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Purchased Services > Contract 2009

Contract 2009- Table of Contents

Provider Summary Page

Microsoft Word* Adobe PDF*  

Standard Agreement Cover Page

Microsoft Word*    

Contract Billing Form

Microsoft Word* Adobe PDF*  

Vendor Form

    Microsoft Excel*

Debarment Form

Microsoft Word* Adobe PDF*  
 

Agreement Authorization

Agreement Authorization Form Microsoft Word* Adobe PDF*  
OCFS/OES Agreement Authorization     Microsoft Excel *
Agreement Authorization - OIT Form Microsoft Word* Adobe PDF*  
 

Signature Page

BP 18 Agreement for Special Services ($5,000 level) Microsoft Word* Adobe PDF*  
BP 54 Agreement to Purchase Services Microsoft Word*    
Amendments Signature Microsoft Word*    
Amendment- Vendor Change Microsoft Word*    
 

Rider "A"

Specifications Of Work To Be Performed - Generic Microsoft Word* Adobe PDF*  
OSA - Prevention Contract Template Microsoft Word*    
OSA - Treatment Contract Template Microsoft Word*    
OSA - Special Services Contract Template Microsoft Word*    
OSA - MECare Contract Template Microsoft Word*    
CDC -  Specification of Work to be Performed Microsoft Word* Adobe PDF*  
 

Rider "B"

Rider B – 12 Monthly Payments Microsoft word* Adobe PDF*  
Rider "B" Program Administrator/Agreement Administrator Microsoft Word* Adobe PDF*  
Rider "B" Purchases' Form Agreement Administrator Only Microsoft Word* Adobe PDF*  
 

Rider "C"

Exceptions to Rider"B"      HTML
Office of Adult Mental Health Microsoft Word* Adobe PDF*  
 

Rider "D"

Addition Requirements – Client Services Microsoft Word* Adobe PDF*  
Addition Requirements – State Services Microsoft Word* Adobe PDF*  
 

Rider "E" Program Requirements

Adult Mental Health Microsoft Word* Adobe PDF* HTML
Children's Behavioral Health Microsoft Word* Adobe PDF* HTML
Adult with Physical and Cognitive Disabilities Microsoft Word* Adobe PDF* HTML
Maine Center for Disease Control Microsoft Word* Adobe PDF*
 
 

Rider "G"

Identification of Country In Which Contracted Work Will Be Performed Microsoft Word* Adobe PDF*    
 

Rider "I"

Assurance of Compliance Microsoft Word* Adobe PDF* HTML
Resolution Agreement Cover Letter Microsoft Word* Adobe PDF*  
 

Service Definitions

    HTML
 

Performance Indicators

Adult Mental Health (updated September 08, 2006)     Microsoft Excel*
Children's Behavioral Health (updated September 08, 2006)     Microsoft Excel*
   Instructions for Reporting Performance Indicators (updated    September 08, 2006) Microsoft Word* Adobe PDF* HTML
 

Budget Forms

Budget Form - Generic     Microsoft Excel*
   Instructions for Completing Budget Forms Microsoft Word* Adobe PDF*  
 
Budget Forms - Adult with Physical and Cognitive Disabilities
   Summary of Services Form 6     Microsoft Excel*
 
Budget Forms - Children's     Microsoft Excel*
   Instructions for Completing Budget Forms Microsoft Word* Adobe PDF*  
 
Budget Forms - Mental Health     Microsoft Excel*
   Instructions for Completing Budget Forms Microsoft Word* Adobe PDF*  
 
Budget Forms - OSA     Microsoft Excel*
 
FY 07 Rate Setting Report - PNMI and Room/Board     Microsoft Excel*
 

Quarterly Financial Report

Quarterly Financial Report Form     Microsoft Excel*
   Instructions for Completing Quarterly Financial Forms Microsoft Word* Adobe PDF* HTML
 

Pro Forma

   Instructions Microsoft Word* Adobe PDF*  
 

Agreement Close-out Report

Agreement Close-out Report     Microsoft Excel*
Sub-recipient Agreement Close-out Report     Microsoft Excel*
Instructions Microsoft Word* Adobe PDF*  
 

Intranet Only (State Employees)

BP 37R - Requisition for Contract/Grant Authorization Microsoft Word* Adobe PDF*  
Commissioner's or Department Head's Request For Contract/Grant/Purchase Approval Microsoft Word*    

 

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