LOW VALUE SERVICE CONTRACTValue Service Contract • April 3rd, 2019
DATE: Enter todays Date ADVANTAGE CONTRACT #: DEPARTMENT AGREEMENT #: Enter internal agreement number if applicable. If not applicable, enter NA CONTRACT AMOUNT: $ START DATE: END DATE: This Contract, is between the following Department of the State of Maine and Provider: State of Maine DEPARTMENT DEPARTMENT: Address: City: State: Zip Code: PROVIDER PROVIDER: Address: City: State: Zip Code: Provider’s Vendor Customer #: Each signatory below represents that the person has the requisite authority to enter into this Contract. The parties sign and cause this Contract to be executed. State of Maine Department Provider Signature of Authorized Representative Date Representative Name and Title Signature of Authorized Representative Date Representative Name and Title
