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<br />CONTRACT BETWEEN GRANTEE AND THIRD PARTY (Continued) <br /> <br />ACCEPTED BY: <br /> <br />Signature of Authorized Official <br /> <br />Signature of Authorized Official <br /> <br />Date <br /> <br /> <br />Date <br /> <br />Name & Title (please print or type) <br /> <br />Name & Title (please print or type) <br /> <br />Name of Grantee Agency <br /> <br />'>; Name of Service Provider <br /> <br />Address (street or post office box) <br /> <br /> <br />Address (street or post office box) <br /> <br />City, State lip <br /> <br />Telephone # (include area code) <br /> <br />City, State lip Telephone # (include area code) <br /> <br />NOTE: The intent of the cm Sample Contract Between Grantee and Third Party is to provide a sample form delineating <br />cm requirements,andois not intended for use as a standard fill-in-the-blanks contract. Contracting panies may have <br />additional provisions'as required by their status or circumstances. <br /> <br />INSTRUCTIONS: <br />· Paragraph One. Ensure that current grant number is used. <br />· Paragraph Two. Specifically describe who will monitor contract performance and when monitoring will occur. <br />· Paragraph Three. Check either "KEEP ALL RECORDS" or "ASSIST THE SERVICE PROVIDER." <br />· Paragraph Four. The statement of services to be pro\;ded must be specific. <br />· Paragraph Five. The method of payment. i.e., how payment will be made for the services to be provided, must be <br />specific. Payment by reimbursement is strongly encouraged. Provide justification for other methods of payment. <br />· Paragraph Ten. Paragraph ten shall include quantifiable measures of contract performance and a timetable setting <br />completion dates for major tasks set forth in paragraph four, above. <br />· Signature of Authorized Official. The Authorized Official is the person authorized to execute contracts. <br /> <br />30 <br />cm Forms Packet <br />Revised: July, 1997 <br />