Service Agreement (Part C) Community Mental Health Services

Agreement for Funding of Services

Schedule

31 March 2017

[#Insert title relating to the Services funded]

[#Insert name of Agency]

ABN [#Insert ABN]

[#Insert name of Provider]

ABN [#Insert ABN]

The Date of the Agreement is [#Insert date of execution from Execution page]

This Schedule is to be read in conjunction with the Agreement for Funding of Services - Standard Terms.

Capitalised terms, where used in this Schedule, have the same meaning as given in the Agreement for Funding of Services - Standard Terms, unless the context requires otherwise.

Details

/

Description

Us (Agency) / Name: / [#Insert Agency name]
ABN: / [#Insert Agency ABN]
Address: / [#Insert Agency address]
Position, name and contact details of Agency representative: / [#Insert position, name and contact details (including email address) of the Agency's representative]
You (Provider) / Name: / [#Insert Provider's name]
ABN/ACN/ICN: / [#Insert Provider's Australian Business Numner / Australian Company Number / Indigenous Corporation Number (as applicable)]
Address: / [#Insert Provider's address]
Position, name and contact details of Provider representative: / [#Insert position, name and contact details (including email address) of the Provider's representative]
Initial Term
(Clauses 1.1 and 3.1) / [#Insert the Initial Term of the Agreement]
[#User Note: The Initial Term of the Agreement should be expressed as a period of time (e.g. 3 years)]
Extension period
(Clause 3.2) / [#Insert any applicable extension period for the Agreement. If no extension period will apply, then insert the words "Not applicable"]
[#User Note: The extension period is a period of time by which the Agency may elect to extend the Agreement following the end of the Initial Term. If an extension period is to apply, then it should be expressed as a period time (e.g. 3 years)]
Services
(Clauses 1.1 and 5) / [#Insert an appropriate description of the Services that the Agency will be funding under the Agreement together with all relevant Agency requirements for the provision of those Services.If this information is contained in separate documents each document should be identified in the "Attachments" below]
[#User Note:
It is important that this section set out a clear and comprehensive description of the Services to be provided by the Provider. To the extent that any tender documentation for the funding included a scope of services and service specifications these should also be included or referenced in this section. In particular, this section should:
(a) contain all of the Agency's requirements and purposes for the Services;
(b) be drafted to provide clear objective benchmarks for the Services against which the Provider's performance of the Services can be assessed;
(c) if the Services are to be provided in stages, clearly indicate what those stages are and what is required to be carried out by the Provider in each stage;
(d) if the section below will specify a Target Group(s) for whom the Services are to be provided then the scope of services relating to each such group should be separately described; and
(e) if the Services are to be provided during any specific period(s) then this should be specified (e.g. by specifying the start and end date)]
Target Group
(Clauses 1.1 and 5.1(a)(i)) / [#Insert any applicable Target Group for whom the Services must be provided. If no Target Group will apply, then insert the words "Not applicable"]
Objectives
(Clauses 1.1 and 5.1(a)(v)) / [#Insert the Agency's objectives for the Services]
Funds and payment
(Clauses 1.1 and 9.1) / Total amount of Funds:
(Clauses 1.1 and 9.1(a)) / $[#Insert] (exclusive of GST)
The Funds will be paid to You on the following basis:
(Clause 9.1(a)) / [#Insert the basis on which Funds will be paid to the Provider]
[#User Note: If the Funds are to be paid in instalments over time, a breakdown should be included with the amount of each instalment together with the time and conditions for payment. See example below]
Instalment / Payment trigger / Date for payment / Supporting documentation for payment claim
[#Insert] / [#Insert] / [#Insert] / [#Insert]
Your bank account details:
(Clause 9.1(b)) / [#Insert Provider's bank account details (including account name, BSB and account number)]
[#User Note: The Provider's account should be with an Australian branch of an established bank, building society or credit union]
You must use the Funds during the following period:
(Clause 9.3(a)(iii)) / [#Insert any specific time period for expenditure of the Funds. If no specific requirements will apply, then insert the words "Not used"]
Budget
(Clauses 1.1 and 9.2) / [#Insert the budget for the expenditure of the Funds. If no budget applies, then insert the words "Not applicable"]
[#If an updated Budget is required to be submitted during the Term specify any conditions for the preparation of the updated Budget and the date(s) for submitting the updated Budget]
[#User Note: Insert the Budget that will govern the Provider's expenditure of the Funds. If the Funds are to be used to purchase Assets then any Budget-related requirements for the expenditure of Funds on Assets should be specified above]
Assets
(Clauses 1.1 and 11) / Asset threshold value:
(Clause 1.1) / $[#Insert amount] (exclusive of GST)
Other items that are Assets:
(Clause 1.1) / [#Insert]
[#User Note: List any items that are to be "Assets" for the purposes of the Agreement and are therefore to be subject to the obligations relating to "Assets" under the Agreement (e.g. clause 11.1)]
Asset obligations:
(Clause 11.1(a)(i)) / [#Insert details of any specific obligations that relate to the Assets. If none apply, insert the words "Nothing stated"]
[#User Note: Consider whether the Provider should comply with any specific obligations regarding the Assets. See clause 11.1 for the default obligations that apply to the Assets]
Owner of assets:
(Clause 11.2) / [#You/#Us]
Milestones
(Clause 1.1 and 5.1(a)(iv)) / Number / Milestone / Due date
1 / [#Insert description of Milestone] / [#Insert date by which Milestone must be achieved]
2 / [#Insert] / [#Insert]
3 / [#Insert] / [#Insert]
[#User Note: This section should include a detailed description of any Milestones that apply to the provision of the Services. EachMilestone should be referrable to the Services section above and should specify the time by which theMilestone must be achieved. If Milestones are also applicable to payment then an appropriate link should also be made with the payment section above. If no Milestones are applicable, then insert the words "Not applicable"]
Notified Policies
(Clauses 1.1 and 5.2(b)) / [#Insert any specific policies, guidelines or codes of the Agency or the NSW Government that the Provider must comply with in providing the Services. If nothing specific will apply, then insert the words "Nothing specified"]
Standards
(Clauses 1.1 and 5.2(c)) / [#Insert any specific standards that the Provider must comply with in providing the Services. If no specific standards will apply, then insert the words "Nothing specified"]
[#User Note: This section should be completed if there are any specific standards other that the Agency wants the Provider to comply with]
Performance and Outcome Measures
(Clauses 1.1 and 5.3) / [#Insert details of:
(a) the specific Performance and Outcome Measures against which the Provider's provision of the Services will be assessed;
(b) the period(s) over whichthose measures apply (e.g. monthly or annually);
(c) how the Provider's performance will be assessed; and
(d) how the Provider must report on its provision of the Services against the Performance and Outcome Measures]
[#User Note: The measures should be focussed on outcomes since the NSW Government is moving towards outcomes-focussed performance measures that demonstrate the impact of human services. Where this is not possible, outputs-focussed performance measures are acceptable]
Subcontracting
(Clauses 1.1 and 6.3) / [#Insert details of any subcontracting that does not require the consent of the Agency. If all subcontracting requires consent, then insert the words "None stated"]
Additional circumstances requiring immediate notification
(Clause 8.2(e)) / [#Insert details of any matters additional to those listed in clause 8.2 of the Standard Terms that require immediate notification to the Agency. If there are no further matters, then insert the words "None stated"]
Additional contributions
(Clause 9.8) / [#Insert details of any additional monetary or in-kind contributions for the Services (or any other activity that is the same as or similar to the Services) that the Provider has disclosed that it is receiving from another party(s)]
Ownership or licensing of Intellectual Property Rights
(Clauses 16.1, 16.2 and 19.4(e)(i)) / [#You/#Us]
[#User Note:
[If the Provider is to own the Intellectual Property Rights which the Provider or its Personnel creates in connection with the Agreement, then select "You" and delete the other option
If the Agency wishes to own the Intellectual Property Rights which the Provider or its Personnel creates in connection with the Agreement, then select "Us" and delete the other option]
Reporting requirements
(Clause 19.4(a)(i)) / Report name / Content of report / report requirements / Frequency of report / Form and method of delivery of report / Details of recipient (name, title and email address)
[#Insert] / [#Insert] / [#Insert] / [#Insert] / [#Insert]
[#User Note: Setting out clear and meaningful reporting provisions is necessary to give government the ability to take action if problems arise in service delivery.
Ask for clear and meaningful reports that will actually be used. Devise a mechanism to deliver feedback to the Provider on the information in these reports.
It is best practice to provide example/s of the required format for every report required. These examples should be included as Attachments, and listed in the "Attachments" section below. This practice ensures that government receives the required information, and the Provider clearly understands reporting requirements.
Make sure you do not ask for information that is already available on the Australian Charities and Not-For-Profit Commission (ACNC) website. It is important not to duplicate information requests to NGOs]
Insurance
(Clause 20.1) / [#Insert any specific insurance requirements of the Agency which the Provider must satisfy under the Agreement]
[#User Note: Consider any specific insurance policies, levels of insurance and insurance terms with which the Provider must comply. If the Agency does not have any specific insurance requirements applicable to the Agreement then general insurance guidance can be found on the NSW Government's ProcurePoint website, otherwise consult with the Agency's applicable insurance representative]
Acknowledgment and publicity
(Clause 21.1) / [#Insert any specific Agency requirements regarding the form and manner that the acknowledgment of funding in any publications, advertising and promotional materials must take. If none apply, insert "None stated"]
Dispute resolution (nominated representatives)
(Clause 22.1(d)) / Our nominated representative: / [#Insert name of Agency's nominated representative for dispute resolution]
Your nominated representative: / [#Insert name of Provider's nominated representative for dispute resolution]
Dispute resolution (senior representatives)
(Clause 22.1(e)) / Our senior representative: / [#Insert name of Agency's senior representative for dispute resolution]
Your senior representative: / [#Insert name of Provider's senior representative for dispute resolution]
Supplementary Conditions
(Clauses 1.1, 2.1(c) and 5.1(a)(vi)) / [#Insert any SupplementaryConditions that will apply to the Agreement. If any such termsare to prevail over any specific terms in the Standard Terms, this must be specifically indicated. If no Supplementary Conditions are to apply, then insert the words "Not applicable"]
[#User Note: Seek specific advice if you are unclear as to what (if any) conditions should be specified in this section]
Attachments
(Clause 1.1) / [#Insert the names of any documents which are to form part of the Agreement]

EXECUTION

The parties agree that by signing this document they enter into an Agreement comprising of the following documents (in order of precedence):

(a)the Agreement for Funding of Services - Standard Terms;

(b)this Agreement for Funding of Services - Schedule; and

(c)any Attachments.

Executed as an agreement on[#Insert date of execution]

[#Note: The clause below is provided as an example only. The Agency should include its form of execution clause if the clause below is not applicable]

Signed for and on behalf of [#Insert Agency name] ABN [#Insert Agency ABN] by its duly authorised officer in the presence of:
Signature of witness / Signatureof authorised officer
Print name / Print name

[#Note: Select execution clause that is appropriate to the Provider's structure and proposed method of execution and delete the execution clause that does not apply]

Signed by [#Insert Provider name] ABN [#Insert Provider ABN] by:
Signature of director/company secretary / Signature of director
Print name / Print name

OR

Signed for and on behalf of [#Insert Provider name] ABN [#Insert Provider ABN] by its duly authorised officer in the presence of:
Signature of witness / Signatureof authorised officer
Print name of witness / Name of authorised officer

Agreement for Funding of Services – Schedule Page 1