Contract 2012 - Table of Contents

Note: Documents open in new window

Business Associate Agreement Microsoft Word* Adobe PDF*  
Contract Billing Form Microsoft Word* Adobe PDF*  
Debarment Form Microsoft Word* Adobe PDF*  
FFATA Subawardee Information Form     Microsoft Excel*
Provider Summary Page Microsoft Word* Adobe PDF*  
Standard Agreement Cover Page Microsoft Word*   Microsoft Excel*
Supplemental Sheet for Contracted Employees     Microsoft Excel*
Agreement Authorization
DHHS Program, Fiscal, and Purchased Services Initiation Form     Microsoft Excel*
Signature Page
Amendments Signature Microsoft Word*    
Amendment Vendor Change Microsoft Word*    
BP18 Agreement for Special Services ($5,000 level) Microsoft Word* Adobe PDF*  
BP54 Agreement to Purchase Services Microsoft Word*    
BP54 EO-IT Microosft Word*    
  • Instructions for BP54 EO-IT
 Microsoft Word* Adobe PDF*  
Cooperative Agreement Microsoft Word* Adobe PDF*  
Cooperative Agreement Amendment Microsoft Word* Adobe PDF*  
Rider "A"
CDC - Specification of Work to be Performed Microsoft Word*    
Cooperative Agreements Scope of Work Microsoft Word*    
OSA Rider A - Cost Sharing Microsoft Word*    
OSA Rider A - Incentive Microsoft Word*    
Specifications Of Work To Be Performed - Generic Microsoft Word*    
Rider "B"
Rider "B" - 12 Monthly Payments Microsoft Word* Adobe PDF*  
Rider "C"
Exceptions to Rider"B"  Microsoft Word* Adobe PDF*  
Rider "D"
Additional Requirements - Client Services Microsoft Word* Adobe PDF*  
Additional Requirements - State Services Microsoft Word* Adobe PDF*  
Rider D for DDPC and RPC Microsoft Word* Adobe PDF*  
Rider "E" Program Requirements
Adult Mental Health Microsoft Word* Adobe PDF*  
Adults with Physical and Cognitive Disabilities Microsoft Word* Adobe PDF*  
CAP Agencies Microsoft Word* Adobe PDF*  
CBHS Out of State Room and Board Microsoft Word* Adobe PDF*  
Children's Behavioral Health Microsoft Word* Adobe PDF*  
Children’s Residential Microsoft Word* Adobe PDF*  
Domestic Violence Microsoft Word* Adobe PDF*  
Maine Center for Disease Control Microsoft Word* Adobe PDF*  
Office of Substance Abuse Microsoft Word* Adobe PDF*  
Sexual Assault Microsoft Word* Adobe PDF*  
Transportation Microsoft Word* Adobe PDF*  
Victim Advocacy Microsoft Word* Adobe PDF*  
Rider "F"
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 - OSA     Microsoft Excel*
Budget Forms - OSA Treatment     Microsoft Excel*
Budget Forms - OES AAA     Microsoft Excel*
Budget Forms - OES Provider     Microsoft Excel*
Rider F1 - Pro Forma, Rider F2 - Agreement Compliance Form   Adobe PDF* Microsoft Excel*
F1 Pro Forma Instructions Microsoft Word* Adobe PDF*  
Rider F1 Pro Forma, Rider F2 Agreement Compliance Form Fee For Service   Adobe PDF* Microsoft Excel*
Rider "G"
Identification of Country In Which Contracted Work Will Be Performed Microsoft Word*    
Rider "I"
Assurance of Compliance Microsoft Word* Adobe PDF*  
Resolution Agreement Cover Letter Microsoft Word* Adobe PDF*  
Quarterly Financial Report
Quarterly Financial Report Form     Microsoft Excel*
Agreement Close-out Report
Agreement Close-out Report     Microsoft Excel*
Fee-for-Service Final Report     Microsoft Excel*
Sub-recipient Agreement Close-out Report     Microsoft Excel*
  • Instructions
 Microsoft Word* Adobe PDF*