including number of weeks provision per annum: Individual Child / Young Specification Start date Review date person/family Outcomes Reference member’s 1. 2. 3. PLACEMENT DETAILS Placement start Projected/Actual date: Individual Placement end date (if known): Cost breakdown Savings – including funding requirements: from health / education: Contact details for Contact details for advocacy service: health provision: THE INDIVIDUAL PLACEMENT FEE: Individual Placement Fee- £ per week Weekly Cost of Services provision in accordance with the Thurrock Council Rolling Select List Agreement, exclusive of VAT: Signatures: The Service Provider and the Council agree to the placement for the named child/young person or family member in accordance with the details and stated outcomes set out above. For the purposes of this Individual Placement Agreement, the commencement date is the date of actual admission of the Looked After Child, Young Person or Family to the Service Provider. This condition and the Individual Placement Agreement in its entirety are not affected or altered in any way by the actual date of signature of this Individual Placement Agreement. COUNCIL SERVICE PROVIDER Authorised Officer Authorised Officer Name: Name: Signature: Signature: Date: Date: PLEASE RETURN COMPLETED, SIGNED AGREEMENT TO: Council Address: Thurrock Council, Commissioning Children’s Team/ Commissioning Placement/Resource Team, Civic Office, Officer: New Road, Grays, RM17 6SL
including number of weeks provision per annum: Individual Child / Young person/family member’s Outcomes Specification Reference Start date Review date 1. 2. 3. PLACEMENT DETAILS Placement start date: Projected/Actual Individual Placement end date (if known): Cost breakdown – including funding from health / education: Savings requirements: Contact details for advocacy service: Contact details for health provision: THE INDIVIDUAL PLACEMENT FEE: Individual Placement Fee- Weekly Cost of Services provision in accordance with the Thurrock Council Rolling Select List Agreement, exclusive of VAT: £ per week Signatures: The Service Provider and the Council agree to the placement for the named child/young person or family member in accordance with the details and stated outcomes set out above. For the purposes of this Individual Placement Agreement, the commencement date is the date of actual admission of the Looked After Child, Young Person or Family to the Service Provider. This condition and the Individual Placement Agreement in its entirety are not affected or altered in any way by the actual date of signature of this Individual Placement Agreement. COUNCIL SERVICE PROVIDER Authorised Officer Name: Authorised Officer Name: Signature: Signature: Date: Date: PLEASE RETURN COMPLETED, SIGNED AGREEMENT TO: Council Commissioning Team/ Placement/Resource Officer: Address: Thurrock Council, Children’s Commissioning Team, Civic Office, New Road, Grays, RM17 6SL
ps2017539-itt-lacplacements-appendix1-v01.docx