ITP. All Service Provider Agencies must complete, sign, and submit the Service Provider Roster. The CDSA may remove an employee / subcontractor of the Service Provider Agency from the Service Provider Roster for failing to fulfill obligations under this Attachment 1 without terminating the Provider Agreement with the Service Provider Agency. A Change Request Form must be submitted to the CDSA detailing any changes to the Service Provider Roster or any agency details.
Appears in 2 contracts
Sources: Provider Agreement, Provider Agreement