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C~~mtract'I L86076-108 <br />Noith Carolina Ciaptist I lospital <br />C. Rate per unit of Service (define the unit): <br />1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br />$300.50/unit <br />2. Negotiated County Rate. <br />D. Number of units to be provided: <br />E. Details of Billing process and Time Frames; <br />Contractor to bill Orange DSS once a month for the previous month's services. DSS will issue payment <br />within two (2) weeks of receipt of the invoice. <br />F. Area to be served/Delivery site(s): Orange County <br />(Signature of C unty Authorized Person) <br />0`1-13~I1 <br />(Date Submitted) <br />(Signature of Contractor) <br />7 ~~ /i <br />(Date Sub tted) <br />Contract-General (06/04) Page 10 of 19 <br />