d356c7 ▇▇▇▇Not Offered via DocuSign ▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇.▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ Security Level: Email, Account Authentication (None) Accepted: 8/2/2021 3:59:58 PM ID: 474773d2-9ba5-441a-b77e-59bd9f48590f ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ CTCM, Unit Director DSHS Security Level: Email, Account Authentication (None) Accepted: 2/23/2023 10:09:46 AM 4/12/2022 1:44:27 PM ID: aee06a180afe5be7-095089ce-448a-9410-48d5-824c-cd597753a6a9 d9c63577abcc ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Director, DSHS CMS Security Level: Email, Account Authentication (None) Accepted: 5/5/2022 12:43:08 4/12/2022 3:00:34 PM ID: f01589da-43a7342d2783-481e-996a-7c50409e5d48 ▇▇b384-42e0-98ba-9914a23c158f ▇▇▇▇ ▇▇▇▇ ▇▇▇▇.▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Security Level: Email, Account Authentication (None) Accepted: 4/12/2022 12:26:09 PM ID: bb6cdeb7-f1dd-43ef-94ce-b22ebaaf58f0 Sent: 4/12/2022 3:50:29 PM ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇.▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Associate Commissioner Texas Health and Human Services Commission Security Level: Email, Account Authentication (None) Using IP Address: 72.178.217.9 Using IP Address: 167.137.1.16 Signature Adoption: Pre-selected Style Using IP Address: 167.137.1.13 Sent: 2/21/2023 3:51:44 PM Viewed: 2/23/2023 10:09:46 AM Signed: 2/23/2023 10:11:56 AM Sent: 2/23/2023 10:12:00 AM Viewed: 2/23/2023 3:18:39 PM Signed: 2/23/2023 3:19:00 PM Sent: 2/23/2023 3:19:06 PM Viewed: 3/7/2023 1:03:20 PM Signed: 3/7/2023 1:03:36 PM Accepted: 7/6/2021 8:08:45 AM ID: 1a6909aa-b026-45a9-be9f-4240c2e32ff9 ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇@▇▇.▇▇▇▇▇▇▇.▇▇.us Health Department Director Grasyon County Health Department Security Level: Email, Account Authentication (None) Accepted: 12/7/2022 10:33:50 AM ID: fea7b990-a14a-4006-aa80-a5d1e5e7f94e Not Offered via DocuSign CMS Internal Routing Mailbox ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ DSHS Contract Management Section Security Level: Email, Account Authentication (None) Not Offered via DocuSign ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇.▇▇▇▇▇▇@▇▇▇▇.▇▇▇▇▇.▇▇▇ Contract Administration Ma Security Level: Email, Account Authentication (None) Not Offered via DocuSign Sent: 1/6/2023 3:38:45 4/12/2022 3:50:30 PM Viewed: 1/9/2023 10:00:10 AM Sent: 3/7/2023 1:03:40 PM Resent: 3/7/2023 1:03:43 PM Sent: 3/7/2023 1:03:40 PM Viewed: 3/8/2023 12:14:18 4/12/2022 3:51:32 PM Envelope Sent Hashed/Encrypted 1/6/2023 3:38:45 PM Envelope Updated Security Checked 1/25/2023 11:28:47 AM Envelope Updated Security Checked 1/25/2023 11:28:47 AM Certified Delivered Security Checked 3/7/2023 1:03:20 PM Signing Complete Security Checked 3/7/2023 1:03:36 PM Completed Security Checked 3/7/2023 1:03:40 4/12/2022 3:50:30 PM Electronic Record and Signature Disclosure created on: 9/14/2020 7:10:18 PM Parties agreed to: ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇ ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇▇ ▇▇▇▇▇ From time to time, DSHS Contract Management Section (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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