[Month & Year]

XXth Omnibus Variation to the 2012/13

Crown Funding Agreement

BETWEEN

HER MAJESTY THE QUEEN

IN RIGHT OF HER GOVERNMENT

IN NEW ZEALAND

Acting by and through the

Director, Service Commissioning

Ministry of Health

AND

[NAME] District Health Board

1

This Variation is between:

Her Majesty the Queen

In Right of Her Government in New Zealand

Acting by and through the Director, Service Commissioning

Ministry of Health (Ministry)

______

Signature

(Authorised Signatory)

______

Name

______

Date

AND

[NAME] District Health Board

District Health Board established under section

19 of the New Zealand Public Health and

Disability Act 2000 (DHB)

______

Signature

(Authorised Signatory)

______

Name

______

Date

(Together described as the Parties)

BACKGROUND AND PURPOSE OF THIS VARIATION

A. The Parties have entered into the Principal Agreement. The Principal Agreement was deemed to commence on [DAY MONTH YEAR]. The Parties have agreed to extend the term of the Principal Agreement by variation, to [DAY MONTH YEAR].

B.The Parties wish to vary the Principal Agreement in order for the DHB to provide the additional services included in this Variation, and in return the Ministry will fund the DHB to provide the additional services set out in the schedules below. The Parties have agreed to enter into this Variation to record the terms.

TERMS OF THis VARIATION

Commencement and Expiry of this Variation

This XXth Omnibus Variation to the Principal Agreement commences on [DAY MONTH YEAR] and expires on the latest expiry date contained in the variations included in this Variation (the Incorporated Variations) or [DAY MONTH YEAR], whichever date is later.

Disclosure of this Variation

In accordance with Clause A.6.1 of the Principal Agreement, copies of any variations to the Principal Agreement will be held by both Parties and will be publicly available.

THE PRINCIPAL AGREEMENT – VARIATION TABLE

This section lists all variations that have been signed and dated by the Parties. Every variation to the Principal Agreement agreed by the Parties will be listed in the appropriate tables below.

The summary table will be updated to reflect each signed variation and each signed variation will have an updated summary table attachedto it.

Variations

Variations / Number / Commencement Date
1st Omnibus variation to the 2012/13 CFA / 1 / 1 February 2013
2nd Omnibus variation to the 2012/13 CFA / 2 / 1 May 2013
3rd Omnibus variation to the 2012/13 CFA / 3 / 1 July 2013
4th Omnibus variation to the 2012/13 CFA / 4 / 1 October 2013
5th Omnibus variation to the 2012/13 CFA / 5 / 1 February 2014
6th Omnibus variation to the 2012/13 CFA / 6 / 1 May 2014
7th Omnibus variation to the 2012/13 CFA / 7 / 1 July 2014
8th Omnibus variation to the 2012/13 CFA / 8 / 1 October 2014
9th Omnibus variation to the 2012/13 CFA / 9 / 1 February 2015
10th Omnibus variation to the 2012/13 CFA / 10 / 1 May 2015
11th Omnibus variation to the 2012/13 CFA / 11 / 1 July 2015
12th Omnibus variation to the 2012/13 CFA / 12 / 1 October 2015
13th Omnibus variation to the 2012/13 CFA / 13 / 1 February 2016
14th Omnibus variation to the 2012/13 CFA / 14 / 1 May 2016
15th Omnibus variation to the 2012/13 CFA / 15 / 1 July 2016
16th Omnibus variation to the 2012/13 CFA / 16 / 1 October 2016
17th Omnibus variation to the 2012/13 CFA / 17 / 1 July 2017
18th Omnibus variation to the 2012/13 CFA / 18 / 1 October 2017

INCORPORATED VARIATIONs

The following table lists all the Incorporated Variations for this Omnibus.

Please indicate which variations you would like to accept in the appropriate boxes below.

Variation name / Schedule number / Page Number

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