1. (a) The vendor shall submit the following information to the regional center on the Form DS2 (7/91), entitled Transportation Cost Statement:

   1. (1) Vendor name;
   2. (2) Business telephone number;
   3. (3) Vendor identification number;
   4. (4) Service code and subcode;
   5. (5) Business and mailing addresses;
   6. (6) Name of management organization, if any;
   7. (7) Name and telephone number of the contact person;
   8. (8) Name of the vendoring and contracting regional center;
   9. (9) Proposed effective date of service; and
   10. (10) Signature of the vendor or designee and the date signed.

Note: Authority cited: Sections 4405, 4631 and 4690.1, Welfare and Institutions Code; and Section 11152, Government Code. Reference: Sections 4631 and 4690.1, Welfare and Institutions Code.

History

1. New section filed 9-26-91; operative 9-26-91 pursuant to Government Code section 11346.2(d) (Register 92, No. 10).