SERVICE DELIVERY STRATEGY FORM 2: Summary of Service Delivery Arrangements Instructions: Make copies of this form and complete one for each service listed on FORM 1, Section IV. Use EXACTLY the same service names listed on FORM 1. Answer each question below, attaching additional pages as necessary. If the contact person for this service (listed at the bottom of the page) changes, this should be reported to the Department of Community Affairs.
COUNTY:TYPE COUNTY NAME HERE	Service:Type the Name of the Service to be Provided Here
1. Check one box that best describes the agreed upon delivery arrangement for this service: a.) Service will be provided countywide (i.e., including all cities and unincorporated areas) by a single service provider. (If this box is checked, identify the government, authority or organization providing the service.):Type Name of Government, Authority or Organization Here b.) Service will be provided only in the unincorporated portion of the county by a single service provider. (If this box is checked, identify the government, authority or organization providing the service.): Type Name of Government, Authority or Organization Here c.) One or more cities will provide this service only within their incorporated boundaries, and the service will not be provided in unincorporated areas. (If this box is checked, identify the government(s), authority or organization providing the service: Type Name of Government, Authority or Organization Here d.) One or more cities will provide this service only within their incorporated boundaries, and the county will provide the service in unincorporated areas. (If this box is checked, identify the government(s), authority or organization providing the service.): Type Name of Government, Authority or Organization Here e.) Other (If this box is checked, attach a legible map delineating the service area of each service provider, and identify the government, authority, or other organization that will provide service within each service area.): Type Name of Government, Authority or Organization Here 2. In developing this strategy, were overlapping service areas, unnecessary competition and/or duplication of this service identified? Yes (if “Yes,” you must attach additional documentation as described, below) No If these conditions will continue under this strategy, attach an explanation for continuing the arrangement (i.e., overlapping but higher levels of service (See O.C.G.A. 36-70-24(1)), overriding benefits of the duplication, or reasons that overlapping service areas or competition cannot be eliminated). Page 1 of 2 If these conditions will be eliminated under the strategy, attach an implementation schedule listing each step or action that will be taken to eliminate them, the responsible party and the agreed upon deadline for completing it.
SDS FORM 2, continued 3. List each government or authority that will help to pay for this service and indicate how the service will be funded (e.g., enterprise funds, user fees, general funds, special service district revenues, hotel/motel taxes, franchise taxes, impact fees, bonded indebtedness, etc.). Local Government or Authority Funding Method Type Gov't/Authority Name Here Detail Funding Here Type Gov't/Authority Name Here Detail Funding Here Type Gov't/Authority Name Here Detail Funding Here Type Gov't/Authority Name Here Detail Funding Here Type Gov't/Authority Name Here Detail Funding Here Type Gov't/Authority Name Here Detail Funding Here 4. How will the strategy change the previous arrangements for providing and/or funding this service within the county? Provide Details Here 5. List any formal service delivery agreements or intergovernmental contracts that will be used to implement the strategy for this service: Agreement Name Contracting Parties Effective and Ending Dates Name Agreement Here List Contracting Parties Here Effective - End Name Agreement Here List Contracting Parties Here Effective - End Name Agreement Here List Contracting Parties Here Effective - End Name Agreement Here List Contracting Parties Here Effective - End Name Agreement Here List Contracting Parties Here Effective - End Name Agreement Here List Contracting Parties Here Effective - End 6. What other mechanisms (if any) will be used to implement the strategy for this service (e.g., ordinances, resolutions, local acts of the General Assembly, rate or fee changes, etc.), and when will they take effect? Provide Details Here 7. Person completing form: Type Your Name & Title Here Phone number: Type Your Phone Number Here Date completed: Type Date Here 8. Is this the person who should be contacted by state agencies when evaluating whether proposed local government projects are consistent with the service delivery strategy? Yes No If not, provide designated contact person(s) and phone number(s) below: TYPE CONTACT NAME, TITLE & PHONE HERE

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