Purchase Order Social Worker in United States Los Angeles –Free Word Template Download with AI
Social Worker Professional Services — United States Los Angeles
PURCHASE ORDER DETAILSPurchase Order Number: PO-LA-2025-04872 Date of Issue: June 12, 2025 Required Service Start Date: July 1, 2025 Required Service End Date: December 31, 2025 Payment Terms: Net 30 Days Currency: United States Dollar (USD) |
BUYING ORGANIZATIONOrganization: Los Angeles County Department of Community Services Address: 200 N. Spring Street, Suite 1400, Los Angeles, California 90012, United States Contact Person: Margaret Ellison, Procurement Director Phone: (213) 555-0147 Email: [email protected] |
VENDOR / SERVICE PROVIDERCompany Name: Pacific Coast Behavioral Health Group, LLC Address: 4500 Wilshire Boulevard, Suite 820, Los Angeles, California 90016, United States Primary Social Worker: Dr. Angela Reyes, LCSW (License No. 148723) Phone: (323) 555-0892 Email: [email protected] FEIN: 84-2917365 |
SERVICE LOCATIONPrimary Site: Los Angeles County Community Center, 1200 S. Grand Avenue, Los Angeles, CA 90015 Secondary Site: Eastside Family Services Office, 3400 E. Olympic Boulevard, Los Angeles, CA 90023 Region: United States Los Angeles Metropolitan Area Service Area: All 88 cities within Los Angeles County, United States |
| Item # | Description of Social Worker Services | Qty | Unit | Unit Price (USD) | Total (USD) |
|---|---|---|---|---|---|
| 1 | Licensed Clinical Social Worker (LCSW) case management services for at-risk families in the United States Los Angeles area. Includes intake assessments, care planning, and bi-weekly client sessions. | 260 | hrs | $145.00 | $37,700.00 |
| 2 | Group therapy facilitation by the assigned Social Worker for youth and adolescent programs in Los Angeles public schools. Minimum 12 sessions per quarter. | 36 | sessions | $425.00 | $15,300.00 |
| 3 | Crisis intervention and emergency response services provided by the Social Worker team across the United States Los Angeles jurisdiction. On-call availability 24/7 with 2-hour response time. | 6 | months | $3,200.00 | $19,200.00 |
| 4 | Community outreach and resource navigation by the Social Worker in underserved neighborhoods of Los Angeles. Includes monthly community workshops and referral coordination with local agencies. | 6 | months | $2,850.00 | $17,100.00 |
| 5 | Documentation, progress reporting, and compliance filing by the Social Worker in accordance with California Department of Social Services (CDSS) regulations and Los Angeles County mandates. | 6 | months | $1,400.00 | $8,400.00 |
| SUBTOTAL: | $97,700.00 | ||||
| Applicable Sales Tax (California 9.5%): | $0.00 (Exempt — Government Contract) | ||||
| PURCHASE ORDER TOTAL: | $97,700.00 USD | ||||
- This Purchase Order constitutes a binding agreement between the Los Angeles County Department of Community Services and Pacific Coast Behavioral Health Group, LLC for the provision of Social Worker professional services within the United States Los Angeles metropolitan area.
- The assigned Social Worker, Dr. Angela Reyes, LCSW, must maintain active licensure through the California Board of Behavioral Sciences for the entire duration of this Purchase Order. Any lapse in licensure shall constitute grounds for immediate termination.
- All Social Worker services shall be delivered in compliance with the California Welfare and Institutions Code, the Los Angeles County Code of Regulations, and all applicable federal guidelines under the United States Department of Health and Human Services.
- Payment shall be issued within thirty (30) calendar days of receipt of a valid invoice referencing this Purchase Order number (PO-LA-2025-04872). Invoices must be submitted to the Accounts Payable department at 200 N. Spring Street, Los Angeles, CA 90012.
- The Social Worker shall maintain strict confidentiality of all client records in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and California Confidentiality of Medical Information Act (CMIA).
- Service delivery is limited to the geographic boundaries of Los Angeles County, United States. Any services rendered outside this jurisdiction require prior written approval from the Procurement Director.
- This Purchase Order may be amended only through a written change order signed by both parties. No verbal modifications to scope, pricing, or timeline shall be recognized.
- The vendor shall carry professional liability insurance of no less than $2,000,000 per occurrence, naming the Los Angeles County Department of Community Services as an additional insured party.
- Termination for convenience may be exercised by the buying organization with thirty (30) days written notice. In such case, the vendor shall be compensated for all Social Worker services rendered up to the effective date of termination.
- This Purchase Order is governed by the laws of the State of California and the United States of America. Any disputes shall be resolved through binding arbitration in Los Angeles, California.
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Authorized by (Buying Organization): Margaret Ellison, Procurement Director Los Angeles County Department of Community Services Date: ____________________ |
Accepted by (Vendor / Social Worker Provider): Dr. Angela Reyes, LCSW Pacific Coast Behavioral Health Group, LLC Date: ____________________ |
This Purchase Order (PO-LA-2025-04872) was issued for Social Worker services to be performed in the United States Los Angeles area. All terms are subject to the governing statutes of the State of California and the United States of America. Document generated on June 12, 2025. Page 1 of 1.
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