Dane County Human Servicespdf.countyofdane.com/Purchasing/RFP115032/RFP 115032... · 2015-04-10 ·...
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(608) 294-8747 Fax : Provider Number : Data Entry Contact : Data Client Starting Target Closing SPC End Income Living Row New Close Client Name Number Units Date Group Diagnosis Date Reason < $15K Alone (Last, First M.I.) 1st 2nd 3rd (x) (x) 1 10 06/01/2014 01 23 27 319 2 17 06/01/2012 01 23 319 3 0 09/13/2013 01 23 319 3 CLOSING INFORMATION Grand Total : = Ending Census : Error Check ran on : CONSUMER INFORMATION OPENING INFORMATION Doug Hunt - Peter Zander Transportation Characteristics Client [email protected] DCDHS IDENTIFYING INFORMATION (Requested from DCDHS Staff) 04/02/2015 12:03:00 PM 27.00 Address : Telephone : Beginning Census : (608) 288-8934 Program Number : Prepared by : 173 E Badger Rd, Madison, WI 53713 Program Area : 0 Dane County Human Services Monthly Client Service Report (610 Form) version 4.3.3 ( Enter as mm / dd / yyyy ) 3 1957 E-Mail : Jamie Mortenson 645 - Closings : 0 Provider Name : Transit Solutions, Inc Mar - 2015 Report For : + Openings :
Transcript of Dane County Human Servicespdf.countyofdane.com/Purchasing/RFP115032/RFP 115032... · 2015-04-10 ·...
(608) 294-8747 Fax :
Provider Number : Data Entry Contact :
Data Client Starting Target Closing SPC End Income LivingRow New Close Client Name Number Units Date Group Diagnosis Date Reason < $15K Alone
(Last, First M.I.) 1st 2nd 3rd (x) (x)1 10 06/01/2014 01 23 27 3192 17 06/01/2012 01 23 3193 0 09/13/2013 01 23 319
3
CLOSING INFORMATION
Grand Total :
= Ending Census :
Error Check ran on :
CONSUMER INFORMATION OPENING INFORMATION
Doug Hunt - Peter Zander Transportation
CharacteristicsClient
DCDHS IDENTIFYING INFORMATION (Requested from DCDHS Staff)
04/02/2015 12:03:00 PM
27.00
Address :
Telephone : Beginning Census : (608) 288-8934
Program Number :
Prepared by : 173 E Badger Rd, Madison, WI 53713
Program Area :
0
Dane County Human ServicesMonthly Client Service Report (610 Form)
version 4.3.3
( Enter as mm / dd / yyyy )
3
1957
E-Mail :
Jamie Mortenson
645
- Closings : 0
Provider Name : Transit Solutions, Inc Mar - 2015Report For :
+ Openings :
608-294-8747 Fax :
Provider Number : Data Entry Contact :
Data Client Starting Target Closing SPC End Income LivingRow New Close Client Name Number Units Date Group Diagnosis Date Reason < $15K Alone
(Last, First M.I.) 1st 2nd 3rd (x) (x)1 19 06/01/2014 01 23 3192 25 02/02/2012 01 26 3193 0 07/01/2009 01 28 3194 0 06/02/2011 01 28 3195 12 09/09/2003 01 356 17 06/23/2003 01 267 12 09/02/2003 01 288 21 07/12/2004 01 269 0 06/01/2014 01 26 31910 14 07/07/2009 01 25 31911 22 06/12/2006 26 31912 4 07/01/2009 01 25 31913 0 05/07/2013 01 25 31914 0 05/01/2002 01 15 21 07/30/2007 01 25 319 Total16 42 01/01/2000 209.00
Dane County Human ServicesMonthly Client Service Report (610 Form)
version 4.3.3
( Enter as mm / dd / yyyy )
Mar - 2015Report For : Address :
Prepared by : Jamie Mortenson173 E. Badger Rd, Madison, WI 53713
Provider Name : Transit Solutions, Inc.
CONSUMER INFORMATION OPENING INFORMATION
16
Program Area : Doug Hunt Peter Zander Transportation1956
DCDHS IDENTIFYING INFORMATION (Requested from DCDHS Staff)645
E-Mail : 016
CLOSING INFORMATION
Grand Total :
= Ending Census : Telephone : Beginning Census : 608-288-8934
Program Number : Error Check ran on : 04/02/2015 12:04:11 PM
209.00
+ Openings :
CharacteristicsClient
- Closings : 0
608-294-8747 Fax :
Provider Number : Data Entry Contact :
Data Client Starting Target Closing SPC End Income LivingRow New Close Client Name Number Units Date Group Diagnosis Date Reason < $15K Alone
(Last, First M.I.) 1st 2nd 3rd (x) (x)1 42 01/01/2000 01 23 272 0 07/09/2009 31 03 3073 40 07/01/2009 01 28 3194 42 01/01/2000 01 26 3175 0 06/01/2012 01 23 3196 24 06/01/2014 01 25 3197 20 07/01/2009 01 26 3198 42 01/01/2000 01 23 26 3179 0 06/01/2014 01 26 31910 0 07/31/2012 01 26 31911 24 05/13/2013 01 26 31912 41 01/01/2000 01 2613 32 06/13/2011 01 26 31914 0 07/08/2013 01 26 31915 21 11/26/2014 31 03 307 Total16 41 06/01/2014 01 26 319 369.00
Error Check ran on : 04/02/2015 12:07:50 PM
757.00
+ Openings :
CharacteristicsClient
- Closings : 0E-Mail : 140
CLOSING INFORMATION
Grand Total :
= Ending Census : Telephone : Beginning Census : 608-288-8934
Program Number :
CONSUMER INFORMATION OPENING INFORMATION
39
Program Area : Doug Hunt - Peter Zander Transportation1955
DCDHS IDENTIFYING INFORMATION (Requested from DCDHS Staff)645
Address : Prepared by : Jamie Mortenson
173 E Badger Rd, Madison, WI 53713Provider Name : Transit Solutions, Inc
Dane County Human ServicesMonthly Client Service Report (610 Form)
version 4.3.3
( Enter as mm / dd / yyyy )
Mar - 2015Report For :
17 22 12/16/2013 01 28 31918 32 05/04/200419 21 06/06/2011 01 26 31920 41 03/06/2013 01 28 23 31921 20 06/18/2013 01 23 31922 0 01/26/2015 31 03 30723 41 09/05/2013 01 23 31924 24 06/01/2014 01 26 31925 20 01/01/2000 18 18 290.426 5 06/01/2014 01 26 31927 13 11/24/2014 01 26 31928 0 05/05/200329 41 12/13/2010 1 26 31930 3 03/07/2013 01 26 23 31931 0 02/13/2012 01 28 319 Total32 0 03/11/2009 31 02 295 283.0033 42 01/04/2010 01 26 31934 0 09/20/2010 31 03 29535 0 11/06/2014 01 26 31936 0 05/04/2009 31 02 30737 42 06/01/2014 01 26 31938 0 11/01/2013 01 28 31939 0 03/01/2011 01 26 31940 x 21 03/01/2015 01 26 319
608-294-8747 Fax :
Provider Number : Data Entry Contact :
Data Client Starting Target Closing SPC End Income LivingRow New Close Client Name Number Units Date Group Diagnosis Date Reason < $15K Alone
(Last, First M.I.) 1st 2nd 3rd (x) (x)1 0 08/15/2005 31 03 3072 42 07/01/2009 01 28 3193 0 07/01/2009 01 28 3194 41 07/01/2009 01 28 3195 33 04/02/2009 01 23 3196 0 01/01/2000 01 26 7 0 07/01/2009 31 03 3078 0 06/13/2011 01 26 3199 40 07/01/2009 01 28 31910 0 07/01/2009 01 25 31911 0 06/13/2005 01 26 31912 20 10/27/2014 01 28 31913 0 05/05/200314 21 09/02/2014 01 26 31915 29 06/13/2011 01 25 319 Total16 42 07/01/2009 01 28 319 268.00
0108
CLOSING INFORMATION
Grand Total :
= Ending Census :
Error Check ran on : 04/02/2015 12:13:09 PM
2,082.00
+ Openings :
CharacteristicsClient
CONSUMER INFORMATION OPENING INFORMATION
Program Area : Doug Hunt - Peter Zander Transportation
E-Mail :
Provider Name : Transit Solutions, Inc.
Telephone : Beginning Census : 608-288-8934
Address : Prepared by : Jamie Mortenson
173 E. Badger Rd. Madison WI 53713
1954
DCDHS IDENTIFYING INFORMATION (Requested from DCDHS Staff)645
- Closings : 0
Program Number :
108
Dane County Human ServicesMonthly Client Service Report (610 Form)
version 4.3.3
( Enter as mm / dd / yyyy )
Mar - 2015Report For :
17 40 01/01/2000 01 26 18 0 07/31/2014 01 26 31919 0 07/01/2009 01 26 31920 42 07/01/2009 01 26 31921 32 07/01/2009 01 28 31922 32 01/01/2000 01 23 26 23 41 07/01/2009 01 23 31924 19 07/01/2009 01 28 31925 39 07/01/2009 01 28 31926 0 07/01/2009 31 03 30727 42 07/01/2009 01 26 31828 34 07/01/2009 01 26 31829 42 10/06/2009 01 25 31930 0 01/13/2012 01 26 31931 42 07/01/2009 01 28 319 Total32 0 06/03/2013 01 23 319 405.0033 22 05/24/2010 01 25 31934 41 06/13/2011 01 26 31935 0 07/01/2009 31 03 29536 41 07/01/2009 01 26 31937 0 07/11/2011 31 03 30738 42 10/21/2002 01 2639 0 05/05/200340 18 09/02/2014 01 26 31941 39 01/01/200042 19 07/01/2009 01 26 31943 40 09/18/2013 01 26 31944 0 07/05/2006 31 03 30745 28 07/01/2009 01 28 31946 35 07/01/2009 01 28 31947 0 06/21/2010 01 23 319 Total48 24 07/01/2009 01 28 319 349.0049 10 03/05/2013 31 03 30750 0 01/01/2000 01 28 2351 40 11/05/2012 01 26 31952 36 01/01/2000 01 2653 0 06/02/2011 01 28 31954 42 07/01/2009 01 28 31955 26 08/14/2014 01 26 31956 0 03/17/2011 31 3 30757 0 05/05/200358 6 03/19/2009 31 03 30759 42 09/02/2014 01 26 31960 0 07/01/2009 01 26 31961 6 07/01/2009 57 09 03 30762 34 07/01/2009 01 26 31963 19 06/03/2013 01 26 319 Total64 42 07/01/2009 01 28 319 303.00
65 41 07/01/2009 01 28 31966 28 05/05/2014 01 26 31967 42 06/09/2003 01 2668 41 07/01/2009 01 26 31969 0 07/01/2009 01 28 31970 0 11/14/2012 01 26 31971 19 07/30/200072 20 04/04/2014 01 26 31973 0 02/01/2010 01 26 31974 42 07/01/2009 01 28 31975 0 01/01/2000 01 26 2376 40 07/01/2009 01 28 31977 6 12/16/2013 31 03 29578 42 07/01/2009 01 26 31979 38 12/19/2013 01 26 319 Total80 26 03/03/2009 01 28 319 385.0081 8 07/07/2010 31 03 30782 0 10/01/2013 01 26 31983 29 04/11/200184 0 04/19/2005 31 03 30785 0 07/01/2009 01 28 31986 0 06/27/2005 31 03 30787 20 07/01/2009 01 25 31988 8 05/22/2014 31 03 30789 40 07/01/2009 01 28 31990 41 07/01/2009 01 28 31991 17 07/12/2010 01 26 31992 0 09/10/2007 01 26 31993 0 09/30/2009 01 28 31994 0 07/01/2009 01 26 31995 0 07/01/2009 31 03 295 Total96 0 01/01/2000 163.0097 0 07/01/2009 01 26 31998 0 07/01/2009 01 28 31999 28 07/01/2009 01 28 318
100 40 07/01/2009 01 28 319101 42 06/03/2011 01 26 319102 8 01/21/2015 31 03 307103 0 01/01/2000104 0 09/17/2012 01 26 319105 16 07/01/2009 01 26 319106 42 07/01/2009 01 28 319107 0 07/01/2009 31 03 307108 33 07/01/2009 01 28 319
