Get North Central Texas Area Agency On Aging A Program Of Bb - Nctcog - Nctcog

Filling out the vendor agreement form for the North Central Texas Area Agency on Aging can be straightforward with the right guidance. This comprehensive guide will walk you through each section of the form to ensure that you complete it accurately and efficiently.

Follow the steps to complete the vendor agreement form effectively.

1. Click ‘Get Form’ button to access the vendor agreement form and open it in your designated online editor.
2. Begin by providing your agency or company information. Fill in the type of agency (Public, Non-Profit, or For-Profit), the agency name, and the billing address. Ensure that all contact details are accurate.
3. Specify if your company is considered a minority-owned or historically underutilized company by checking the appropriate boxes.
4. In the agency or company background section, prepare a separate document detailing the purpose of your agency, a history of services provided, references, staff qualifications, and the number of staff available to deliver services.
5. Attach all necessary documentation, which includes copies of certifications, licenses, policies, procedures, your Tax ID number, and proof of insurance coverage as applicable.
6. Indicate the county or counties served by your agency and fill out the customary monthly monitoring fees for both Emergency Response Services and Medication Monitoring Services, ensuring that these align with the specified Texas Department of Aging and Disability Services rates.
7. Provide information on any discounts offered and their amounts, if applicable.
8. Review your inputs for correctness, ensuring all fields are filled out according to the outlined expectations in the agreement.
9. Lastly, sign the form as an authorized official, provide the date, and include your title before submitting the document through the designated method.

Ensure all documentation is complete and submit your vendor agreement form online today.