ContractClient Service Contract • October 20th, 2022 • Washington
CLIENT SERVICE CONTRACT Adult Family Home (AFH)Meaningful Day - HCS DSHS Contract Number:2212-60170Program Contract Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. ProviderOne ID and Location Number: CONTRACTOR NAME John J. Smith CONTRACTOR Doing Business As (DBA) Johns Place AFH CONTRACTOR MAILING ADDRESS 1234 12th Ave NEJunction City WA 98333-3333 ADULT FAMILY HOME (AFH) STREET ADDRESS 3421 Main StreetSuite 40-11Aberdeen Junction WA 98333-3333 CONTRACTOR Uniform Business Identifier (UBI) 600-123-123 CONTRACTOR DSHS INDEX NUMBER 146175 AFH LICENSE NUMBER CONTRACTOR CONTACTJohn Smith CONTRACTOR TELEPHONE(360) 555-1212 CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS john@someemail.com DSHS ADMINISTRATION Aging & Long Term Support Admin DSHS DIVISION Division of Home And Community Services DSHS CONTRACT CODE 1080XS-12 DSHS CONTACT NAME AND TITLE Student One Contracts Manager DSHS CONTACT ADDRESS 4500
ContractClient Service Contract • March 15th, 2023 • Washington
CLIENT SERVICE CONTRACT Job Service and IL Service Contract DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION DSHS 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? ASSISTANCE LISTING NUMBER(S) CONTRACT START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A Data Security Requirements
ContractClient Service Contract • May 20th, 2020 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number: RFP 0913-343 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION Medicaid Purchasing Administration DSHS DIVISION Division of Healthcare Services DSHS CONTRACT CODE 7054XS-13 DSHS CONTACT NAME AND TITLE RosaMaria Espinoza Program Manager DSHS CONTACT ADDRESS PO Box 45530626 - 8th Ave.Olympia, WA 98504-5530 DSHS CONTACT TELEPHONE (360) 725-1721 Ext: DSHS CONTACT FAX (360) 664-0261 DSHS CONTACT E-MAIL ADDRESS rosamaria.espinoza@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? No CFDA NUMBER(S) 93.778 CONTRACT START
ContractClient Service Contract • July 13th, 2023 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION DSHS 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 START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A - Data Security Requirements Exhibit B: InsuranceRequirements; Exhibit- C
ContractClient Service Contract • June 27th, 2016 • Washington
CLIENT SERVICE CONTRACT HCA Contract Number: THIS AGREEMENT made by and between Washington State Health Care Authority, hereinafter referred to as "HCA," and the party whose name appears below, hereinafter referred to as the "Contractor." CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR E-MAIL ADDRESS HCA PROGRAMKidney Disease Program H A DIVISION/SECTIONFinancial Services HCA CONTACT NAME AND TITLE Stefanie Slakey HCA CONTACT ADDRESS626 8th AvenueOlympia, WA 98501 HCA CONTACT TELEPHONE (360) 725-1243 HCA CONTACT E-MAIL ADDRESS stefanie.slakey@hca.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? YES NO CFDA NUMBER(S)N/A FFATA Form Required YES NO CONTRACT START DATE 07/01/2016 CONTRA T END DATE 06/30/2018 TOTAL MAXIMUM ONTRACT AMO NT$ PURPOSE OF CO TRACT:To assist perso s who meet the Kidney Disease Program (KD ) Eligibility Requirements to gain
RAGING POINT OUTFITTERS, LLCClient Service Contract • March 6th, 2023
CLIENT SERVICE CONTRACT BETWEEN CO-SIGNER.COM AND IMAGINE MEDIA GROUP, LLC. This Exclusive Technical Consulting and Services Agreement (the "Agreement") is entered into as of July 1,Client Service Contract • August 15th, 2013 • Co-Signer, Inc. • Household audio & video equipment • California
WHEREAS, CONTRACTOR shall be the provider of technical consulting and related services to CLIENT, and CLIENT hereby agrees to accept such technical consulting and services;
ContractClient Service Contract • July 28th, 2022 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number:2213-811 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION DSHS 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 START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A - Data Security Requirements ; See Special Terms and Conditions Sect
CLIENT SERVICE CONTRACT NURSING FACILITY SERVICESClient Service Contract • October 19th, 2007 • Ensign Group, Inc • Services-skilled nursing care facilities • Washington
This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below
ContractClient Service Contract • October 20th, 2022 • Washington
CLIENT SERVICE CONTRACT Adult Family Home (AFH)Expanded Community Services (ECS) DSHS Contract Number:2212-60170Program Contract Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. ProviderOne ID and Location Number: CONTRACTOR NAME John J. Smith CONTRACTOR Doing Business As (DBA) Johns Place AFH CONTRACTOR MAILING ADDRESS 1234 12th Ave NEJunction City WA 98333-3333 ADULT FAMILY HOME (AFH) STREET ADDRESS 3421 Main StreetSuite 40-11Aberdeen Junction WA 98333-3333 CONTRACTOR Uniform Business Identifier (UBI) 600-123-123 CONTRACTOR DSHS INDEX NUMBER 146175 AFH LICENSE NUMBER CONTRACTOR CONTACTJohn Smith CONTRACTOR TELEPHONE(360) 555-1212 CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS john@someemail.com DSHS ADMINISTRATION Aging & Long Term Support Admin DSHS DIVISION Division of Home And Community Services DSHS CONTRACT CODE 1080XS-12 DSHS CONTACT NAME AND TITLE Student One Contracts Manager DSHS CONTACT
ContractClient Service Contract • July 22nd, 2021 • Washington
CLIENT SERVICE CONTRACT Staffed LRA Residence DSHS Contract Number: Resulting From Solicitation Number:2313-837 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION DSHS 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? ASSISTANCE LISTING NUMBER(S) CONTRACT START DATE 11/01/2023 CONTRACT END DATE 10/31/2026 CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A - Data S
CLIENT SERVICE CONTRACT BETWEENClient Service Contract • June 1st, 2015 • Cross Click Media Inc. • Household audio & video equipment • California
This Technical Consulting and Services Agreement (the "Agreement") is entered into as of May 27, 2015 between the following two parties:
ContractClient Service Contract • July 10th, 2017 • Washington
CLIENT SERVICE CONTRACT Access & Visitation DSHS Contract Number:Click here to enter text. Resulting From Solicitation Number: Click here to enter text. This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Click here to enter text. Contractor Contract Number: CONTRACTOR NAME Click here to enter text. CONTRACTOR doing business as (DBA) Click here to enter text. CONTRACTOR ADDRESS Click here to enter text.Click here to enter text., Click here to enter text. Click here to enter text. WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) Click here to enter text. DSHS INDEX NUMBER Click here to enter text. CONTRACTOR CONTACT Click here to enter text. CONTRACTOR TELEPHONE Click here to enter text. CONTRACTOR FAX Click here to enter text. CONTRACTOR E-MAIL ADDRESS Click here to enter text. DSHS ADMINISTRATION Click here to enter text. DSHS DIVISION Click here to enter text. DSHS CONTRACT CODE C
ContractClient Service Contract • March 6th, 2024 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number:Click here to enter text. Resulting From Solicitation Number: Click here to enter text. This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Click here to enter text. Contractor Contract Number: CONTRACTOR NAME Click here to enter text. CONTRACTOR doing business as (DBA) Click here to enter text. CONTRACTOR ADDRESS Click here to enter text.Click here to enter text., Click here to enter text. Click here to enter text. WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) Click here to enter text. DSHS INDEX NUMBER Click here to enter text. CONTRACTOR CONTACT Click here to enter text. CONTRACTOR TELEPHONE Click here to enter text. CONTRACTOR FAX Click here to enter text. CONTRACTOR E-MAIL ADDRESS Click here to enter text. DSHS ADMINISTRATION Click here to enter text. DSHS DIVISION Click here to enter text. DSHS CONTRACT CODE Click here to enter t
ContractClient Service Contract • July 5th, 2019 • Washington
CLIENT SERVICE CONTRACT Supportive Housing DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION Aging & Long Term Support Admin DSHS DIVISION Division of Home And Community Services DSHS CONTRACT CODE 1070XP-12 DSHS CONTACT NAME AND TITLE Suemary Trobaugh Program Manager DSHS CONTACT ADDRESS 4450 10th AVE SE P O Box 45600Lacey, WA 98504-5600 DSHS CONTACT TELEPHONE (360)725-2557 DSHS CONTACT FAX Click here to enter text. DSHS CONTACT E-MAIL ADDRESS trobas@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? No CFDA NUMBER(S) CONTRACT START DATE
DSHS Administration: ESA DSHS Division: Region 5 DSHS Contract Code: 3003 DSHS Contact name and title: Margaret A. Gonzales DSHS Contact address: 2121 South State Street, MS: N27-1, Tacoma, WA 98405 Contract start date: 07/01/00 Contract end date:...Client Service Contract • November 13th, 2000 • L L Brown International Inc • Washington
ContractClient Service Contract • August 31st, 2021 • Washington
CLIENT SERVICE CONTRACT LRA Services DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME CONTRACTOR doing business as (DBA) CONTRACTOR ADDRESS , WASHINGTON UNIFORM BUSINESS IDENTIFIER (UBI) DSHS INDEX NUMBER CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX DSHS ADMINISTRATION DSHS 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 START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): No Data Security ExhibitNo Exhibits. The terms and conditions of this Contract are an integra
ContractClient Service Contract • June 1st, 2022 • Washington
CLIENT SERVICE CONTRACT DSHS Contract Number: Resulting From Solicitation Number:2213-811 This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION DSHS 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 START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A - Data Security Requirements ; See Special Terms and Conditions Sect
ContractClient Service Contract • October 20th, 2022 • Washington
CLIENT SERVICE CONTRACT Adult Family Home (AFH) DSHS Contract Number:2212-60170Program Contract Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. ProviderOne ID and Location Number: CONTRACTOR NAME John J. Smith CONTRACTOR Doing Business As (DBA) Johns Place AFH CONTRACTOR MAILING ADDRESS 1234 12th Ave NEJunction City WA 98333-3333 ADULT FAMILY HOME (AFH) STREET ADDRESS 3421 Main StreetSuite 40-11Aberdeen Junction WA 98333-3333 CONTRACTOR Uniform Business Identifier (UBI) 600-123-123 CONTRACTOR DSHS INDEX NUMBER 146175 AFH LICENSE NUMBER CONTRACTOR CONTACTJohn Smith CONTRACTOR TELEPHONE(360) 555-1212 CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS john@someemail.com DSHS ADMINISTRATION Aging & Long Term Support Admin DSHS DIVISION Division of Home And Community Services DSHS CONTRACT CODE 1080XS-12 DSHS CONTACT NAME AND TITLE Student One Contracts Manager DSHS CONTACT ADDRESS 4500 10th Ave SE Lacey,
ContractClient Service Contract • August 4th, 2017 • Washington
CLIENT SERVICE CONTRACTGang Repression, Intervention, and Prevention (GRIP) Services DSHS Contract Number: Resulting From Solicitation Number: This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Contractor Contract Number: CONTRACTOR NAME 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 ADMINISTRATION DSHS 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 START DATE CONTRACT END DATE CONTRACT MAXIMUM AMOUNT EXHIBITS. The following Exhibits are attached and are incorporated into this Contract by reference: Exhibits (specify): Exhibit A: Statement of
CLIENT SERVICE CONTRACT Children’s Voluntary Placement Services in a Group Care Facility DSHS Contract Number: Click here to enter text. Resulting From Solicitation Number: Click here to enter text.Client Service Contract • August 22nd, 2016
This Contract is between the State of Washington Department of Social and Health Services (DSHS) and the Contractor identified below. Program Contract Number: Click here to enter text. Contractor Contract Number:
