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City, State Zip Telephone it (include area code) City, State Zip Telephone it (include area code) <br />ri NOTE: The intent of:the CJD Sample Contract. Between Grantee and Third Party is to provide a sample form delineating <br />CJD requirement.,, andis. not intended for use as a standard fill -in -the- blanks contract. Contracting parties may have <br />additional provisions as required by their status or circumstances. <br />' INSTRUCTIONS: <br />' • Paragraph One. Ensure that current grant number is used. <br />I • 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 provided 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 />j- 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 />j 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 />30 <br />CJD Forms Packet <br />Revised: July, 1997 <br />