HomeMy WebLinkAboutContract 2011 2356 N; m
Dakota County Receiving Center Inc.
Detoxification, Substance Use and Dual Disorder Services
- (651) 4i, -4585
1294 EAST 18 rH _51 e BUILDING #2 F MINNESOTA 5503 ! x_800- 742 - 4058
PHONE (6511437-4209 e 1AX (651) 438 -4144
TRANSPORTATION AGREEMENT
This Agreement covers transportation to /from the Hastings Detox Center from purchaser
locations for a fixed fee as described below:
PROVIDER:
Dakota County Receiving Center, Inc.
1294 E. 18` Street, Bldg. 2
Hastings, MN 55033
651- 437 -4209
PURCHASER:
D Agency: (id _T
Attention: J( CF r \ NO
Address
Phone: 1 LL - 104 Fax: , (a _ I
Provider agrees to provide one -way transportation to or from Detox at 1294 E. 18 St, Hastings,
MN and the following Purchaser's locations:
1.
2. Various mid - points between Detox and Purchaser as arranged ad -hoc.
Purchaser, upon written invoicing by the Provider, agrees to pay sixty -seven ($67.00) for each
client transported. Payment shall be made no later than thirty (30) days after billing. Invoicing
shall be made to Purchaser in a manner similar to that for detox services, plus the referring
officer's badge number, if available. Invoicing shall be made to Purchaser at the following
address:
1. Same as above or other address:
From time to time, the Provider may receive payment from the detox client's insurance in excess
of the daily rate for detox as stated in the Host County Contract. Refund of the transportation
fee, up to the amount of the excess collected, will be refunded to the Purchaser by check or credit
invoice within thirty (30) days. The term of this agreement shall begin January 1, 2011 and will
roll over through the following years, unless major changes need to be made. Changes in fees
may be done by adding an addendum. This agreement may be terminated with or without cause
by either party giving the other party seven (7) days advance written notice.
SIGNATURES TO AGREEMENT:
PROVIDER:
Dakota County Receiving Center Inc. Provider FEIN: 41-1234378
1294 E. 18 Street, Bldg. 2
Hastings, MN 55033
'
By .0 4A! N A' 4 -
Louise Skogstad, Executive Di 4ctor
Date — )
PURCHASER:
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Agency: CC , Ilk I, fr) 1
, -
By
Title
'n ed Name:
Date
Dakota County Receiving Center, Inc. , 01.NN Si 41,
Detoxification, Substance Use and Dual Disorder Services PHON E
(651) 437-4585
1294 EAST 18TH STREET • BUILDING #2 • HASTINGS, MINNESOTA 55033
1
PHONE (651) 437-4209 • FAX (651) 438-4144
January 10, 2011
Columbia Heights Police
Atten: Chief of Police
825 41st Ave NE
Columbia Heights, MN 55421
Enclosed is our copy of the contract for Detox Transportation which exists between our facility
and yours. We have revamped it and it now has a continuous renewal, so a new one will not be
sent to you each year.
We will leave the current cost at $67.00, which it has remained for some time. Should we need
to increase this fee in the future, we will notify you.
Please sign both copies as indicated. Keep one for your files and return a signed copy to us in the
enclosed postage paid envelope. If you should have any questions, please feel free to contact us
at 651-437-4209.
Thank you for your continued use of our facility.
Sincerely,
4
Louise Skogstad
Executive Director
enclosure