Assignment_and_Agreement_Form_2025-_Signed.pdf
PDF 276 KB Posted
- Attached to
- Master Agreement AZ|CTR076660
- Contract number
- CTR076660
- Issued by
- Arizona
About this file
This is an Assignment and Agreement Form from the Arizona Department of Child Safety's Office of Procurement & Contracts, involving two related entities: Foster Success Education Services Inc (assignor) and Foster Success INC. (assignee). The document transfers all rights and responsibilities from the original contract CTR066736 to a new contract with identification number CTR076660, with the assignee located at 546 E 17th St Suite 206 in Indianapolis, Indiana 46202.
The document does not provide specific details about the goods or services under contract. It is a formal assignment document that transfers contractual rights from one legal entity to another, with consent from the Department of Child Safety. The assignee (Foster Success INC.) accepts all terms and conditions of the original contract, and the assignment is effective upon execution by the Department. The document is signed by Maggie Stevens as CEO & President for both entities, and includes a consent signature from the DCS Procurement Manager, with all signatures dated 4/25/2025.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment_1.docx | DOCX document | |
| CSO-2040.pdf | ||
| CTR066736_2025-010-02_COI_WC.pdf | ||
| CTR066736_Signed_HIPPA_Business_Associate_Agreement.pdf | ||
| Amendment_2.docx | DOCX document | |
| Amendment_3.docx | DOCX document | |
| CTR066736_2025-010-02_COI.pdf | ||
| AZ_Dept_of_Child_Safety_COI.pdf | ||
| AZ_Dept_of_Child_Safety_EPI.pdf | ||
| CSO-1229A.pdf | ||
| CSO-1637 (1).pdf | ||
| CTR076660_Executed_Contract_5.15.2025.pdf |
Show all 12
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Text version
Department of Child Services
Assignment and Agreement Form
State of Arizona Department of Child Safety
Office of Procurement & Contracts 3003 N. Central Avenue, 20th Floor
Phoenix, AZ 85012
Assignor Foster Success Education Services Inc (Company Name) relinquishes and assigns all rights and responsibilities under the terms and conditions of the attached contract CTR066736 to include any executed amendments, to assignee, Foster Success INC.
Effective upon execution by the Department_ assignee accepts all the terms and conditions of the assigned (Date) contract. The new contract identification number is _CTR076660_. The assignee’s address for the purpose of the Agreement is:
546 E 17th St Suite 206 (No. and Street)
Indianapolis, Indiana 46202 (City, State and ZIP Code)
317-917-8940 (Area Code and Telephone No.)
(Area Code and FAX No.)
Assignor:
Foster Success Education Services Inc
(Typed Name and Title)
(Signature)
(Date)
Assignee:
Foster Success INC.
(FEI No.)
(Typed Name and Title)
(Signature)
(Date)
Consenting Authority:
Pursuant to the “Assignment and Delegation” section of the Uniform Terms and Conditions, the Department of Child Safety consents to the foregoing assignment.
(DCS Procurement Manager Signature) (Date)
Docusign Envelope ID: E7B63F55-68EE-4445-99DA-497B898AE942
CEO & President
CEO & President
Maggie Stevens
45-5056874
Maggie Stevens
4/25/2025 | 12:08 PM PDT
4/25/2025 | 12:08 PM PDT
4/25/2025 | 12:54 PM MST
| 2025-04-25T12:54:18-0700 | |
| Digitally verifiable PDF exported from www.docusign.com |
File details come from the government source that posted it. Updated .