Instructions Program Summary Enter the information on the site where services for this program are provided. Contract Summary Sheet Enter Agency Name, Address, Telephone and Contract No., Federal Identification No., Contract effective dates (as noted in the DFD contract award letter) and contract ceiling (per Annex B). Enter CEO and Agency notice information. All data must be completed. Authorized Signatories Enter Authorized Signatory for the Contract (as authorized by Agency Bylaws or Board Resolution). IMPORTANT - This is the address where the signed contract and all relevant legal correspondence will be mailed so please ensure this is the accurate address. – Service Delivery Information Service will be provided as follows for each day of the week, enter the hours the agency will provide contracted services. Please indicate if there is a difference among any of the contracted services in the program specific narrative. Emergency Provisions Describe any special arrangements which have been made to handle emergencies, e.g. voice mail instructions, special telephone numbers etc. Service will not be provided on the following occasions List the occasions and dates when service will not be provided, e.g. December 25-Christmas, July 4-Independence Day, etc. Program Narrative *Please see specific instructions attached to this section
Instructions Program Summary Enter the information on the site where services for this program are provided. Contract Summary Sheet Enter Agency Name, Address, Telephone and Contract No., Federal Identification No., Contract effective dates (as noted in the DFD contract award letter) and contract ceiling (per Annex B). Enter CEO and Agency notice information. All data must be completed. Authorized Signatories Enter Authorized Signatory for the Contract (as authorized by Agency Bylaws or Board Resolution). IMPORTANT - This is the address where the signed contract and all relevant legal correspondence will be mailed – so please ensure this is the accurate address. Service Delivery Information Service will be provided as follows for each day of the week, enter the hours the agency will provide contracted services. Please indicate if there is a difference among any of the contracted services in the program specific narrative. Emergency Provisions Describe any special arrangements which have been made to handle emergencies, e.g. voice mail instructions, special telephone numbers etc. Service will not be provided on the following occasions List the occasions and dates when service will not be provided, e.g. December 25-Christmas, July 4-Independence Day, etc. Program Narrative *Please see specific instructions attached to this section
fy15refugee_etech_annex_a.docx