FBS Provider Agreement UNITED WAY of WELD COUNTY EARLY CARE & EDUCATION SERVICES FAMILY BUSINESS SOLUTION PROGRAM PROVIDER AGREEMENT This agreement is entered into between United Way of Weld County’s Family Business Solution Program, herein referred to as “United Way” and the Child Care Provider as “Provider”. The Provider will offer child care to families participating in our Family Business Solution (FBS) Program. This agreement shall take effect on the 1st of the following month and shall be terminated when the child(ren) are no longer in the above stated provider’s care, or when the business, or United Way’s Business Financial Support Program is discontinued or expires. The Provider agrees to the following: Collect parental fees directly from the parent. The parent is required to pay the amount due in excess of the approved benefit allotment. Bill United Way of Weld County for benefit amount only. If the total child care bill is less than the benefit allotment only the services rendered are billable. Parents eligible for Financial Business Solutions support may also participate in CCCAP Bill United Way of Weld County up to the total amount of child care cost due, less the applicable parent fee, not to exceed the agreed upon rates of reimbursement as set forth in initial email sent by UWWC. Submit a copy of the parent sign-in/sign-out sheet documenting the child’s attendance at the program with each billing submission Hold the parent(s) harmless for eligible financial assistance dollars whether or not billed by the Provider to United Way for any of our financial assistance programs. Hold United Way of Weld County harmless for any loss or actions caused during the performance of this agreement or for any uncollected parent fees. Conform to United Way of Weld County’s billing procedures. Adhere to all State & Federal licensing requirements and laws. Submit a copy of your renewed license annually to United Way of Weld County, if applicable. Carry adequate licensed child care home or center liability insurance, if licensed facility. Accept referrals for child care without discrimination with regard to race, color, creed, national origin, age, sex, religion, gender preference, or physical/mental disabilities. Financial assistance dollars are to be used for child care and not for initial entry fees, payment of back child care costs or to cover any costs upon termination of child care by the parent Contractor shall satisfy all tax and other governmentally imposed responsibilities including, but not limited to: payment of state, federal and social security taxes, unemployment taxes, workers’ compensation and self-employment taxes. No federal, state or local taxes of any kind shall be withheld or paid by the Company. Contractor is not entitled to unemployment insurance benefits or workers’ compensation benefits unless such coverage is provided by the independent contractor. United Way of Weld County agrees to the following: Inform the provider of the amount and effective date of any rate changes. Rate changes will not be retroactive. Reimburse the provider for authorized child care in accordance with the agreed upon rates of reimbursement as stated in introductory email. Invoices must be submitted by the 5th day of the following month, payment/direct deposit will be mailed/made by the 15th day of that month. Notify the provider of changes in added or deleted eligible children. Agreed to and accepted as follows:Child Care Provider – Authorized Representative(Required)Business Name (if applicable)Email(Required) Date(Required) MM slash DD slash YYYY Address Street Address City State Zip Δ