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2024-112
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2024-112
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Last modified
6/17/2024 10:39:54 AM
Creation date
6/17/2024 10:38:28 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
05/21/2024
Control Number
2024-112
Agenda Item Number
13.A.
Entity Name
Southeast Florida Behavioral Health Network, Inc.
Subject
Service Agreement for Administration of Opioid Class Action Lawsuit Settlement Fund Allocation
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Southeast Florid <br />B. This certification is a material representation of fact upon which reliance was placed <br />when this transaction was made or entered into. Submission of this certification is a <br />prerequisite for making or entering into this transaction imposed by section 1352, Title <br />31, U.S. Code. Any person who fails to file the required certification shall be subject <br />to a civil penalty of not less than $10,000 and not more than $100,000 for each such <br />failure. <br />�Docusigned by: 6/12/2024 <br />UWA, AJAPAs <br />2246622EFF404B2 Signature Date <br />Susan Adams AGR75 <br />Name of Authorized Individual Application or Contract <br />Number <br />Indian River County Board of County <br />Commissioners <br />Name of Organization <br />1801 27th Street, Vero Beach, FL 32960 <br />Address of Organization <br />Certification Packet 5 Agreement No.: AGR75 <br />Indian River County Board of <br />County Commissioners <br />
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