Sandbox Signature and Acceptance Form.pdf
PDF 248 KB Posted
- Attached to
- 2019-MeHI-02 Digital Health Sandbox Program
- Solicitation number
- BD-19-1367-1367C-1367L-38752
- Issued by
- Massachusetts
About this file
This document is the Authorized Applicant's Signature and Acceptance Form for the 2029-MeHI-02 Digital Health Sandbox Program, offered by the Massachusetts eHealth Institute, a division of the Massachusetts Technology Collaborative. The program provides grants to support companies testing and validating new products and services in a sandbox environment. The form outlines the mandatory terms and conditions of the Notice of Funding Opportunity (NOFO), including compliance with all requirements, acknowledgement of procedures for handling submitted materials, and agreement to be bound by those procedures. Applicants must either specify exceptions and counter-proposals to the Sandbox Access Grant Agreement, or agree to the terms and conditions set forth therein. The entire bid response must remain valid for 60 days from receipt by the Massachusetts Technology Collaborative. The authorized representative must certify that the applicant is in compliance with corporate filing requirements and state tax laws, and that the statements made in the response are true and correct.
The document does not provide details on pricing terms, set asides, incumbents, funding requirements and sources, or other salient information beyond the signature and acceptance form. The focus is on the mandatory terms and conditions of the NOFO and the Sandbox Access Grant Agreement.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Sandbox Grant Program QA 2020.01.09.pdf | ||
| Sandbox Rolling Grant RFP - 2024 Update.pdf | ||
| Sandbox Grant Program QA 2019.04.24.pdf | ||
| Sandbox Grant Program QA 2020.06.08.pdf | ||
| Sandbox Project Plan Template.xlsx | XLSX spreadsheet | |
| Sandbox Budget Template.xlsx | XLSX spreadsheet |
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Text version
2029-MeHI-02
Massachusetts Technology Collaborative
Authorized Applicant’s Signature and Acceptance Form
The undersigned is a duly authorized representative of the Applicant listed below. The Applicant has read and understands the NOFO requirements. The Applicant acknowledges that all of the terms and conditions of the NOFO are mandatory. By executing this Authorized Applicant’s Signature and
Acceptance Form, Applicant certifies that they (1) are in compliance with the terms, conditions and specifications contained in this NOFO, (2) acknowledges and understands the procedures for handling materials submitted to the Mass Tech Collaborative as set forth above, (3) agrees to be bound by those procedures, and (4) agrees that the Mass Tech Collaborative shall not be liable under any circumstances for the disclosure of any materials submitted to the Mass Tech Collaborative pursuant to this NOFO or upon the Applicant’s selection.
The Applicant understands that, if selected by the Mass Tech Collaborative, the Applicant and Mass Tech Collaborative will execute an Agreement specifying the mutual requirements of participation. The undersigned has either (please check one):
specified exceptions and counter-proposals to the terms and conditions of the Sandbox Access Grant Agreement; or agrees to the terms and conditions set forth therein;
The undersigned acknowledges and agrees that the failure to submit exceptions and counter-proposals with this response shall be deemed a waiver, and the Agreement shall not be subject to further negotiation.
Applicant agrees that the entire bid response will remain valid for sixty (60) days from receipt by the Mass Tech Collaborative.
I certify that Applicant is in compliance with all corporate filing requirements and State tax laws.
I further certify that the statements made in this response to the NOFO, including all attachments and exhibits, are true and correct to the best of my knowledge.
Applicant:
(Printed Name of Applicant)
By:
(Signature of Authorized Representative)
Name:
Title:
Date:
https://masstech.org/procurements https://masstech.org/procurements
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