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Section 1 Service provider and funded service details Name of service provider Service provider s COMS code Name of service specification (As described in the Service Agreement, its schedules and annexures or other relevant documents such as Letters of Agreements or other contractual documents signed between Community Services and service provider) Service specification COMS code Name of funding program Contact person (The name of the person who can be contacted to discuss the report, and a contact phone number) Target group/s (Identify target groups as detailed in the service specification or other relevant documents) Funding level: As described in the Service Agreement, its schedules and annexure or other relevant documents such Letters of Agreement or other contractual documents signed between Community Services and service provider Funding term (please circle) Fixed term/one-off/renewable Weekly hours of operation Section 2 Performance details The details provided in this section should reflect the relevant information outlined in the funded service service specification (2010/11)..