435505-W25-FME1679-02 Exhibit 2 SAMPLE Engagement Letter.docx.pdf
PDF 572 KB Posted
- Attached to
- Consultant Services
- Contract number
- 435505-W25-FME1679-00
- Issued by
- Wisconsin
About this file
This document is a sample engagement letter template for consultant services between the Wisconsin Department of Health Services and contractors operating under the Consultant Services Contract 435505-W25-FME1679-0X. The engagement letter serves as a subsidiary agreement that allows authorized users within the Department of Health Services to engage specific contractors for individual projects while operating under the broader statewide contract framework. The document establishes the relationship between the authorized user (Department of Health Services divisions) and contractors, with all terms referencing an accompanying Statement of Work (SoW) that contains the specific project details.
The engagement letter covers consultant services with key elements including project deliverables, contracted personnel, reporting requirements, and funding arrangements all detailed in the referenced Statement of Work. The agreement allows for extensions beyond the initial term and incorporates all terms and conditions from the primary Consultant Services Contract. The document requires formal approval signatures from both the State of Wisconsin Department of Health Services authorized representative and the contractor's authorized representative. Pricing, specific services, and project scope are not detailed in this template but are referenced as being contained within the accompanying Statement of Work, making this a framework document for executing specific consulting engagements under the broader state contract vehicle.
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Text version
Exhibit 2 – Sample Engagement Letter
Consultant Services Supplier Engagement Letter
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 435505-W25-FME1679-0X.
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 – 435505-W25-
FME1679-0X 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 35 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
Docusign Envelope ID: 171D48EE-DBD9-46AC-A36D-E1045B4197A0
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
State of Wisconsin Contractor
Department of Health Services
Contractor Name:
Authorized Representative Authorized Representative
Name:
Name:
Title: Title:
Signature: Signature:
Date: Date:
Docusign Envelope ID: 171D48EE-DBD9-46AC-A36D-E1045B4197A0
| 2025-02-06T12:11:40-0800 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .