ATTACHMENT A: Sample ContractWashington • November 29th, 2017
Jurisdiction FiledNovember 29th, 2017IT PROFESSIONAL SERVICE CONTRACT Network & Telephony Managed Services DSHS Contract Number:SAMPLE CONTRACTResulting From Procurement Number:RFP 1723-652 This Contract is between the state of Washington Department of Social and Health Services (DSHS) and the Contractor identified below, and isgoverned by chapter 39.26 RCW. Program Contract Number: Contractor Contract Number: CONTRACTOR NAMERFP Note: The Apparent Successful Bidder of RFP #1723-652 will be listed here CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) DSHS INDEX NUMBER CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS DSHS ADMINISTRATIONServices and Enterprise Support Administration DSHS DIVISIONEnterprise Services Division DSHS CONTRACT CODE DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBER(S) CONTRACT