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DocuSign Envelope ID: 55869249-D071-43C6-B9B7-126B43EDD48D <br /> Contract#68-2030 <br /> Chatham Transit Network <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax Id. or SSN <br /> Contract# 68-2030 <br /> A. CONTRACTOR INFORMATION <br /> 1. Contractor Agency Name: Chatham Transit Network <br /> 2. Ifdafftrent from Contract Administrator Information in General Contract: <br /> Address <br /> Telephone Number: Fax Number: Email: <br /> 3. Name of Program (s): Medicaid Transportation <br /> 4. Status: ( ) Public (X) Private,Not for Profit Private, For Profit <br /> S. Contractor's Financial Reporting Year July 1, 2015 through— June 30,2016 <br /> B. Explanation of Services to be provided and to whom(include SIS Service Code): - The <br /> Contractor will provide transportation services to client(s) identified by the County The <br /> Contractor will transtiort client(s)to and from medical anwintments. The Contractor is required <br /> to meet all goals and outcomes listed in Attachment N. <br /> C. Rate per unit of Service(define the unit): <br /> 1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br /> 2. Negotiated County Rate. <br /> D.Number of units to be provided: <br /> E. Details of Billing process and Time Frames; The County will reimburse the Contractor for <br /> services described in this contract up to the budgetary limits of the contract allotment. For <br /> reimbursement,the Contractor must submit an origin il and two copies of an invoice by the fifth <br /> of the month for the preceding month's expenditures to the des4aynated County Administrator. <br /> The County will reimburse the Contractor monthly upon..receipt of a complete and correctly filed <br /> report. <br /> The Contractor shall be compensated at the rates set out in this Attachment for all avoroved trins. <br /> F. Area to be served/Delivery, site(s): Orange Count <br /> Contract-Scope of Work(06/04) Page 1 of 1 <br />