Commonwealth of Massachusetts
Standard Contract Form Instructions and Contractor Certifications
This form is jointly issued and published by the Office of the Comptroller (CTR), the Executive Office for Administration and
Finance (ANF), and the Operational Services Division (OSD) as the default contract for all Commonwealth Departments when
another form is not prescribed by regulation or policy. The Commonwealth deems void any changes made on or by attachment
(in the form of addendum, engagement letters, contract forms or invoice terms) to the terms in this published form or to the
Standard Contract Form Instructions and Contractor Certifications
_________________________________________________,
the ___________________________________________________
Commonwealth Terms and Conditions for Human and Social Services
or the ___________________________________
which are incorporated by reference herein. Additional non-conflicting
Commonwealth IT Terms and Conditions
terms may be added by Attachment. Contractors are required to access published forms at CTR Forms:
___________________________.
Forms are also posted at OSD Forms: ____________________________.
https://www.mass.gov/lists/osd-forms
https://www.macomptroller.org/forms

Contractor Legal Name

Commonwealth Department Name

MMARS Department Code
Contractor D/B/A Name

Commonwealth Department Mailing Address

Contractor Legal Address

City

Number, street and apartment or suite number

Number, street and apartment or suite number
(Form W-9, W-4)

City

State

Contract Manager

Phone

Zip Code

State

Zip Code

Commonwealth Department Billing Address
Number, street and apartment or suite number (If different)

City

State

Zip Code

Commonwealth Department Billing Email Address

E-Mail

Fax

Contract Manager

Phone

Contractor Vendor Code

E-Mail

Fax

Vendor Code Address ID

DOC Code

AD______

MMARS Doc ID(s)
MMARS Doc ID(s)

(e.g. “AD001”)

Note: The Address ID must be set up for EFT payments.

RFR/Procurement or other ID Number

CT

MMARS Version Number
Budget Fiscal Year

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DOC Code

Commonwealth of Massachusetts
Standard Contract Form Instructions and Contractor Certifications

Should this Contract go to the Office of the Comptroller?

MMARS Doc ID

_____ Yes

______ No

Is this a new contract or a contract amendment?
______ New Contract

______ Contract Amendment

Complete the “FOR NEW CONTRACTS” section below.

Complete the “FOR CONTRACT AMENDMENTS” section below

FOR NEW CONTRACTS

FOR CONTRACT AMENDMENTS

Procurement or Exception Type

Current Contract End Date Prior to Amendment

Check only one option.

______

Statewide Contract

Amendment Amount

OSD or an OSD-designated Department.

______

$ __________________

Collective Purchase
Attach OSD approval, scope, and budget.
815 CMR 2.00

______

Check if there is no change to the contract amount.

Department Procurement
Includes all Grants –
Solicitation Notice or RFR,
and Response or other procurement supporting documentation.

______

Amendment Type
Check one option only. Attach details of amendment changes.

______ Amendment to Date, Scope or Budget

Emergency Contract

Attach updated scope and budget.

Attach justification for emergency, scope, and budget.

______

______ Interim Contract

Contract Employee

Attach justification for Interim Contract and updated scope/budget.

Attach Employment Status Form, scope, and budget.

______ Contract Employee
______

Attach any updates to scope or budget.

Other Procurement Exception
Attach authorizing language, legislation with specific exemption or
earmark, and exception justification, scope, and budget.

______ Other Procurement Exception
Attach authorizing language/justification and updated scope and budget.

The Standard Contract Form Instructions and Contractor Certifications and the following Commonwealth Terms
and Conditions document are incorporated by reference into this Contract and are legally binding.
Check ONE option.

____ Commonwealth Terms and Conditions
____ Commonwealth Terms and Conditions for Human and Social Services
____ Commonwealth IT Terms and Conditions

Compensation
Check ONE option.

The Department certifies that payments for authorized performance accepted in accordance with the terms of this Contract will be
supported in the state accounting system by sufficient appropriations or other non-appropriated funds, subject to intercept for
Commonwealth owed debts under 815 CMR 9.00
____ Rate Contract (No Maximum Obligation)
Attach details of all rates, units, calculations, conditions or terms and any changes if rates or terms are being
amended.
____ Maximum Obligation Contract
Enter total maximum obligation for total duration of this contract (or new total if Contract is being amended).
$_______________________________

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Commonwealth of Massachusetts
Standard Contract Form Instructions and Contractor Certifications

MMARS Doc ID

Prompt Payment Discounts (PPD)
Commonwealth payments are issued through Electronic Funds Transfer 45 days from invoice receipt. Contractors requesting
accelerated payments must identify a Prompt Payment Discount as follows:
Payment issued within 10 days ________% PPD; Payment issued within 15 days ________

% PPD;

Payment issued within 20 days ________% PPD; Payment issued within 30 days ________

% PPD.

If PPD percentages are left blank, identify reason:
_ __ Agree to standard 45-day cycle
_ __ Statutory/legal or Ready Payments
_ __ Only initial payment (Subsequent payments scheduled to support standard EFT 45-day payment cycle. See.

Brief Description of Contract Performance or Reason for Amendment
Enter the Contract title, purpose, fiscal year(s) and a detailed description of the scope of performance or what is being amended for a Contract Amendment. Attach all supporting
documentation and justifications.

Anticipated Start Date
Complete ONE option only.

The Department and Contractor certify for this Contract, or Contract Amendment, that Contract obligations:
_____ 1. may be incurred as of the Effective Date (latest signature date below) and no obligations have been incurred prior to the Effective Date.
_____ 2. may be incurred as of ___________________ a date LATER than the Effective Date below and no obligations have been incurred prior to the
Effective Date.
_____ 3. were incurred as of ___________________ a date PRIOR to the Effective Date below, and the parties agree that payments for any
obligations incurred prior to the Effective Date are authorized to be made either as settlement payments or as authorized reimbursement payments,
and that the details and circumstances of all obligations under this Contract are attached and incorporated into this Contract. Acceptance of
payments forever releases the Commonwealth from further claims related to these obligations.

Contract End Date
Contract performance shall terminate as of
__________ ___ with no new obligations being incurred after this date unless the
Contract is properly amended, provided that the terms of this Contract and performance expectations and obligations shall survive its
termination for the purpose of resolving any claim or dispute, for completing any negotiated terms and warranties, to allow any close
out or transition performance, reporting, invoicing or final payments, or during any lapse between amendments.

Certifications
Notwithstanding verbal or other representations by the parties, the “Effective Date” of this Contract or Amendment shall be the latest date that this Contract or Amendment has been
executed by an authorized signatory of the Contractor, the Department, or a later Contract or Amendment Start Date specified above, subject to any required approvals. The Contractor
certifies that they have accessed and reviewed all documents incorporated by reference as electronically published and the Contractor makes all certifications required under the
Standard Contract Form Instructions and Contractor Certifications under the pains and penalties of perjury, and further agrees to provide any required documentation upon request to
support compliance, and agrees that all terms governing performance of this Contract and doing business in Massachusetts are attached or incorporated by reference herein according
to the following hierarchy of document precedence, the applicable Commonwealth Terms and Conditions, this Standard Contract Form, the Standard Contract Form Instructions and
Contractor Certifications, the Request for Response (RFR) or other solicitation, the Contractor’s Response (excluding any language stricken by a Department as unacceptable, and
additional negotiated terms, provided that additional negotiated terms will take precedence over the relevant terms in the RFR and the Contractor’s Response only if made using the
process outlined in in
incorporated herein, provided that any amended RFR or Response terms result in best value, lower costs, or a more cost effective Contract.

Authorizing Signature for the Contractor

Authorizing Signature for the Commonwealth

Signature and Date Must Be Captured at Time of Signature

Signature and Date Must Be Captured at Time of Signature

X

.

X

Date _________________

Date ____________________

Print Name _________________________

Print Name _________________________

Print Title _________________________

Print Title _________________________

- Page 3 of 4 -

.

Commonwealth of Massachusetts
Standard Contract Form Instructions and Contractor Certifications

MMARS Doc ID

Certifications, Terms
and Conditions

URL (below URL’s can be viewed in PDF)

Standard Contract Form
Instructions and Contractor
Certifications

http://www.macomptroller.org/wp-content/uploads/instructions_standard-contract-form.pdf

Commonwealth Terms and
Conditions for Human and
Social Services

https://www.macomptroller.org/wp-content/uploads/form_commonwealth-terms-and-conditions-for-human-and-socialservices.pdf

Commonwealth Terms and
Conditions

https://www.macomptroller.org/wp-content/uploads/form_commonwealth-terms-and-conditions.pdf

Commonwealth IT Terms and
Conditions

https://www.macomptroller.org/wp-content/uploads/form_commonwealth-terms-and-conditions-for-informationtechnology.pdf

Prompt Payment Discounts
Policy

https://public.powerdms.com/MAComptroller/documents/1779666

Office of the Comptroller:
Forms Website

https://www.macomptroller.org/forms

Operational Services Division:
Forms Website

https://www.mass.gov/lists/osd-forms

801 CMR 21.07

https://www.mass.gov/law-library/801-cmr

815 CMR 2.00

https://www.mass.gov/law-library/815-cmr

815 CMR 9.00

https://www.mass.gov/law-library/815-cmr

M.G.L. c. 29, § 23A

https://malegislature.gov/Laws/GeneralLaws/PartI/TitleIII/Chapter29/Section23A

- Page 4 of 4 -

Inmate Telephone System. Provide, install, and maintain per RFR C08 and
Bidder’s response. Commission of 85% with no minimum annual guarantee.
Additionally the Department agrees to be invoiced for 12 10-minute free calls per
inmate at $.018 per minute. Both commission and 12 10-minute calls will be
effective through 11/30/2023. Effective 12/1/2023 system to allow unlimited free
calling time for all inmates and residents. This will be at no charge to the inmates
and/or family & friends. Effective 12/1/2023 Contractor shall invoice the
Department at a rate of $0.016 per minutes used per month. Additionally
Textbehind offsite scan mail for Managed Plus Service will be implemented at the
following rates: Offsite physical non-privileged mail processing for up to 2,000
letters per month across all 4 Department facilities are included in software and
service monthly fee of $1,800 ($450/facility). Volume in excess of 2,000 will be
invoiced at $1.59 per letter. Content page limit rule applied. Mail review,
approval, investigations, etc… and legal mail solution/software license per facility
included. Mail shipping and handling costs to be invoiced monthly and at cost.
Start date to be determined.
THIS AGREEMENT WILL BE IN EFFECT FROM October 1, 2023 THROUGH
AND INCLUDING September 30, 2024 AND MAY BE RENEWED FOR 1
ADDITIONAL 1-YEAR PERIODS SUBJECT TO THE SOLE DISCRETION OF
HAMPDEN COUNTY PURCHASING. WHEN EXERCISING ONE-YEAR
OPTIONS PRICING MAY BE ADJUSTED, INCREASED OR DECREASED, AT
THE DEPARTMENT DISCRETION

Certificate Of Completion
Envelope Id: 64476FBC639B4480AEEF6F25BBADB525

Status: Sent

Subject: DocuSign: Initiate Standard Contract Form for Michael Kennedy
Document Type: SCF
Source Envelope:
Document Pages: 5

Signatures: 2

Envelope Originator:

Certificate Pages: 2

Initials: 0

Massachusetts Office of the Comptroller

AutoNav: Enabled

1 Ashburton Place 9th Floor

EnvelopeId Stamping: Enabled

Boston, MA 02108

Time Zone: (UTC-05:00) Eastern Time (US & Canada)

CTR.DocuSign.SCF@mass.gov
IP Address: 170.63.192.1

Record Tracking
Status: Original
12/13/2023 8:15:24 AM

Holder: Massachusetts Office of the Comptroller

Location: DocuSign

CTR.DocuSign.SCF@mass.gov

Security Appliance Status: Connected

Pool: StateLocal

Storage Appliance Status: Connected

Pool: Massachusetts Office of the Comptroller

Location: DocuSign

Signer Events

Signature

Timestamp

Ann Speziali

Completed

Sent: 12/13/2023 8:15:26 AM

ann.speziali@sdh.state.ma.us
Security Level:
DocuSign.email
ID: 1
12/13/2023 8:15:27 AM

Viewed: 12/13/2023 8:15:38 AM
Signed: 12/13/2023 8:28:04 AM

Using IP Address: 170.63.192.1

Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Ann Speziali
ann.speziali@sdh.state.ma.us

Completed

Director of Purchasing
Security Level: Email, Account Authentication
(Optional)

Sent: 12/13/2023 8:28:07 AM
Viewed: 12/13/2023 8:29:54 AM
Signed: 12/13/2023 8:30:11 AM

Using IP Address: 170.63.192.1

Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Michael Kennedy

Sent: 12/13/2023 8:30:12 AM

mkennedy@icsolutions.com

Viewed: 12/20/2023 10:40:26 AM

VP Sales and Marketing

Signed: 12/20/2023 10:41:01 AM

Security Level: Email, Account Authentication
(Optional)

Signature Adoption: Drawn on Device
Using IP Address: 66.177.79.76

Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Ann Speziali

Sent: 12/20/2023 10:41:03 AM

ann.speziali@sdh.state.ma.us

Viewed: 12/21/2023 8:03:30 AM

Director of Purchasing

Signed: 12/21/2023 8:04:58 AM

Security Level: Email, Account Authentication
(Optional)

Signature Adoption: Drawn on Device
Using IP Address: 170.63.192.1

Electronic Record and Signature Disclosure:
Not Offered via DocuSign

Signer Events

Signature

Timestamp

Ann Speziali

Completed

Sent: 12/21/2023 8:05:00 AM

ann.speziali@sdh.state.ma.us
Director of Purchasing
Security Level: Email, Account Authentication
(Optional)

Viewed: 12/21/2023 8:05:41 AM
Signed: 12/21/2023 8:05:47 AM

Using IP Address: 170.63.192.1

Electronic Record and Signature Disclosure:
Not Offered via DocuSign

In Person Signer Events

Signature

Timestamp

Editor Delivery Events

Status

Timestamp

Agent Delivery Events

Status

Timestamp

Intermediary Delivery Events

Status

Timestamp

Certified Delivery Events

Status

Timestamp

Carbon Copy Events

Status

Timestamp

Ann Speziali

Sent: 12/13/2023 8:28:06 AM

ann.speziali@sdh.state.ma.us

Viewed: 12/13/2023 8:29:03 AM

Director of Purchasing
Security Level: Email, Account Authentication
(Optional)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
CTR Contracts Team
CTRDIGITALCONTRACTS@mass.gov
Security Level: Email, Account Authentication
(Optional)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign

Witness Events

Signature

Timestamp

Notary Events

Signature

Timestamp

Envelope Summary Events

Status

Timestamps

Envelope Sent

Hashed/Encrypted

12/13/2023 8:15:26 AM

Envelope Updated

Security Checked

12/13/2023 8:28:05 AM

Certified Delivered

Security Checked

12/21/2023 8:05:41 AM

Signing Complete

Security Checked

12/21/2023 8:05:47 AM

Payment Events

Status

Timestamps