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<br /> <br /> <br />Contract-Scope of Work (7-2008) Page 1of 1 <br />ATTACHMENT B – Scope of Work Federal Tax Id. or SSN 88-0712648 <br /> Contract # 68-1031 <br />A. CONTRACTOR INFORMATION <br />1. Contractor Agency Name: GFC & S Transportation, LLC <br />2. If different from Contract Administrator Information in General Contract: <br />Address <br /> <br />Telephone Number: Fax Number: Email: <br />3. Name of Program (s): Non-Emergency Medical Transportation (NEMT) <br />4. Status: Public Private, Not for Profit Private, For Profit <br />5. Contractor's Financial Reporting Year January through December <br /> <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): <br />The Contractor will provide transportation services to client(s) identified by the County. <br />The Contractor will transport client(s) to and from medical appointments. The Contractor <br />is required to meet all goals and outcomes listed in Attachment O. <br /> <br />C. Rate per unit of Service (define the unit): <br /> <br />1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br /> <br />N/A <br /> <br />2. Negotiated County Rate. <br /> <br />$45/one way trip; $90/roundtrip <br /> <br />D. Number of units to be provided: <br /> <br />E. Details of Billing process and Time Frames; Billing and reimbursement processes are <br />handled through the NC Tracks system rather than the County. The Contractor must <br />submit the information through NC Tracks in order to receive reimbursement for services <br />provided. <br /> <br /> <br />F. Area to be served/Delivery site(s): Orange, Alamance, Durham, Wake, and Chatham <br />Counties. <br /> <br /> <br />____________________________________ ___________________________________ <br />(Nancy Coston, Social Services Director) (Signature of Contractor) <br /> <br />________________________________ ________________________________ <br />(Date Submitted) (Date Submitted) <br />Docusign Envelope ID: 7CF2A7AA-A9CE-402C-AFAB-5E326B8F1A0B <br />7/22/20247/24/2024