Vendor Contract Exhibits & Forms
The documents below are required to execute a contract between a vendor and the NH Department of Health and Human Services (DHHS).
- Exhibit A - Scope of Services – Provides the full statement of work for all goods and services to be provided as agreed to by State of New Hampshire/DHHS and the vendor.
- Exhibit C - Special Provisions – 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-1 - Additional Special Provisions – 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 – Secures a vendor's agreement to comply with requirements set forth in the Drug-Free Workplace Act of 1988.
- Exhibit E - Certification Regarding Lobbying – Secures a vendor's agreement to comply with specified lobbying restrictions.
- Exhibit F - Certification Regarding Debarment, Suspension and Other Responsibility Matters – 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 – Secures a vendor's agreement to make reasonable efforts to comply with the Americans with Disabilities Act.
- Exhibit H - Certification Regarding Environmental Tobacco Smoke – 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 – 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.
- Exhibit J - Certification Regarding Federal Funding Accountability & Transparency Act (FFATA) Compliance
- P37 - General Contract Agreement – 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 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 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 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 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 (a/k/a Certificate of Registration or Authorization) – Provides affirmation from the Department 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 Department of State at (603) 271-3242.
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