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DocuSign Envelope ID:BD69DF46-15CD-49E6-8588-93617FCCFB94 <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 Nctworj <br /> 2. /fJh9�ren/Iiwnn Contract&dnmioisho1nrInfhroahonin General Contract: <br /> If — <br /> &ddrcus_' _ - — — -- — <br /> --- - _ <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 /> 5. Contractor's Financial Reporting Year July 1, 2016 through June 30 2017 <br /> B. Explanation of Services to be provided and to whom(include SlS Service Code): The <br /> Coutr�o�or�*U| providutranopo�n1iooverviceutoc}icn1�jideodf5edbytbuCounty. The <br /> Contractor will transport client(s)to and from medical appointments. The Contractor is required <br /> to meet all goals and outcomes listed i AttachmentN. <br /> C. Rate per unit of Service(define the unit): <br /> I. If Standard Fixed Rate, Maximum Allowable,(See Rates for Services Chart) <br /> 2. Negotiated County Rate. <br /> $60.20/one way trip <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 original and two copies of an invoice by the fifth <br /> of the month for the preceding iiionth's, penditures to he designated 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 approved trips. <br /> F. Area to be served/Delivery site(s): Orange County� ___ <br /> Contract-Scope of Work(06/04) Page lof 1 <br />