HomeMy WebLinkAbout2018-19 Presence Learning ServicenocuS;gn Envelop<> ID: 8281t96F-3B69-4BD7-95EA-C:5Cl92A04E'91A
Presence lea rn ing
Service Order Form
C ustomer Name and Contact Information
Name: Bonneville Joint School District 93 -ID
Address: 3497 N AMMON RD IDAHO FALLS, lD
Customer Primary Point of Contact
Name: Julian Duffey
Email Address: duffeyj@d93.k12.id.us
Customer Secondary Poin t of Contact
Name:
Email Address:
Presencelearning Contact lnforn1ation
Name: Sarah Finney
Email Address: sarah@presencelearning.com
oocuSlgn Envelope JD: 828'196F-31369..4607·95EA·E5B92AB4E9 IA
Service Order Form
Services &Assessments
Service Student Quantity Price per Service Service Total
Service Lisense • SLP 270 $1.435.00 $387,450.00
Service Licensa·. OT 0 $1.435.00 $0.00
Service License • BMH 0 $1.435.00 $0.00
SLP Assessment 0 $375.00 $0.00
OT Assessment 0 $375.00 $0.00
SMH Assessment 0 $500.00 $0.00
Assessment Bilingual SLPIOT 0 $500.00 $0.00
Screonings by SLP 0 $55.90 $0.00
Screenings by OT. 0 $55.90 $0.00
Sc1-eenings by MHP 0 S55.90 $0.00
Screenings by SLP Bl 0 $55.90 $0.00
Evaluation Review of Records by SLP 0 $357.90 $0.00
Evaluatipn Review of Records by OT 0 $357.90 $0.00
Evaluation Review of Records by BMH 0 $357.90 $0.00
Psychoeducational Assessments
Student Quantity Price per Service Service Service Total
$0.00Evaluation Coordination and Rt<>pnrting 0 $225.00
$225.00Review of R0cords by School Psychologist 0 $0.00
$115.00 $0.00Cognitive Selected Index 0
Neuro Processing Selected Index $115.00 $0.000
$115.00Achievement Selected Index 0 $0.00
$115.00 $0.00Rating ·Scale Assessment 0
$75.00 $0.00Classro.om Observation 0 -Achievement Standard Battery $225.00 $G.OO0
$225.00 $0.000Cognitive .Standard Battery
$225.00 $().00Additional Assessment by School Psychologlsl 0
$225.00 $().00Standard Neuro Processing Battery 0
$115.000 $0.00Additional Requested Meetings
School Psych Consultation 0 $75.00 $0.00
OocuSi n Envelope ID: 8281196F-3B69-4B07-95t:A-£5'B92AB4E91A
Service Order Form
Minimum fees Per Service Order $387,450.00
Assessments Commitment 54
Flat Rate Assumptions AssumGd Average Therapy Prescription: 30 minutes
Assurned Average Scheduled Group Site: 1.3 stud1;1nts
Psychoeducational Assessmerit Commitment $2,250.00
Document Camero $85.00 (each)
Tenn July 1, 2018 through June 30, 2019
Modified Terms
The terms of the Master Services Agreement or Master Contract applicable to services through June 30. 2018
shall apply for the Term set forth herein.
OocuSp,jo Envelope JU: 82B l f98F-3BSll-4BD7~E5892AB4E91A
Service Order Form
Except as expressly set forth In this Service Order, the parties agree to be bound by the terms of the Presenceleaming
Master Services Agreement available at https:/1\1/ww.presencelearning.comltc!flat-rate/, which is incorporilted herein by
reference. This Service Orde1· and U1e MSA together constffute the entire agreement between. Presenceleaming and
Customer governing the seJVices .and products referenced above (the "Agreement"), to the exclusion of all other terms. To
the extent there is ;my conflict between this Se1vice Order and the MSA, this Service Order sl'lall govern. The signatory below
represents that he or she has the autho1ity to bind Customer to the terms of this Agreement. The terms ofthis Service Order
are Presencelearning confidential information.
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed as of July 1, 2018 (Effective Date).
Presencel earning, Inc. Customer
Name; Name:
Julian DuffeyJacl< Phillips
Title: Title:
Spec·i al tdU<.:'9tion Oi re:c:torVP, customer success
Date: Date:
2018-06-19 2018-06-19