Llc Agreement Sc by qvp56346

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									                  RMJ Pharmacy Solutions, LLC
                       Service Agreement
Service Agreement Date:                     _____________________

Pharmacy:             _______________________________________________

Pharmacy Representative:                    ___________________________________

RMJ Pharmacy Solutions Representative:                            _______________________

Scheduled Days & Hours:                     ___________________

                                            ___________________

                                            ___________________



Rate & Fees:                                ____________________

**Starting January 2010 all invoices not paid within 14 days will incur a $75 late fee**

Discounts:                                  Initial 30 miles no charge



An invoice will be provided and payment scheduled within _____ days of receipt of

invoice.



____________________________                                                                    ___________________
Pharmacy Representative                                                                          Date


____________________________
Ranarda Jones, PharmD, Owner

*This document maybe emailed to RMJ Pharmacy Solutions. Please type in the information and send. The verifiable email address
will serve as signature and acceptance of the Agreement to Pay. The form may also be faxed to 803-781-0871. This form must be
received by RMJ Pharmacy Solutions before services are rendered. Failure to do so will result in default of any verbal agreements to
provide staffing on said scheduled dates.
Updated 1/11/10




              6 Crown Point Ct • Irmo, SC 29063 • 8039205053 • 8037810871 fax

                                        www.rmjpharmacysolutions.com
 RMJ Pharmacy Solutions, LLC




6 Crown Point Ct • Irmo, SC 29063 • 8039205053 • 8037810871 fax

               www.rmjpharmacysolutions.com

								
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