Attachment B - Contact Form~1.docx

Attachment B is a general information form used by the Department of Elementary and Secondary Education (DESE) in Massachusetts for vendor submissions related to state and local contract opportunities. The form requires organizations to provide their basic identification information, including organization name, vendor code, and physical address. Vendors must designate an authorized signatory who possesses the legal authority to execute contracts on behalf of the organization, along with contact information for that individual. Additionally, vendors must identify a contact person responsible for answering substantive questions about the submission, and if applicable, designate a local representative from the vendor's organization who would serve as the primary point of contact for work conducted on behalf of DESE and its districts.

The form serves as a standardized submission document to be completed and uploaded through COMMBUYS, Massachusetts's procurement system. The contact information collected includes name, title, phone number, and email address for each designated role. This form is part of a broader contracting process related to the Department's procurement of services, such as the National Student Clearinghouse contract for maintaining a nationwide central repository of secondary and postsecondary education student data. The document is located at 135 Santilli Highway, Everett, MA 02149, and can be contacted at 781.338.3000 or through TTY via N.E.T. Relay at 800.439.2370.