Transition to Work Services Deed 2016 – 2020
Schedule 1: Deed and business details
Item 1
Account Manager (clause 71.3, Annexure A1)
Account Manager
<Account Manager Physical Address Line1>
<Account Manager Physical Address Line2>
<Account Manager Physical Address Line3>
<Account Manager Suburb> <A/Manager State> <A/Manager Postcode>
Account Manager
<Account Manager Postal Address Line1>
<Account Manager Postal Address Line2>
<Account Manager Postal Address Line3>
<A/Manager Suburb> <A/Manager State> <A/Manager Postal Postcode>
Managing Office Contact Phone Number: <Managing Office Switch Phone>
Item 2
Contact Person (clause 71.3, Annexure A1)
Contact
Position
Telephone
Email
<Contract Contact Title> <Contract Contact First Name> <Contract Contact Surname>
<Contract Contact Position>
<Contract Contact Phone>
Mobile
<Contract Contact Mobile>
<Contract Contact Email>
Item 3
Service Start Date(s) (clause 5.1, Annexure A1)
[insert Service Start Date(s) for each Employment Region]
Item 4
Service Period (clause 5.1, Annexure A1)
The first Service Start Date specified at item 3 – 30 June 2020
Transition to Work Services Deed 2016-2020
Schedule: Deed and business details
<Deed Number ID>
Provider Initials ……………
Department’s Initials ……………
Page 1 of 4
Transition to Work Services Deed 2016 – 2020
Schedule 1: Deed and business details
Item 5
Account details for payment (clause 15.1)
Bank BSB Number
Bank Account Number
Bank Account Name
<Primary BSB number>
<Primary Account number>
<Primary Account Name>
Bank Name
Bank Branch
<Bank Name>
<Branch Address Details>
Item 6
Transition to Work Services (clause 5 and Annexure A1)
6.1
6.2
6.3
6.4
6.5
6.6
6.7
Employment Region
(clause 5.2)
Location
(clause 5.2)
Site(s)
(clause 5.2)
Site frequency of service
(clause 5.2)
(Full-time, Part-time, or Outreach)
Business Days of
operation
(clause 5.4)
Tendering
Group
(Y/N)
Subcontractor(s)
(Y/N)
Transition to Work Services Deed 2016-2020
Schedule: Deed and business details
<Deed Number ID>
Provider Initials ……………
Department’s Initials ……………
Page 2 of 4
Transition to Work Services Deed 2016 – 2020
Schedule 1: Deed and business details
Item 7
Tendering Group members (clause 44.1, Annexure A1)
Name
Item 8
Address
ABN
Site(s)
Subcontractors approved at the Deed Commencement Date (clause 48.3, Annexure A1)
Name
Transition to Work Services Deed 2016-2020
Schedule: Deed and business details
<Deed Number ID>
Address
ABN
Provider Initials ……………
Department’s Initials ……………
Site(s)
Terms and conditions
Page 3 of 4
Transition to Work Services Deed 2016 – 2020
Schedule 1: Deed and business details
Item 9 Places (clause 96 and Annexure A1)
1.
2.
9.1
9.2
9.3
Employment Region
(clause 5.2)
Places1
(clauses 96.3 and 96.5)
Referral Cap for jobactive2
(clauses 96.3 and 96.5)
For the first three months following the Service Start Date for each Employment Region, the number of Places and Referral Cap for jobactive will be 75 per cent of the numbers specified at items 9.2 and
9.3, respectively.
Referral Cap for jobactive means the maximum number of Places that can be used to service Group Three Participants (who are Participants referred from jobactive).
Transition to Work Services Deed 2016-2020
Schedule: Deed and business details
<Deed Number ID>
Provider Initials ……………
Department’s Initials ……………
Page 4 of 4