08 S-0761 DHS-20 Exhibit G - SAMPLE Engagement Letter.docx
DOCX document 185 KB Posted
- Attached to
- Consultant Services
- Contract number
- 435820-O20-CONSULTANT-00
- Issued by
- Wisconsin
About this file
This document is a sample engagement letter template (Exhibit G) for consultant services under contract S-0761 DHS-20 between the State of Wisconsin Department of Health Services, Division of Care and Treatment Services and contractors. The template is designed to facilitate engagements between authorized users within the Wisconsin DHS and contractors who have an existing consultant services contract with the state. Governor Tony Evers and Secretary Andrea Palm are identified as the current state leadership, with the department located at 1 West Wilson Street, Madison, Wisconsin.
The engagement letter template establishes the framework for project-specific consultant services, with key details including project deliverables, scope of work, contracted personnel, and key staff to be defined in accompanying Statement of Work documents. The template includes placeholder fields for funding and payment terms, fees, and project duration, with the engagement letter only being effective while the underlying consultant services contract remains in force. Contact information sections are provided for both contractor and authorized user representatives, and the document requires signatures from both parties to authorize commencement of services. The engagement letter serves as the contractual instrument for specific project engagements under the broader consultant services contract framework.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 435820-O20-CONSULTANT-02 R3.docx.pdf | ||
| 435820-020-CONSULTANT-04 R3.docx.pdf | ||
| 435820-O20-CONSULTANT-03 R3.docx.pdf | ||
| 435820-O20-CONSULTANT-05 R3.docx.pdf | ||
| 435820-O20-CONSULTANT-06 R3.docx.pdf | ||
| Request for Services.docx | DOCX document | |
| 07 S-0761 DHS-20 Exhibit F - SAMPLE Statement of Work.docx | DOCX document | |
| 435820-O20-CONSULTANT-01 R3.docx.pdf | ||
| S-0761 DHS-20 Consultant Services Fee Schedule 2-16-23.xlsx | XLSX spreadsheet |
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Text version
S-0761 DHS-20 Exhibit G – SAMPLE Engagement Letter
Tony Evers Governor
DIVISION OF CARE AND TREATMENT SERVICES
1 WEST WILSON STREET
PO BOX 7851
MADISON WI 53707-7851
Andrea Palm Secretary
State of Wisconsin
Telephone: 608-266-2717 Fax: 608-266-2579
TTY: 888-241-9432
dhs.wisconsin.gov
Department of Health Services
Tony Evers Governor
DIVISION OF CARE AND TREATMENT SERVICES
1 WEST WILSON STREET
PO BOX 7851
MADISON WI 53707-7851
Andrea Palm Secretary
State of Wisconsin
Telephone: 608-266-2717 Fax: 608-266-2579
TTY: 888-241-9432
dhs.wisconsin.gov
Department of Health Services
Consultant Services SUPPLIER ENGAGEMENT LETTER www.dhs.wisconsin.gov www.dhs.wisconsin.gov
This Engagement Letter (EL) is between the Department of Health Services, Division of XXXX (the “Authorized User”) and XXXX (the “Contractor”). Capitalized terms not otherwise defined herein shall have the meaning given to them in the Consultant Services Contract.
Project Title –
Project Overview - See Statement of Work (SoW) - Background and Objectives
Project Deliverables - See SoW – Scope
Contracted Personnel – See SoW – Key Personnel
Authorized User’s Key Staff –
Change Control –
Reporting and Monitoring – See SoW – Project Management Approach
Funding and Payments – See SoW – Fees
Term of the Agreement – This Engagement Letter will be in effect XXXX, through XXXX, with the possibility of extension.
This Engagement Letter is only effective to the extent the current Consultant Services Contract – enter Contract number is in effect.
Upon the termination of this engagement for any reason, or upon engagement’s expiration, each party shall be released from all obligations to the other party arising after the date of termination or expiration, except for the parties’ respective termination obligations set forth in Section XX of the Contract and those that by their terms survive such termination or expiration.
Engagement All terms and conditions outlined in the Contract for Services by and between State of Wisconsin Department of Health Services and XXXX (the “Contractor”) for the Consultant Services Contract apply to Authorized Users and its RFS, Contractor, and this Engagement Letter.
Such Consultant Services Contract is incorporated into this Engagement Letter.
Contact Information
Communications to either Contractor or Authorized User shall be provided in the manner(s) indicated herein. The parties reserve the right to make changes to the contact information by giving thirty (30) days’ written Notice to the other.
| Contractor |
| Name: XXXX |
Title: XXXX Address: XXXX Phone: XXXX E-mail: XXXX
| Authorized User |
| Name: XXXX |
Title: XXXX Address: XXXX Phone: XXXX E-mail: XXXX
With the signatures affixed below, Contractor is granted written authorization to proceed with the engagement and commence with the requested services.
As per Section 4 of the Contract, the Engagement Letter and SOW will serve as the contractual instrument for this specific engagement. The services performed under this Engagement Letter shall provide the Authorized User with the identified deliverables.
Approvals
___________________________________________ Date_________________ Contractor Representative
XXXX
XXXX
___________________________________________ Date_________________ Authorized User
Enclosure:
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