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| The Provider Details: | |
| Participant: | {{$clientdata['name']??''}} |
| Provider Organisation ID: | {{$settings['company_name']??''}} |
| Attachment |
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| Participant’s Contact details: | The [Participant / the Participant’s representative] can be contacted on: |
| Participant’s name | {{$clientdata['name']??''}} |
| DOB | {{$clientdata['dob']??''}} |
| NDIS no | {{$clientdata['ndis_number']??''}} |
| Phone | {{$clientdata['phone']??''}} |
| Mobile | {{$clientdata['mobile']??''}} |
| {{$clientdata['email']??''}} | |
| Address | {{$clientdata['address']??''}} |
| Alternative contact person/ guardian/ advocate/ other | {{$clientdata['alternative_contact_number']}} |
| Service Agreement Specification: |
| No | Service Agreement items | Description |
|---|---|---|
| 1 |
The Supports that will be Provided -Supported accommodation, -out of home respite care, -in home support, -Community access, -working on skill building exercise, -Personal care, General Cleaning and household tasks -Behaviour support etc |
{{$data['support_provided']??''}} |
| 2 | The cost of those supports | {{$data['cost_support']??''}} |
| 3 | how, when, and where the participant requires the support to be delivered |
| @foreach($days as $day) | {{$day}} | @endforeach
| {{$x}} | @foreach($days as $day){{$supportData[$xindex][strtolower($day)]??""}} | @endforeach
| 4 | how long the participant requires the support to be provided | {{$data['how_long_support']??''}} |
| 5 | when and how the Service Agreement will be reviewed |
{{$data['service_agreement_renew']??''}} {{-- Participant or their representative will be consulted with a written agreement. --}} |
| 6 | how participant and provider will deal with any problems or questions that may arise. | Please see below in {{$settings['app_short_name']??"We Care Cloud"}} responsibilities section Same as it is seen. |
| 7 | what the participant’s responsibilities are under the Service Agreement—for example, how much notice the participant must give to the provider if they cannot attend an appointment. | Minimum 24 hours of prior notice for service cancelation Please read through below in “Responsibilities of Participant ’s/ Participant ’s represent” for detailed information. |
| 8 | what the provider’s ({{$settings['app_short_name']??"We Care Cloud"}}) responsibilities are under the Service Agreement—for example, to work with the participant to provide supports that suit their needs and how the agreed supports will be provided. | Please read through below in “Responsibilities of Provider” for detailed information. |
| 9 | what notice is needed for the participant or provider to change or end the Service Agreement and how this is done—for example, by email or mail. | Read through below. |
| 10 | Participant ’s cultural need/ other support. |
Yes/no/not appricable,Tf 'Yes' Then. {{ $data['particiapant_culture']??'' }} |
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Parties involve Service Agreement. This Service Agreement is for "{{$clientdata['name']??''}}", a participant in the National Disability Insurance Scheme ("{{$clientdata['name']??''}}"), and is made between: |
| 1.[Participant / Participant’s representative (such as a family member or friend)] | {{($data['participant_reprentative']??($clientdata['name']??''))}} |
| {!! isset($data['participant_reprentative']) || isset($clientdata['name'])? 'And ' : '' !!} 2. Provider |
{{ $settings['company_name'] ?? '' }} |
| This Service Agreement will commence on {{ isset($data['commence_on_date'])?date('d-m-Y', strtotime($data['commence_on_date'])):'' }} for the period {{isset($data['period_from'])?date('d-m-Y', strtotime($data['period_from'])):''}} to {{isset($data['period_to'])?date('d-m-Y', strtotime($data['period_to'])):''}} |
| The NDIS and this Service Agreement |
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| Schedule of support (time and cost) |
| Exclusions or Additional expenses (i.e., things that are not included as part of a Participant’s NDIS supports) are the responsibility of the {{($data['participant_reprentative']??($clientdata['name']??''))}} and are not included in the cost of the support. Examples include entrance fees, event tickets, meals, etc. |
| Payments |
| {{$settings['app_short_name']??"We Care Cloud"}} will seek payment for their provision of supports after the [Participant / Participant ’s representative] confirms satisfactory delivery. [One or more of the below paragraphs may apply. Delete those that do not apply.] [If the funding for any of the supports provided under this Service Agreement is managed by the Participant :] The Participant has chosen to self-manage the funding for NDIS supports provided under this Service Agreement. After providing those supports, {{$settings['app_short_name']??"We Care Cloud"}} will send the Participant an invoice for those supports for the Participant to pay. The Participant will pay the invoice by [specify cash / cheque / EFT] within 7 days. [AND / OR] [If the funding for any of the supports provided under this Service Agreement is managed by a Plan Nominee:] The Participant ’s Nominee manages the funding for supports provided under this Service Agreement. After providing those supports, {{$settings['app_short_name']??"We Care Cloud"}} will send the Participant ’s Nominee an invoice for those supports for the Participant ’s Nominee to pay. The Participant ’s Nominee will pay the invoice by [specify cash / cheque / EFT] within [insert reasonable time period, e.g. 7 days]. [AND / OR] [If the funding for any of the supports provided under this Service Agreement is managed by the National Disability Insurance Agency:] The Participant has nominated the NDIA to manage the funding for supports provided under this Service Agreement. After providing those supports, {{$settings['app_short_name']??"We Care Cloud"}} will claim payment for those supports from the NDIA. [AND / OR] {{-- One or more of the below may apply. --}} |
| Changes to this Service Agreement |
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| Ending this Service Agreement |
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| Goods and services tax (GST) |
For the purposes of GST legislation, the Parties confirm that:
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| Agreement signatures |
| The Parties agree to the terms and conditions of this Service Agreement. |
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{{$data['signature_participant']??''}}
Signature of [Participant / Participant ’s representative] Name of [Participant / Participant ’s representative] |
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{{$data['sign_of']??''}}
Signature of authorised person from {{$settings['app_short_name']??"We Care Cloud"}} Name of authorised person from {{$settings['app_short_name']??"We Care Cloud"}} |
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{{isset($data['agreement_date']) ? date('d-m-Y', strtotime($data['agreement_date'])) : ''}}
Date |
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{{$data['sign_of_authorized_person']??''}}
Signature of the authorised person from {{$settings['app_short_name']??"We Care Cloud"}} |
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{{$data['name_of_authorized']??''}}
Name of authorised person from {{$settings['app_short_name']??"We Care Cloud"}} |
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{{isset($data['entry_date']) ? date('d-m-Y', strtotime($data['entry_date'])) : ''}}
Date |