The documents below are required to execute a contract between a vendor and the NH Department of Health and Human Services.
EXHIBITS:
Exhibit A-Scope of Services (1 page) - This document provides the full statement of work for all goods and services to be provided as agreed to by State of New Hampshire/DHHS/DHHS and the vendor.
Exhibit B-Methods and Conditions Precedent to Payment - This document defines the terms of payment. It may include billing and reporting requirements. It contains the source of funds and other information required by the State of New Hampshire/DHHS in order to create this vendor account. UPDATED VERSION NOT AVAILABLE AT THIS TIME.
Exhibit C-Special Provisions (4 pages) - This document outlines and describes provisions and requirements set forth by the State of New Hampshire/DHHS that must be adhered to in addition to those outlined in the P-37, General Contract Agreement. These provisions and requirements more specifically relate to DHHS programs and services.
Exhibit C-Special Provisions-BFAM etc. (1 page) - This document outlines and describes provisions and requirements set forth by the State of New Hampshire/DHHS that must be adhered to in addition to those outlined in the P-37, General Contract Agreement. These provisions and requirements more specifically relate to DHHS Bureau of Facilities & Asset Management and similar procurements.
Exhibit C-1-Additional Special Provisions (1 page) - This document outlines any additional special provisions that must be added specific to a single program or contract or set of contracts. This Exhibit is optional and is only required when program specific requirements must be added.
Exhibit D-Certification Regarding Drug Free Workplace Requirements (2 pages) - This document secures a vendor's agreement to comply with requirements set forth in the Drug-Free Workplace Act of 1988.
Exhibit E-Certification Regarding Lobbying (1 page) - This document secures a vendor's agreement to comply with specified lobbying restrictions.
Exhibit F-Certification Regarding Debarment, Suspension and Other Responsibility Matters (3 pages) - This document outlines the restrictions and rights of parties who have been disbarred, suspended or ineligible from participating in the contract.
Exhibit G-Certification Regarding Americans With Disabilities Act Compliance (1 page) - This document secures a vendor's agreement to make reasonable efforts to comply with the Americans with Disabilities Act.
Exhibit H-Certification Regarding Environmental Tobacco Smoke (1 page) - This document secures a vendor's agreement to make reasonable efforts to comply with the Pro-Children Act of 1994, which pertains to environmental tobacco smoke in certain facilities.
Exhibit I-HIPAA Business Associate Agreement (5 pages) - This document defines the rights and responsibilities of a vendor in reference to the Health Insurance Portability and Accountability Act, which pertains to the security and privacy of patient health information.
FORMS:
P37-General Contract Agreement (2 pages) - This document outlines the overall terms and conditions of a contractual relationship with the State of New Hampshire/DHHS in a standardized text format. This document also secures the signatures of all parties thereby binding them to the contract terms.
Certificate of Authority-Sole Proprietor (1 page) - This document provides an affirmation by an individual that s/he is sole owner of said proprietorship and is authorized to enter into a contractual relationship with the State of New Hampshire/DHHS.
Certificate of Authority-Partnership (2 pages) - This document provides authorization from the members of said partnership for a named representative(s), by position, to enter into a contractual relationship with the State of New Hampshire/DHHS.
Certificate of Vote with Seal (2 pages) - This document provides authorization from a vendor's Board of Director's for a vendor's representative(s), by position, to enter into a contractual relationship with the State of New Hampshire/DHHS. This certificate is used when a vendor has a corporate seal.
Certificate of Vote without Seal (1 page) - This document provides authorization from a vendor's Board of Director's for a vendor's representative(s), by position, to enter into a contractual relationship with the State of New Hampshire/DHHS. This certificate is used when a vendor does not have a corporate seal.
Certificate of Good Standing (AKA Certificate of Registration or Authorization) - This document provides affirmation from the Office of the Secretary of State that a vendor has filed all required annual reports, paid all fees, has no dissolution in process, and has a legal existence. For more information, contact the Office of the Secretary of State at 603-271-3242 or visit their website at http://www.sos.nh.gov/corporate/ (see FAQ #8). |
