Attachment B - Contact Form~1.docx

This is a General Information Form attachment for a Departmental Master Agreement submission to the Massachusetts Department of Elementary and Secondary Education (DESE) seeking early literacy screening assessments in English for students in grades K-3. The form requires vendors to provide organizational information including vendor code, business address, and identification of an authorized signatory with legal authority to execute documents on behalf of the organization. The submission process requires vendors to complete the form and upload it through the COMMBUYS system, with a designated contact person identified to answer substantive questions regarding the submission and, if applicable, a local representative to serve as the primary point of contact for work conducted with DESE and school districts.

The form itself contains no pricing information, set-asides, incumbent details, funding amounts, or contract timeline specifications. It functions solely as an administrative vehicle for capturing essential vendor registration and contact information necessary for DESE's review and approval process for early literacy screening assessments. Vendors must ensure all required fields are completed accurately prior to submission on the COMMBUYS platform, with the submission address listed as 135 Santilli Highway, Everett, MA 02149.