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COLUCCI, DENNIS A. 2-2001
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COLUCCI, DENNIS A. 2-2001
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Last modified
1/3/2012 3:10:40 PM
Creation date
2/24/2006 10:24:30 AM
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Template:
Contracts
Company Name
Dennis Colucci
Contract #
N-2001-055
Agency
Personnel Services
Expiration Date
6/30/2002
Insurance Exp Date
3/10/2001
Destruction Year
2010
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<br />.. <br /> <br />Jan-OB_OI 10~OIA Dennis Colucc; <br /> <br />714 249 .2024 <br /> <br />p.OI <br /> <br />, <br />" <br /> <br />24.~,)2 MJtJ/ton Parkway <br />Lag"n. Wo<XI', Ca 926~ <br />949 e>>S770 FI\X 0:)(>-2324 <br /> <br />Dennis A. Colucci$ M.A., FAAA <br /> <br />AVrJiology ana Hearing RahBbfHtBtlon <br />BOSlrd C'Irlified in Audiology <br /> <br />January 8, 2001 <br /> <br />Ann Garcia <br />loss Control Analyst <br />City of Santa Ana <br />20 Civic Center Drive <br />Santa Ana, Califomia 92702 <br /> <br />Dear Ms. Garcia, <br /> <br />Per our conversation and your request I would like to outline the service agreement. For <br />consideration J ""HI provide the following service to the City of Santa Ana. <br /> <br />1. Basic Hearing Evaluation. $17500, includes a i-hour visit and a review of the patient's <br />abbreviated profile of hearing and/or hearing aid benefit with brief report and findings <br /> <br />2, Further diagnostic testing (discovery) not to exceed $150.00 per patient. <br /> <br />Thi~ agreement shall be in force for a period of one year. Fees will be resssassed annually <br />and changed with agreement by both parties. All payments shall b9 made directly to Dennis A. <br />Colucci, M.A., FAAA at the addri;lss listed ebove within eo days of receipt of billino_ If payment <br />is not received within 60 days a 20.00 per monlh lala fee thereafter shall apply. <br /> <br /> <br />
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