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c Special Terms and Conditions (1) Job Seeker Tools: Paid upon receipt of a School-to-Work Billing Checklist and a written report in the Student Guide. The total billable amount for this activity is $1,000 per Student. (2) Job Offer: Paid upon receipt of a School{o-Work Billing Checklist and a written report in the Student Guide. The total billable amount for this activity is $2,000 per Student. A job offer is payable once upon receipt of the offer regardless of whether or not the Student accepts the job offer. (3) lf a Student with a placement goal of 10 hours per week or more accepts a placement for less than 10 hours per week, an exception for payment may be granted with approval of the appropriate DVR Supervisor. This approval shall be in consultation with the team including the Student, Student's Family (as applicable), DVR Counselor, CRP, and CountY staff. Employment Phase - A total payment of $6,000 per Student shall be paid to the Contractor when the individual Student has completed the following activities: (1) Employment Verification: Paid upon receipt of a School-to-Work Billing Checklist and a written report in the Student Guide. The total billable amount for this activity is $1,000 per Student. (2) Job Stabilization: Paid upon receipt of a School-to-Work Billing Checklist and a written report in the Student Guide. The total billable amount for this activity is $5,000 per Student. Billing and Payment a. The Contractor shall submit no less than three (3) separate original Schoolto-Work Billing Checklists to the assigned DVR Vocational Rehabilitation Counselor for each Student who is successfully served by this Agreement. (1) At a minimum, one School-to-Work Billing Checklist per phase as outlined in Section 5, Statement of Work. (2) School{o-Work Billing Checklists may only be submitted to DVR upon the successful completion of an activity outlined in the SDOP. b. Payment shall be considered timely if made by DSHS within thirty (30) days after receipt and acieptance by the designated DVR Counselor of the properly completed School{o-Work Billing Checklist. Payment shatl be sent to the address designated by the Contractor on page one (1) of this Agreement. c. DSHS may at its sole discretion, withhold payment claimed by the Contractor for services rendered if the Contractor fails to satisfactory comply with any term or condition of this Agreement. lnsurance - Self-l nsured a. DSHS certifies that it is self-insured under the State's self-insurance liability program, as provided by RCW 4.92.130, and shall pay for losses for which it is found liable. b. The Contractor certifies, by checking the appropriate box below, initialing to the left of the box selected, and signing this Agreement, that: 10. 11. DSHS Central Contract Services 6017CF County Program Agreement (10-31-2017)Page 14