Model Statement of Work (SOW).docx
DOCX document 24 KB Posted
- Solicitation number
- BD-25-1022-DMH07-7120-108311
- Issued by
- Massachusetts
About this file
This document is a Statement of Work (SOW) for emergency transportation services under the Department of Mental Health (DMH) Emergency Transportation Master Agreement in the Commonwealth of Massachusetts. The SOW outlines the requirements for the transportation of patients/clients/staff, including the number of individuals, type of vehicle, and any special transportation needs. The contract term will be from the start date through the end date specified. The vendor is responsible for submitting timely invoices to DMH for the agreed upon rate per day/hour for the total cost of the services. Funding for this engagement is subject to appropriation by the Massachusetts Legislature, and DMH may terminate the engagement without cause or for vendor non-performance. The contract requires handwritten or verified electronic signatures from the authorized vendor and DMH representatives.
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Commonwealth of Massachusetts - Department of Mental Health Statement of Work Under the EMERGENCY TRANSPORTATION Master Agreement Request For Response COMMBUYS Bid#: ____________________; DMH Document#: 2025-DMH-3030-01
DMH Master Agreement Contract MMARS Doc. ID: MA DMH EMERGENTRANSMA25TO35 VL: _______ DMH SOW MMARS Doc ID: MMDMH8220025XXXXXXXX |_| New |_| Amended
Vendor Name:
Contract Manager Name:
Email:
Phone Number:
Department of Mental Health Contract Manager Name:
Email:
Phone Number:
I. Dates of Service:
Start Date: ___________________ End Date: _______________________
II. Locations From: ____________________________________ To: ______________________________________
III. Transportation Details Number of Patients/Clients/Staff to be transported: __________ Luggage or other good to be transported: _________________________________________________________________ Type of vehicle(s) to be used: ____________________________________________________________________________ Special transportations needs of Patients/Clients/Staff: _______________________________________________________
| IV. Cost and Payment Mechanism | |
| Rate: | per Day / Hour Total Cost: ____________________ |
The vendor is responsible to submit timely invoices to DMH.
Invoices should be emailed to: DMH_CO_Vendor_Billing_and_Contracts@MassMail.State.MA.US
V. Additional Terms:
Funding: Funding for this engagement is subject to the appropriation of funds by the Massachusetts Legislature for the year(s) in which services are delivered.
Changes to Scope and/or Terms: Any changes to this engagement must be agreed upon in writing in advance by both parties.
Termination: The Department, upon prior written notice, may terminate this engagement without cause and without penalty, or may terminate or suspend an engagement if the vendor breaches any material term or condition or fails to perform or fulfill any material obligation required by this engagement, or in the event of an elimination of an appropriation or absence of sufficient funds for the purposes of an engagement, or in the event of an unforeseen public emergency mandating immediate department action.
VI. Signatures: Authorized Vendor/DMH Signatures and Dates (Must be handwritten or Verified Electronic Signatures). Typed text in cursive font is not allowable.
Vendor:
Signature Date Print Name Title Department of Mental Health:
Signature Date Print Name Title
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