Since the teenager who is the subject of this document does
    not want his name indexed on Google, we have blotted it out.
    You can read it on the photocopy.



    Ministry of                                Ministere des
    Community and        SOUTH EAST REGION     services sociaux
    Social Services                            et communautaires
    Ontario                                    Ontario
            

    To be completed by the society     Initial:      _
                                       Renewal:      _

    SPECIAL RATE AGREEMENT

    Child:         Xxxxx Xxxxxx
    Date of Birth: 05 March 1991
    Status:        Interim Society Ward
    Society:       Frontenac CAS

    Outside Paid Resource:        Loyalist Youth Services

    Reason For Special Rate: (Please mention if used for school)
    See attached
    ____________________________________________________________
    ____________________________________________________________
    ____________________________________________________________


    Special Rate To Provide:
    One to one staffing:     x
    Hourly rate              $17.70
    Maximum Hours per Day:   24
    Other                    _
    Explain:                 14 days Jan. 10/06 - 8:00 p.m until
                                     Jan. 24/06 - 8:00 p.m

    Regular per diem:         $165.24
    Special Rate:             $424.80
    Total per diem:           $590.04
    Total cost:              $8260.56

    Length of Agreement:     14 days

    Beginning on:            Jan 10/06
    Ending on:               Jan 24/06
    To be reviewed on:       Jan 24/06

    Approval:
    Society:                 L Braithwaite
                             CAS representative
    Date:                    Jan. 10/06

    Reviewed:
    MCSS:
                             Program Supervisor
    Date:

    Distribution: CAS, OPL, MCSS Licensing, CSU file

                                                   June 12, 2000
    ____________________________________________________________

                                                              57