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E-Blast: RBWO Contracts: Authorized Signer & Approval Information Form -- UPDATE

February 26, 2021 1:51 PM

Dear Directors:

Update: The completed form should be uploaded to GA+SCORE by COB on March 5, 2021.

To assist DFCS in processing your contract, please fill out the Authorized Signer & Approver Information Form. In the "Authorized Signer Information" section, list all individuals who are authorized to sign the RBWO contract.

  • If the Provider is Non Profit, the authorized signer(s) must match the signer on the Corporate Resolution.
  • If the Provider is For Profit, please list approved names to sign the RBWO contract in the Authorized Signer(s) section.
Once the form is completed, upload it to GA+SCORE using the same process as other contract documents. When logged in as a super user, click on the orange Profile tab for any program site, then on Contract Docs. Click the link to upload a file and select "Authorized Signer Form" as the type.
If you have questions, please contact

Thank you.

The Office of Provider Management