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COMMONWEALTH OF MASSACHUSETTS - STANDARD CONTRACT FORM
'this form Is Jointly Issued and pubShed by. the Executive Office for Administration and Finance IANFl the Office of the Comotroller ICTRI snd the Ooeretmhal Services DNklon IOS01
so the default contract for all Commonwealth Departments when another loan Is not pfescnbed b/ regulavon.or policy. Any changes to Ne official printed language of this form shall be
volt. Addiffmai noncon0lctng terms may be added by Attachment Contractors may not require any additional agreement, engagement letters, contract forms or other additional lams
as padof this ContmctwffiM pdor Depmtmnt approval. Clickon hypedinks fordefinitlons, Instructions and legal requlrements thalam Incorporated by reference Into this Contract An
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CONTRACTOR LEGAL NAME: TOWN OF MANSFIEW
COMMONWEALTH DEPARTMENT NAME: Massachusetts Emergency Management
(and dlbl# Mansfield CERT. _
Agerq '
MMARS Denertment Code:'CDA
Business Ataillna Address: 400 Worcester Road, Framingham, MA 01702.5399
Laos[ Addreacs 6 Park Row, Mansfield, MA 02048
Lggl%dM0Agpr. Robert ButtBn
Billing Address (If different):
rbtdlonPbnans0eldme.com
ConlrgUmanr:c David Cruz '
Phone: 5ok- •7301
Fa[:506-261-T456
EMaO: us
ho e•598-820.200g 7T Fax: 508.820.2030
Contracilp odor Code: VC6000191867
Vendor Code Address ID (e.g. `ADOat`): AD001_
MMAR6 Doe IDIe1: FY14ECP12W0000MANSF
(Note: The Address ld Must be set up for ELT payments.)
RFR(Procu montpi0theriDNumber2012SHSP)CCPAOF:
X .NEW CONTRACT _ CONTRACT AMENDMENT.
PROCUREMENT OR EXCEPTION TYPE (Check one option only) EruerCurrent Contract End Oats PParto Ammdrrcent,_, 20_,
_•StatevAde CQntnr l(OSDoran OSD-designated Depadmerd' - EnterAmendmantAmount$ (or'no changed'
Collective Purchase (Attach OSD approval, scope, budget) AMENDMENT' TYPE: (Chec)rone option only. Attach delete of Amendment changes.)
X Department Procurement (Includes State or Federal grants 8%Cht22.W1 —Amendment to Scooe or Budget (Attach Updated scope and budget)
diRFRandResponseorotherprocurementsuppoNkg.documentation)
—IntadmContraat(AttachJusOgeallooforinterimContactandupdatedscopdbudgsQ
oenev Coldmcl(AtachJustlflcatlon foremegehcy,sops, budgeQ Controm Emnlovee (Attach any updatsaN scope or budget)
act Ernoloveo (AUach tusl!l91g, sonPe, get) —L�tr
latvelLegal orONer. (Altsdh mdladdn0langungefj0stilkalfon, $rope and — yl�al or OtiteP (Attach aulhwirVhgtengimgaQnfii agon and updated
�� � ��Uwing
C,LOMMONWFALTH T,gRMS AND CONORIONS (T&C) has been executed, filed wits CTR end Is incorpomtad�6y reference Into Nle Canfmct
semi
monwealtlhTemhsantlCondltlom,_Commawr�tlhTermsandCandltlorhsFarHumanandSodalServicest(SATK)N:
(ChedrONE option): The DeparOrenlaemTlas thalpaymmhts forauttodzed perWnnence aaepfed Id a000rdehce wth the terms of this Contract will be supported.
oroNer nwnappmpdeted funds, su6Jectto InierceptfoaCommonwcelN aved debis under 815 CMR g.00.
te aanimNg system bysuMdent appropriations
Contract (No Maximum Ob(gaticn. Atadh deteof et rates, cola, calaietiom, ardtam or fzrtns end any dmnges tralsa ortanm are being amended.)m
m0_ bi1� iaatlonContracf E.nlerTOWMeWmmnObfgaimfortataldumtanofo%hoontred(ornew7otaiM(bntacttrbakgs endad4h ..:
PROMPT PAYMENT DISCOUNTS IPPD): Calvnonwrealth payments am Issued throu0h )F45 days from Invoice recdpt Contracts mquesting accelerated payments must
Idamf(ya PPDasfofwax Paymeelissueawfihih in days_%PPP; Peymmd Issued vANkh lS days— %PFD;PaVmantbsuedwlthln20days_%PPD;PaymentisSuadwfimin30
days —% PPD. If PPD percentages am left blank Identify reason: —sgmo to standard 45 day cy� — slatutorydiegal or Ready Payments IO.L. o. 29. 6 23A}; X only Initial
payment(subsertuentpayments scheduled toss standard EFT 45 da rent .See
PERFORMANCE or REASON FORAMENDMENT: (Enter the Contract Me, purpose, local years) and a detailed description of the scope of
BRIEF DESCRIPHON OF CONTRACT
pedurna"M orwhatis being amended for a Contract Amendment Attach atsuppadug doraxnenraton chidlu%t0wtlonsJ Fundingforthisgrentlaprovided through the
FFY2012 State Homeland Security Program great The catalogueoifederal Domestic Assisimae(CfUNnumbwfs97-067. Theerrtltyfrdands to pumhessa portable
mend
generator, traffic cones, and "Eft
ANTICIPATED START DATE: (CompbtsONEopton only) The Deparhneiltend Cadmctwos*'kfthis Contact, Or Contract Amendment that Contredobfilatons:
X I. maybe Incurred as of the EBad mDate(latest signature date be* and gq, obligations have been incurred pripttolhe E110*0
may beincumed as of�20_, adate LATEROM the EfW*ADale belowand 000bligallons here been Mauned RoXiO Die Effirefiep Delp•
—2.
_3.wereincunedasof_-�20 adak+PWORtotheESac4veDelabebw,andOrePatieshgreetatpaymentsforanyohOgatorolncurredprWto6wEeecO✓eDataam
auNodzed to be made ether assettlamem paymmds or as augme adzed reimbursement payments, and that Do details end dramstarhces o(a1 oUigatona under this Contend are
'atachadandim mtedinlolhisODnhad.Acre rice of mentsfomV¢traleareStheCommohweeAhfimnhetlhm'dakcsrdeledbtlhesaob. atdmhS.
�0 T TENODATE: Contract pedanhenoe shot termimle as of Mar 31.2014.withnonswobigallons.beig lncmred allertits dale unless Ne OaYradlB property amended,
provided Nat Ne tams of this Conhacl and pedonance expects8ons and oblations shall shniee to termna8on for the PuNOSOof MiOl frg say dalmor dispute, fwoompletirg any
regelated derma end weran�s, to allow any dose oulor Mahon partmmance, repoNng, Invoking "final paYmeMs, ordudng any" between amendments.
CERTIFICATIONS NotvAOoWAV verbal or other raprasentagahs by he parties, the "EBecttva Dabs' of this Contract or Amendment $hat be Ne JeW dale fist this Contract or
the Contractor, the Depafi»ent, or a Icier Contract or -Amendment Start Date specified abovo, sub)ad to any required
Amendment has been executed by an authorized signatory of
approvals. The Contractormakes all oeti8catons required under the alldled Cmdredor CedillceliODs (incorporated by reference t not ailadhed hereby under the pakhs and
penafies of pedu y, agrees to provide any requited dommoolaton upon reghresltu supPOft mhplimm and dress Natal le ns govemkg pedomearm of Nk Cdntraof and dol g
the IDDOA" hierarchy of docrerienlpreeadence, the applicable CommonrAaelIII Temps and
.business in Massachusetts am alas ad or Inoorponded by reference Iaruin acoordig to
Con—..dtions.Nis Standard ConlradFomnNdudkgNe and Contractor gafflofim. NaRequest for Response Q"oro0rersolicitation the CartaaarsResponso,and
that temp will take Precedence over the mlavaot term tan the RFR and Ne Conhedors Response only t made using the
additional negotiated arms, previded additional rx gogated
process outbhed do 80f CMR 21.07 Incorporated here a. provided that any amended RFR or Response terms result bestvalue, lower costs, as moo 0*811e0tve ConOatL
AUTH sUeTDRD 0 • ONTRACT RR; j AUTHORIZING SIGNATURE FOR THE COMMONWEALTH,
_)
Date: )°f�Y �.f% Date: //-Y-rr
x X
(Signature and Date Must Be HandwdDenAtTime of Signetu (ftrudaer and Ddta Must Be HendommAt Tim of Signa(ure)
Print Neme• Roberta Buft PdrdName: David Mohr .
Print Title: EMAICERT Director PdMTMe:• Chlefstsal Officer
(Updated 612712011) Page 1 of 3
SHSP/CCP 2012 Grant Funding
Item
Discription
Quanit
Unit Price
Extended Price
Vendor ProPac Quote #11869
T1178
Cool Draft M1-360 Misting Fan,
Pedistal Style
1
$ 749.00
$ 749.00
L2021
Military Style Cot, Standard
60
$ 33.00
$ 1,980.00
L2030
Special Needs Cot, Enhanced
2
$ 139.001
$ 278.00
K3108-Pro
Unisex Hygiene Tube Kit, Adult,
Case of 30
2
$ 63.00
$ 126.00
K3004
Kids tube Kit, Case of 30
1
$ 82.50
$ 82.50
L2200
Folding Stretcher
1
$ 97,00
$ 97.00
K3300
Medical Responders Pack
1
$ 224.95
$ 224.95
S1310
CERT Quick Shelter 10x10
1
$ 565.00
$ 565.00
S1011-Green
Shelter Wall 10ft Green
2
$ 60.00
$ 120.00
S1012-Green
Shelter Wall, 10ft w/Door, Green
1
$ 80.00
$ 80.00
S1500-CERT
CERT Half Wall for 10x10 Shelter
1
$ 75.00
$ 75.00
K20113
ProPac CERT Kit Pro3
15
$ 63.18
$ 947.70
D5115
Headlight, Helmet Mounted,
Rayovac
22
$ 15.00
$ 330.00
Total
$ 5,655.15
SHSP/CCP 2012 Grant Funding
Item
Discription
0 i;j nity
Unit Price
Extended Price
Vendor Norfolk Power
Honda EU2001, Generator
1
$ 984.00
$ 984.00
Total
$ 984.00
SHSP/CCP 2012 Grant Funding
Item
Discription
gganity
Unit Price
Extended Price
Vendor?
Retractable Traffic Cone Bar
Barricades, Set of 4
2
$ 130.00
$ 260.00
Total
$ 260.00
SHSP/CCP 2012 Grant Funding
Item
Discription
0 nit
Unit Price
Extended Price
Vendor?
Magellan RoadMate 925OT-LMB
4
$ 150.00
$ 600.00
Total
$ 600.00
Grand Total
$ 7,499.15