COA_form~1.docx

DOCX document 107 KB Posted

Attached to
MCD06 ASL Interpreters and Transliterators for the Deaf and Hard of Hearing
Solicitation number
BD-18-1067-MCD01-MCD01-26742
Issued by
Massachusetts

About this file

This document is a Change of Address form from the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH) for its Department of Interpreter and CART Services contract titled "MCD06 ASL Interpreters and Transliterators for the Deaf and Hard of Hearing." The contract opportunity is for the provision of American Sign Language (ASL) interpreting and transliterating services to the state of Massachusetts, specifically in the Boston region, Metro region, Northeast region, Southeast region, Central region, and Western region, as well as various after-hours emergency regions. The contract package is due by U.S. Mail to MCDHH two weeks after downloading the required forms from the provided site. The contract MBPO (Master Blanket Purchase Order) number is PO-18-1067-MCD01-MCD01-13286.

The document does not provide details on pricing terms, set-asides, incumbents, funding requirements or sources, or other financial information. It solely focuses on the administrative process for vendors to change their address and service coverage regions for the MCDHH contract.

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Text version

The Commonwealth of Massachusetts Executive Office of Health and Human Services Massachusetts Commission for the Deaf and Hard of Hearing 600 Washington Street Boston, Massachusetts 02111 Tel. (617) 740-1600

TTY (617) 740-1700

VP (617) 326-7546

Fax (617) 740-1880 www.mass.gov/mcdhh

Department of Interpreter and CART Services / A & F Change of Address

To: MCDHH Business Department;

From: __________________________________________ Effective date of address change: ____________________

Please change my address from:

CURRENT ADDRESS

Mailing Address:

Legal Address:

City:
State:
Zip + 4:
Home Phone:
Home Fax:

To:

NEW ADDRESS

Mailing Address:

Legal Address:

City:
State:
Zip + 4:
Home Phone:
Home Fax:

Please select regions you will cover from your new address

General Referral Regions:

Boston Region
Metro Region
Northeast Region
Southeast Region
Central Region
Western Region

After-Hours Emergency Regions:

Berkshire County Region
Western Region
Central Region
Metro/Central Region
Northeast Region
Greater Boston Region
Southeast Region
Cape Cod & Islands Region

Signature of Vendor Date

INTERNAL USE ONLY

MMARS updated – By: _____________________

Date sent to OSC: ____________________________

Approved by OSC – date: ____________________

Avianco updated – By: _________________________

DATE RECEIVED

Effective 4/6/12 image1.wmf oleObject1.bin

File details come from the government source that posted it. Updated .