Calmer Lives - Professional Referrer & Purchaser Service Agreement

Calmer Lives - Professional Referrer & Purchaser Service Agreement

Registered in England & Wales as Community, Equality, Disability Action by guarantee 4693500. Registered Charity No.1096528
Terms and conditions set out in this document provide a contract between CEDA, Calmer Lives and ithe service purchaser. The contract will commence from the point it is signed and submitted. Service charges are subject to inflationary increase. Either party may terminate this agreement by giving 4 weeks written notice to the other party.
Service Provider: CEDA (Calmer Lives) The Clare Milne Centre, Emperor Way, Exeter Business Park, Exeter, EX1 3QS

Telephone: 01392 360645 / Email: accounts@cedaonline.org.uk
Service Requester: To the individual completing this form requesting service on behalf of young person, parent and/or family, please provide your name, contact number, email
Service User: Please provide name and contacts details for whom this service is being purchased. Please include any ID code if known. e.g. PER1234. (This space can also be used to provide specific information on who will be attending the Calmer Lives service and what the funding is seeking to achieve.)
Service Purcasher

NameOrganisation
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityCounty

Post Code
What support are you purchasing?

There is no minimum or maximum limit to sessions and adminstration options that can be purchased. Session prices are based on 30 min = £27.50 / 60 min = £55.00 / 90 min = £82.50 (Additional costs can be found withing the T's & C's section of this form)

e.g.

Summary of service provision

Unit cost

Total cost

8 hours - family support sessions

1 hour - multiagency meeting

30 min - supporting letter admin

1 hour - summary report admin

£55.00

£27.50

£55.00

£440.00

£55.00

£27.50

£55.00

£577.50

Please specify what you wish to purchase providing hours and total calculations
How will payment be made?
Purchase Order Number: (This is specifically for Devon County Council or other social service purchasers. Please note, this must be attained and finance agreed before Calmer Lives can provide its service)
I consent to Calmer Lives adding my email details to their mailing list and receive news updates or promotional materials periodically. This will not be shared with third parties (Full details of CEDA, Calmer Lives privacy policy can be found at cedaonline.org.uk/privacy-policy)
Please sign and date to acknowledge and agree to this contract.
Service Requester/Purchaser Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: