Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency] By: By: Title: Title: Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxx X.Xxxxxx, Director Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved as to Form and Legality: Office of the Attorney General By: (for) Xxxxxx X. Xxxx, Xx., Attorney General Refer to Electronic Approval History found after the final page of the Executed Contract for details.
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. Coordinated Care Corporation Indiana Indiana Family & Social Services Administration By:\s1\ By:\s2\ Title:\t1C\EO Date:\d31/\29/2021 | 15:13 CDT Title:\t2M\edicaid director Date:\d32/\29/2021 | 16:15 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X. Xxxxxx, Attorney General EXHIBIT 1 SCOPE OF WORK Table of Contents 1.0 Background 33 2.0 Administrative Requirements 33 2.1 State Licensure 33 2.2 National Committee for Quality Assurance (NCQA) Accreditation 33 2.3 Subcontracts 34 2.4 Financial Stability 36 2.4.1 Solvency 36 2.4.2 Insolvency and Receivership 36 2.4.3 Reinsurance 37 2.4.4 Performance Bond Requirements 38 2.4.5 Financial Accounting Requirements 38 2.4.6 Insurance Requirements 40 2.5 Maintenance of Records 40 2.6 Disclosures 40 2.6.1 Definition of a Party in Interest 40 2.6.2 Types of Transactions Which Must Be Disclosed 41 2.7 Debarred Individuals 41 2.8 Medical Loss Ratio 42 2.9 Health Insurance Providers Fee 43 2.10 Administrative and Organizational Structure 43 2.10.1 Staffing 44 2.10.2 Key Staff 44 2.10.3 Other Required Staff Pos...
Agreement to Use Electronic Signatures. By checking the “I accept the terms of service” check box you are electronically signing this E-Sign Agreement and the Terms of Use related to the Services. You specifically agree that any electronic signatures that you provide through this online process are valid and enforceable as your legal signature. You acknowledge that these electronic signatures will legally bind you to the terms and conditions contained in the E-Sign Agreement and Terms of Use documents just as if you had physically signed the same documents with a pen.
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL? In Witness Whereof, the Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. [Contractor] [Indiana Agency] By: _________________________________ By: _______________________________ _____________________________________ ___________________________________ Name and Title, Printed Name and Title, Printed Date: _____________________________ Date: ___________________________ Approved by: Approved by: Indiana Department of Administration State Budget Agency By: ________________________________(for) By: _______________________________ (for) Xxxxxxx Xxxxxxxx, Commissioner Xxxxxxx X. Xxxxxxx, Director Date: ________________________________ Date: _________________________________ APPROVED as to Form and Legality: Office of the Attorney General ___________________________________(for) Xxxxxxxx X. Xxxxxx, Attorney General Date: _________________________________ Approved by: Indiana Office of Technology By: __________________________________ (for) Xxxxx X. Xxxxxx, Chief Information Officer Date: _________________________________
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL?
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. Vendor Name Indiana Department of Child Services By: By: Title: Title:
Agreement to Use Electronic Signatures. You specifically agree that any electronic signatures that you provide through this online process are valid and enforceable as your legal signature. You acknowledge that these electronic signatures will legally bind you to the terms and conditions contained in the related documents just as if you had physically signed the same documents with a pen.
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Grant Agreement by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Grant Agreement to the State of Indiana. I understand that my signing and submitting this Grant Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Grant Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Grant Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Grant Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The PARTIES, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof.
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Origination Agreement by accessing the electronic signature tool in Adobe to electronically submit this Origination Agreement to IHCDA. I understand that my signing and submitting this Origination Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Origination Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Origination Agreement in this fashion I am affirming to the truth of the information contained therein and my authority to bind the Participant. I also understand that if I decide not to sign this Origination Agreement electronically, I must notify IHCDA so that this Origination Agreement may be re- submitted to me and I may sign it and return it to IHCDA in the traditional manner.
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Contractor and the State have, through their duly authorized representatives, entered into this Contract. The parties, having read and understood the foregoing terms of this Contract, do by their respective signatures dated below agree to the terms thereof. PITNEY XXXXX INC By: Indiana Department of Administration Title: Government Account Manager By: Title: Vendor Manager Date: 6/15/2021 | 09:29 EDT Date: 6/15/2021 | 09:57 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxx X. Xxxxx, Commissioner
