16. Attachment H- Contracting Requirements.docx

Request For Application Massachusetts Jail/Arrest Diversion Grant Program

ATTACHMENT H

Contracting Requirements

1) Forms. The following forms (unless otherwise indicated) must be submitted upon notification of award in order to execute a contact with the Massachusetts Department of Mental Health for a Jail/Arrest Diversion program or service:

___ An Executed Standard Contract Form (two originals will be required for an awarded a contract.

___ A completed Contract Summary Form (Attachment A). This will be the running document that narratively memorializes all subsequent contract amendments and renewals.

___ An executed Commonwealth Terms and Conditions Form (an original must be submitted for a newly awarded contract.)

___ A Contractor Authorized Signatory Listing Form (an original must be submitted for a newly awarded contract.) Note: both pages are required, with the second page notarized) ___ An executed Massachusetts Form W-9 (an original must be submitted for a newly awarded contract.)

___ Authorization for Electronic Funds Payment Form (original must be submitted for a newly awarded contract.)

___ Audited Financial Statement (Not-For-Profits and For-Profits only)

*Note: If an Applicant has already submitted to DMH or another Commonwealth agency signed Terms and Conditions, Form W-9, and/or Authorization for Electronic Funds Payment as listed above and such are on record with the Office of the Comptroller, the Applicant does not need to submit copies of these documents. DMH will verify that they are on record with the Office of the Comptroller if applicable.

2) Final Budget(s). An Awardee must submit the finalized program budget(s) if any budget alterations were negotiated after the initial Proposal and Funding Request was submitted, using ATTACHMENT D (DMH Budget Worksheet). The Budget(s) must include all expenses for the program/center being proposed.