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Statement of Work and Terms of Agreement


Section C    Description/Statement of Work   (pdf)
    
C.1   Local Needs for Treatment Services   (pdf)
C.2   Local NeedS for Urinalysis Collection Hours   (pdf)
Section D    Packing and Marking (pdf)
Section E    Inspection and Acceptance (pdf)
Section F    Deliveries or Performance (pdf)
Section G    Agreement Administration Data (pdf)
Section H    Special Agreement Requirements (pdf)
Section I    Required Clauses (pdf)
Section J    Attachments:
    
J.1   Program Discharge Summary Profile   (pdf)
J.2   Sample Program Plan (Probation Form 45)  (pdf)
J.3   For Future Use
J.4   Monthly Treatment Report (Probation Form 46)  (wpd)
J.5   Authorization to Release Confidential Information (PROB FORMS 11B, 11E, and 11I; PSA FORMS 6B and 6D) (pdf)
J.6   Daily Log  (pdf)
J.7   Daily Travel Record (Probation Form 17)  (wpd)
J.8   Invoice   Part A  (pdf)   Part B  (pdf)
J.9   Urinalysis Log  (pdf)
J.10   Department of Labor Wage Determination (as Required by the Service Contract Act - See Above.) (Please print the SF98, Department of Labor Wage Determination, for the County where your clinic is located.)
J.10A   Boone, Stephenson, Ogle, Winnebago
J.10B   Cook, DeKalb, DuPage, Kane, Lake, Lee, McHenry
J.10C   Grundy, Iroquois, Kankakee, Kendall, LaSalle, Livingston, Will
Section K    Representations, certifications, and Other Statements of Offerors (pdf)
Section L    Instructions, Conditions, and Notices to Offerors (pdf)
Section M    Evaluation Factors for Award (pdf)
 
Section N    Local Forms
    
N.1   90 Day Treatment Plan Final.pdf
N.2   Postal Supply Ordering Instructions.pdf  
N.3   UA Supply Order Form.pdf