APPENDIX 3 Example of DHS Community Service Agreement & ExhibitsCommunity Services Agreement • September 17th, 2020 • Illinois
The Illinois Department of Human Services (DHS), with its principal office at ___________________________________________________________________________, and ___________ (Provider), with its principal office at ______________________________ and payment address (if different than principal office) at ______________________________________________, hereby enter into this Community Services Agreement (“Agreement”). DHS and Provider are collectively referred to herein as “Parties” or individually as a “Party.”
ATTACHMENT E – Example of DHS Community Service Agreement and ExhibitsCommunity Services Agreement • September 17th, 2020 • Illinois
The Illinois Department of Human Services (DHS), with its principal office at ___________________________________________________________________________, and ___________ (Provider), with its principal office at ______________________________ and payment address (if different than principal office) at ______________________________________________, hereby enter into this Community Services Agreement (“Agreement”). DHS and Provider are collectively referred to herein as “Parties” or individually as a “Party.”
Aged Care Residential & Community Services Agreement (NSW)Community Services Agreement • April 20th, 2012
COMMUNITY SERVICES AGREEMENTCommunity Services Agreement • September 8th, 2023
This Agreement is entered this 14th day of December, 2020 by and between FAIRFIELD TOWNSHIP, TIPPECANOE COUNTY, INDIANA (“TOWNSHIP”) and Lafayette Lions Club, an
COMMUNITY SERVICES AGREEMENT FISCAL YEAR 2012Community Services Agreement • June 23rd, 2011 • Illinois
COMMUNITY SERVICES AGREEMENTCommunity Services Agreement • September 6th, 2019 • Arizona
THIS AGREEMENT, entered into this 12th day of September, 2019, by and between the TOWN OF PRESCOTT VALLEY, a municipal corporation of Arizona (hereinafter the "TOWN"), and PREVENT CHILD ABUSE, INC., a non-profit corporation of Arizona (hereinafter "SERVICE PROVIDER");
ContractCommunity Services Agreement • February 24th, 2020 • Washington
COMMUNITY SERVICES AGREEMENT –OTHER GOVERNMENT PHSKC Agreement # 5112 EMS This Agreement is between King County and the Recipient identified below. The County department overseeing the work to be performed in this Agreement is the Department of Public Health (PHSKC). RECIPIENT NAME King County Fire District #4 dba Shoreline Fire Department RECIPIENT FEDERAL TAX ID # 916007732 RECIPIENT ADDRESS 17525 Aurora Ave N, Shoreline, WA 98133 RECIPIENT CONTACT & EMAIL ADDRESS John Nankervis; JNankervis@shorelinefire.com PHSKC DIVISIONEMS PROJECT TITLEAdvanced Life Support Services AGREEMENT START DATEJan 01 2020 AGREEMENT END DATEDec 31 2025 AGREEMENT MAXIMUM AMOUNT$8,542,290.00 FUNDING DETAILS Funding Source PHSKC Contract # Amount Effective DatesEMS Levy $8,542,290.00 Jan 01 2020 TO Dec 31 2025 FUNDING SUMMARYFEDERAL: $0.00 COUNTY: $8,542,290.00 STATE: $0.00 OTHER: $0.00 IS THE RECIPIENT A SUBRECIPIENT FOR PURPOSES OF THIS AGREEMENT? No EXHIBITS. The following Exhibits are attached and ar
ContractCommunity Services Agreement • June 21st, 2012
COMMUNITY SERVICES AGREEMENTCommunity Services Agreement • September 6th, 2019 • Arizona
THIS AGREEMENT is made and entered into this 12th day of September, 2019, by and between the TOWN OF PRESCOTT VALLEY, a municipal corporation of Arizona (hereinafter the “TOWN”), and ARIZONA CRISIS TEAM, INC., INC., (hereinafter “SERVICE PROVIDER”);
COMMUNITY SERVICES AGREEMENT FISCAL YEAR 2011Community Services Agreement • June 23rd, 2010 • Illinois
This Community Services Agreement (“Agreement”) is by and between the Illinois Department of Human Services (hereinafter referred to as the “Department” or “DHS”), with its principal office at and (hereinafter referred to as the "Provider"), with its principal address at: .
AMENDMENT TO COMMUNITY SERVICES AGREEMENTCommunity Services Agreement • September 9th, 2011 • Illinois
This Amendment to the FY12 Community Services Agreement (“Amendment”) is entered into between the Illinois Department of Human Services (“Department”) and (“Provider”). The Department and Provider are referred to herein collectively as “Parties” and individually as a “Party”.
