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CONTRACT #Contract NumberATTACHMENT B SAMPLE PURCHASE OF SERVICE AGREEMENTThe state of North Dakota, acting through its North Dakota Department of Health and Human Services, Economic Assistance Section
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Attachment A: Sample POS Agreement is a document that outlines the terms and conditions of a point-of-sale agreement between a provider and a payor.
Providers who enter into point-of-sale agreements with payors are required to complete and file the attachment A document.
To fill out the attachment A document, complete the specified sections with relevant details about the agreement, including the parties involved, terms, and any additional required information.
The purpose of the attachment A document is to ensure transparency and compliance with regulatory requirements concerning point-of-sale agreements.
The document must report details such as the names of the parties involved, effective dates, payment terms, and any specific services included in the agreement.
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