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<br />NOT APPLICABLE TO THIS GRANT <br /> <br />CONTRACT FOR RESlDEN1IAL SERVICES <br />STAn: OF n:XAS, COUNTy OF <br />- <br /> <br />Ponn RA 6 <br /> <br />L PROVIsIONS OF SERVICES <br /> <br />In accordance with the Uniform Grant and Contract Ma/llJgement Standards and provisions o[ the GOVelnor's <br />Office, CrintinaJ Justice Division, Grant No. and <br />(Name of the Granite) <br />~ --' hereinafter called SeJVice A8ency, by this A~ and in COllsidetation o[ <br />the mutual PTOlllises Set forth below, agree that: <br /> <br />--- <br /> <br />ll'prl;: SPecify here the level o[ care to be provided (circle one): <br /> <br />The Service Agency agrees to provide the following seJVices, ~itic.h sban be limited to a1Jeged to adjUdicated <br />Juvenile offenders in licensed c.hi1d care fucilities: <br /> <br />F. Each billing should contain ~ Dalne of ~e client or cl!ents. [or whom payment is being requested along with the <br />Dwnberof days (staltd COIlsecubvely) for whic.h paYll1ent IS hemg requested. <br /> <br />. G,. l1le SeJVice AgenCj' is IlDdeJ: 1)0 obligation to accept a client who is deemed inappropriate [or placement in the <br />prograzn by Sezvice Agency. <br />16 <br />CJD Fonns Packe~ revised 7/96 <br /> <br />B. Reco8lliz:ing that a parr o[ a client's r~ililalioD prosnun may include lime a~~y from the residential setting <br />0: the Se:nc:e Agency, suc.h as Weekends, holidays, etc., and that the SetvJce Agency must retain SPace for this <br />client II!ltiJ his retu1ll, - will pay the SeJVice Agency the above . o.ee-upon <br />1Noo.,,~ _ ~. <br />amOUnt [or suc.h regularly scheduled days away from the SeJVice A8ency or its prosnun providing thcy do DOt <br />~ ten (10) days at anYone time._ <br /> <br />C. If a client DIa/ces an IIllauthorized departw-e fr01l1 the SeJVice Agency, the _ <br />(Nllllco[~ . _ <br />sban be Dotified inunediateJY. If the client returns to the SeJVice Agency within ten (10) days or prior to the last billing <br />day of the month, wbicbcver sban 0CQlr .6m, the SeJVice Agency sban I'CCeive paYll1ent [or those days <br />the client Was abSQlt from the Service A8ency, but Dot to exceed then (10) days paYll1ent <br /> <br />D. The Service Agency is under DO obligation to retain space [or the client in llDauthorized departure situations. <br /> <br />E. PaYll1ent is to be made monthly. C1aim.for paYll1ent will be submitted DO later than ten (10) days from the last day <br />o[ the mODth [or wbic.h payment is being requested. <br /> <br />Primary Specialized Inlennediate Emergency shelter Thezapeutic Intensive In-Patient PSYchiatric . <br /> <br />Levels o[ care and Services to be Provided at each level are those defured the ClD Marimum1/ate Schedule. The <br />r exas COJrunon Application [or Placement o[ c.hi1dren in residential seJVices sban be USed or aIJ juveniles placed <br />under C<lDtract. A C<lpy o[ the CODnnon application sban be lllainrained in the project records. <br /> <br />A. For and in COIlsideJation of the above-mentioned seJVices, the _ _ agrees to pay the <br />. IN...".. c;",;) <br />SeJVJce .Agency an amount Dot to exceed $- _ per client per day. This fee does DOt exceed the amOllDt aIJOWed <br />1D the culTent ClD MOXimum1/ate Schedule. r otal reimbunement under this C<lDl1act sban Dot exceed $ <br /> <br />------ -- . <br /> <br />~"- -- .- -. <br />