Participant Agreement I understand that as a condition for participating in the Program I must comply with the Program’s rules and standards of conduct and follow all reasonable direction of the Program Staff. Failure to comply with the Program’s rules and standards of conduct or failure to comply with the reasonable direction of Program Staff may result in my being dismissed from the Program. Participant Signature: Date: PARENT/LEGAL GUARDIAN AGREEMENT I understand that my child will be subject to the rules and standards of conduct of the Program, Valdosta State University and the University System of Georgia. I further understand that my child’s violation of the rules and standards of conduct or failure to comply with the reasonable direction of Program Staff may result in my child’s dismissal from the Program. I accept responsibility for all costs associated with removing my child from the Program, including but not limited to transportation costs to return the Participant home. I understand that Dismissed Participants are not eligible for a refund of any fees or expenses. Parent/Guardian Signature: Date:
Dissemination of Research Findings and Acknowledgement of Controlled-Access Datasets Subject to the NIH GDS Policy It is NIH’s intent to promote the dissemination of research findings from use of controlled-access dataset(s) subject to the NIH GDS Policy as widely as possible through scientific publication or other appropriate public dissemination mechanisms. Approved Users are strongly encouraged to publish their results in peer-reviewed journals and to present research findings at scientific meetings.
Participant Signature Ratification, Acceptance(A), Approval(AA), Accession(a)
Designation of Key Personnel The Contractor’s Contract Manager for this engagement shall be Xxxxxxx Xxxxxxx, Phone: (000) 000-0000, Email Address: xxxxxxx@xxxxxxxxxx.xxx. The City’s Contract Manager for the engagement shall be Xxx Xxxxx, Phone: ( 512 ) 974 - 8211 , Email Address: Xxx.Xxxxx@xxxxxxxxxxx.xxx. The City and the Contractor resolve to keep the same key personnel assigned to this engagement throughout its term. In the event that it becomes necessary for the Contractor to replace any key personnel, the replacement will be an individual having equivalent experience and competence in executing projects such as the one described herein. Additionally, the Contractor will promptly notify the City Contract Manager and obtain approval for the replacement. Such approval shall not be unreasonably withheld.
Supplementation of Compensation Award If an employee is prevented from performing the employee's regular work with the City on account of an occupational accident that is recognized by the Workers' Compensation Board as compensable within the meaning of the Workers' Compensation Act, the City will supplement the award made by the Workers' Compensation Board for loss of wages to the employee by such an amount that the award of the Workers' Compensation Board for loss of wages (excluding non- economic loss payment), together with the supplementation by the City, will equal 100% of the employee's regular net wage (gross pay less statutory deductions, union dues and required benefit plan contributions). The said supplementation shall not be payable to any employee entitled to compensation after pension age if such an employee is entitled to an unreduced pension as provided under the Local Authorities Pension Plan or after the full age of 65 years if such an employee is not entitled to a pension. Subject to the foregoing limitation, the procedure to be followed in operating this policy shall be as follows:
ADDITIONAL GRANT INFORMATION Federal Award Identification Number (XXXX): B08TI083054-01 Federal Award Date: 10/01/2019 Name of Federal Awarding Agency: Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA) CFDA Name and Number: 93.959 Awarding Official Contact Information: Xxxxxx Xxxxxxx, Grants Management Officer, Point of Contact is Xxxxx Xxxx, Grants Specialist, Contact Number: (000) 000-0000, Facsimile: (000) 000-0000, Email: Xxxxx.Xxxx@xxxxxx.xxx.xxx SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT NO. HHS000663700012 HEALTH AND HUMAN SERVICES COMMISSION XXXX XXXX HOME, INC Xxxxx Ita Associate Commissioner Name: Title: Xxxxxx Xxxxx Chief Executive Officer Date of execution: _July 22, 2020 Date of execution: July 22, 2020 THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT NO. HHS000663700012 ARE HEREBY INCORPORATED BY REFERENCE: ATTACHMENT A STATEMENT OF WORK ATTACHMENT A-1 STATEMENT OF WORK SUPPLEMENTAL ATTACHMENT A-2 SUBSTANCE ABUSE PREVENTION AND TREATMENT (SAPT) BLOCK GRANT CONTRACT SUPPLEMENTAL ATTACHMENT B PROGRAM SERVICES & UNIT RATES ATTACHMENT C GENERAL AFFIRMATIONS ATTACHMENT D UNIFORM TERMS AND CONDITIONS-GRANTEE ATTACHMENT E SPECIAL CONDITIONS VERSION 1.2 ATTACHMENT F FEDERAL ASSURANCES AND CERTIFICATIONS ATTACHMENT G DATA USE AGREEMENT VERSION 8.5 ATTACHMENT H FISCAL FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA) FORM ATTACHMENT I SYSTEM AGENCY SOLICITATION NO. HHS0006637 INCLUDING ANY CLARIFICATIONS OR MODIFICATIONS MADE IN RESPONSE TO QUESTIONS SUBMITTED DURING POSTING AND ANY ADDENDUM ATTACHMENT X XXXXXXX’S PROPOSAL FOR SOLICITATION NO. HHS0006637 ATTACHMENTS FOLLOW ATTACHMENT A: STATEMENT OF WORK TREATMENT FOR ADULTS SECTION I: PURPOSE Grantee shall provide substance use disorder treatment services to the target population at one or more of the following service types/levels of care. The below service types/levels of care are based on Texas Administrative Code (TAC) requirements, as referenced in the Substance Use Disorder (SUD) Utilization Management (UM) Guidelines, located at the following link: xxxxx://xxx.xxxxx.xxx/doing-business-hhs/provider-portals/behavioral-health-services- providers/substance-use-disorder-service-providers, and American Society of Addiction Medicine (ASAM) criteria located at the following link: xxx.xxxx.xxx, which is a collection of objective guidelines that give clinicians a standardized approach to admission and treatment planning.
Certification Regarding Entire TIPS Agreement for Part 1 and Part 2 Contracts 5 This is a two part solicitation. Part 1 is solicited for TIPS sales that are not considered a "public work" construction project. Part 1 permits the sale of goods and non-construction/non-"public work" services such as maintenance and minor repairs. Part 2 Job Order Contract (JOC) is solicited for projects considered by your TIPS Member Customers to be a "public work" construction project. The determination of whether or not a TIPS sale amounts to a "public work" construction project requiring a Part 2 JOC contract is made by the TIPS Member Customer at the time of each TIPS sale. Thus, Vendors are encouraged to respond to both Parts 1 and 2 in case your TIPS Member Customers require that a sale be made under one Part or the other. However, responding to both Parts is not required. If Vendor responds and is awarded to both Parts, Vendor will have one contract for Part 1 and a separate contract for Part 2.
XXXX ANTI-LOBBYING AMENDMENT Xxxx Anti-Lobbying Amendment (31U.S.C. 1352) – Contractors that apply or bid for an award exceeding ,000 must file the required anti-lobbying certification. Each tier must certify to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the Customer. As applicable, Contractor agrees to file all certifications and disclosures required by, and otherwise comply with, the Xxxx Anti-Lobbying Amendment (31 USC 1352).Contractor certifies that it is currently in compliance with all applicable provisions of the Xxxx Anti-Lobbying Amendment (31 U.S.C. 1352) and will continue to be in compliance throughout the term of the Contract and further certifies that:
Passwords and Employee Access Provider shall secure usernames, passwords, and any other means of gaining access to the Services or to Student Data, at a level suggested by Article 4.3 of NIST 800-63-3. Provider shall only provide access to Student Data to employees or contractors that are performing the Services. Employees with access to Student Data shall have signed confidentiality agreements regarding said Student Data. All employees with access to Student Records shall pass criminal background checks.
Implementation of Agreement Each Party must promptly execute all documents and do all such acts and things as is necessary or desirable to implement and give full effect to the provisions of this Agreement.
