1. Parties This Service Agreement is for This Service Agreement is for , a participant in the National Disability Insurance Scheme, and is made between: Participant / Participant’s RepresentativeNDIS Participant Number: Participant Date of Birth: Plan ManagerDYNAMIC PLAN MANAGEMENT PTY LTDACN: 644 049 954ABN: 21 644 049 954Address: 1-3, 77-79 Ashley st, Braybrook, VIC 3019 AustraliaTel: 0413 748 966 The Service Agreement is dated: 2. The NDIS and this Service Agreement This agreement is made for the purpose of providing support under the Participant’s NDIS plan. The parties agree that this agreement is made in the context of the NDIS, which is a scheme that aims to: Support the independence and social and economic participation of people with disability, and Enable people with a disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports. 3. Schedule of Services The Service Provider agrees to provide the Participant the supports as per the schedule for the duration as per the schedule. The prices for the supports are set out in the attached schedule.All prices are GST inclusive (if applicable) and include the cost of providing the supports. Additional expenses (i.e. things that are not included as part of a Client’s NDIS supports) are the responsibility of the (Participant/Participant’s representative) and are not included in the cost of the supports.Examples include entrance fees, event tickets, meals, etc. 4. Responsibilities of the Plan Manager The plan manager agrees to: Treat the Participant with courtesy and respect Consult the Participant on decisions about how services are provided Give the Participant information about managing any complaints or disagreements Listen to the Participant’s feedback and resolve problems quickly Give the Participant the required notice if the provider needs to end the Service Agreement (see ‘Ending this Service Agreement’ below for more information) Protect the Participant’s privacy and confidential information Provide services in a manner consistent with all relevant laws, including the National Disability Insurance Scheme Act 2013 and rules, the Australian Consumer Law and Accounting Professional and Ethical Standards; keep accurate records on the services provided to the participant Issue regular invoices and statements of the supports delivered to the participant. 5. Responsibilities of the Participant/ Participant’s Representative The client/client’s representative agrees to Inform the Provider about how they wish the supports to be delivered to meet the Participant’s needs. Treat the Provider with courtesy and respect. Talk to the Provider if the client has any concerns about the supports being provided. Give the Provider the required notice if the client needs to end this agreement (see ‘Termination’ below for more information); and Let the Provider know immediately if the client’s NDIS plan is suspended or replaced by a new NDIS plan or the client stops being in the NDIS. 6. Payments The Plan Manager will seek payment for their provision of services after the delivery of scheduled services.The Participant has nominated the Plan Manager to manage the funding for his/her NDIS supports. After receiving valid tax invoices from the Participant / Participant’s representative and/or service providers engaged by the Participant, the Plan Manager will claim from NDIA for funding up to the amounts specified in relevant support categories of the Participant’s NDIS plan. After receiving funding from NDIA, the Plan Manager will make payments to the Participant / Participant’s representative and/or service providers engaged by the Participant. The Participant authorises the Plan Manager to claim from NDIA for the Plan Manager’s services per the items and amounts listed at Attachment 1 – Schedule of Services at any time during the period of the Service Agreement, and to disburse those amounts from their funds held in trust 7. Changes to this Service Agreement If changes to the supports or their delivery are required, the parties agree to discuss and review this agreement. The parties agree that any changes to this agreement will be in writing, signed, and dated by the parties. 8. Ending the Service Agreement Should either party wish to end this Service Agreement they must give one-month notice. If either party seriously breaches this Service Agreement the requirement of notice will be waived 9. Feedback, Complaints and Disputes If the Participant wishes to give the provider feedback, the Participant can talk to the Plan Manager’s nominated contact person (see ‘Contact details’ below). If the Participant is not happy with the provision of services and wishes to make a complaint, the Participant can talk to Pranav Menon, on 0413 748 966, or email admin@dynamicplan.com.au. If the client is not satisfied or does not want to talk to this person, the client can contact the National Disability Insurance Agency by calling 1800 800 110, visiting one of their offices in person, or visiting ndis.gov.au for further information. 10. Goods and Service Taxes For the purposes of GST legislation, the Parties confirm that: A supply of supports under this Service Agreement is a supply of one or more of the reasonable and necessary supports specified in the statement included, under subsection 33(2) of the National Disability Insurance Scheme Act 2013 (NDIS Act), in the Participant’s NDIS plan currently in effect under section 37 of the NDIS Act; The Participant’s NDIS plan is expected to remain in effect during the period the supports are provided; and The Participant/Participant’s representative will immediately notify the Plan Manager if the Participant’s NDIS Plan is replaced by a new plan or the Participant stops being a participant in the NDIS. 11. Contact Details The Participant/ Participants representative can be contacted on: Phone / Mobile*: Email*: Address*: Signature*: Alternative Person Details Name: Phone: Email: The Plan manager can be contacted on: Contact Person: Phone Number: Email*: Address*: I have double checked every input prior to submitting this form. Note: You have to click twice on submit if form is not submitted on first attempt.