Generate a Requisition using the WayneBuy PSC form, attach the signed PSC and approved PSC Checklist, and complete. The document outlines an agreement between a client and a provider for services.The purpose of this Agreement is to set forth the terms and conditions for participation in the Early Intervention. Free Service Agreement. Answer a few simple questions. This Provider Agreement shall become effective upon DPH approval and remain in effect until June 30, 2015 subject to the provision for cancellation herein. The. The cover letter shall provide the name, address, telephone and facsimile numbers of the Service. This Service Contract Template can be easily customized and used for most any service agreement between a company (or person) and customer. This Service Agreement ("Agreement") is effective as of the date of the last authorizing signature affixed hereto. The individual value of each Contract is indeterminate and will depend upon the number of contracts issued and the competitiveness of the pricing offered.