Contract Forms
This page provides a convenient way for Division of Public Health employees to access needed Contracts Unit materials. Each "package" below contains the forms, instructions, and documents you need to begin and complete the various contracts submission processes. The forms have been modified from those found on the DHHS Center of Excellence website to include DPH specifications.
All forms required for submission from a package are indicated in the "Required" column by either a "Yes" or "No" value. In addition, any required form includes "(req)" in its file name. However, there may be other forms you want to include for your particular contract. Please refer to the checklist in each contract package for more detailed instructions.
For clarification or if you have questions, please contact the appropriate person from the Staff Directory.
PLEASE NOTE: Items marked with "(HT)" have instructions included as "Hidden text" to assist users with developing appropriate responses. Hidden text can be viewed by depressing the "Show/Hide" -- "¶" -- button on the "Standard" MS Word toolbar. Hidden text will appear in red, underscored with a broken line, and will only be visible on the document while viewing it on the monitor -- unless you have the option enabled to print hidden text. (To disable the option which allows hidden text to print, in MS Word go to Tools/Options/Print and un-check “Hidden text”.) Remember, since the hidden text will not appear in print, please include a form of the questions in red in your response.
To view the files listed below, the free viewers for Word and Excel may be helpful if you don't have Word and/or Excel installed on your machine.
Forms
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AGREEMENT ADDENDUM
| Form Name |
Format, Size |
Last Modified |
Required |
| Agreement Addendum Template Fiscal Year 2011-2012 |
DOC, 71 KB |
09/10/11 |
Yes |
| Agreement Addendum Template Fiscal Year 2012-2013 |
DOC, 67 KB |
09/26/11 |
Yes |
| Agreement Addendum Guidelines |
DOC, 70 KB |
09/09/09 |
No |
| ARRA Funds Provisions |
DOC, 56 KB |
DPH rev. 06/15/10 |
Yes (if ARRA funds) |
| CA-AA-BE Timeline Chart |
DOC, 37 KB |
09/09/09 |
No |
| Consolidated Agreement, Agreement Addendum, Budgetary Estimate, and Funding Authorization Processing Procedures |
PDF, 210 KB |
09/10/10 |
No |
| Consolidated Agreement Fiscal Year 2012-2013 |
PDF, 194 KB |
01/10/12 |
No |
| Consolidated Agreement Fiscal Year 2011-2012 |
PDF, 350KB |
02/15/11 |
No |
| LHD Legal Names List |
DOC, 65 KB |
09/10/10 |
No |
| Quality Assurance Checklist |
DOC, 47 KB |
09/10/10 |
Yes |
BUDGET REALIGNMENT FORM
CASH ADVANCE
CHANGE REQUEST
CONTRACT
CONTRACT AMENDMENT
DIRECT PAY REQUEST
| Form Name |
Format, Size |
Last Modified |
Required |
| Forms are currently under review - 09/14/10. |
|
|
|
DIRECTIVES
DUAL EMPLOYMENT
EXPENDITURE REPORTS - CURRENT AND LATE
INTRA-DEPARTMENTAL MEMORANDUM OF AGREEMENT (IMOA)
MEMORANDUM OF AGREEMENT (MOA)
OPEN WINDOW WORKSHEETS
| Form Name |
Format, Size |
Last Modified |
Required |
| Open Window Amendment Justification Worksheet |
DOC, 36 KB |
12/06/11 |
No |
| How to Fill Out the Open Window Budget Form |
DOC, 405 KB |
01/18/12 |
No |
| Open Window Budget Worksheet |
XLS, 1 MB |
01/19/12 |
No |
| Open Window CAF |
DOC, 80 KB |
12/08/11 |
Yes |
| Open Window Contract Entry Guide |
PDF, 6.8 MB |
12/07/11 |
No |
| Open Window Federal Award Worksheet |
DOC, 63 KB |
03/02/12 |
No |
| Open Window Justification Worksheet |
DOC, 101 KB |
12/08/11 |
No |
| Open Window Measures Worksheet |
DOC, 182 KB |
12/08/11 |
No |
| Open Window Scope of Work |
DOC, 31 KB |
01/18/12 |
No |
| Open Window Writing Style Guide |
PDF, 46 KB |
07/11/11 |
No |
| Three Column Budget |
XLS, 31 KB |
03/07/12 |
Yes |
PERSONAL SERVICES CONTRACT
PERSONAL SERVICES CONTRACT AMENDMENT
REQUEST FOR APPLICATIONS
| Form Name |
Format, Size |
Last Modified |
Required |
| IT Checklist Detail and Summary |
DOC, 86 KB |
10/28/08 |
Yes |
| IT Checklist Detail and Summary Instructions |
DOC, 35 KB |
11/02/04 |
No |
| Notice of Funding Availability Reporting Form |
DOC, 84 KB |
10/29/10 |
Yes |
| RFA Approval Form |
DOC, 40 KB |
07/07/09 |
Yes |
| RFA Approval Form Instructions |
DOC, 41 KB |
10/29/10 |
No |
| RFA Checklist |
DOC, 27 KB |
09/09/08 |
Yes |
| RFA Justification Memorandum (HT -- Please see note in red above.) |
DOC, 60 KB |
10/29/10 |
Yes |
| RFA Awards Template |
DOC, 46 KB |
10/29/10 |
Yes |
| RFA Template |
DOC, 278 KB |
04/24/12 |
Yes |
| RFA Questions and Answers Template |
DOC, 34 KB |
10/29/10 |
Yes |
REQUEST FOR APPLICATIONS AGREEMENT ADDENDA
| Form Name |
Format, Size |
Last Modified |
Required |
| RFA Agreement Addenda are under review. |
|
|
|
REQUEST FOR PROPOSALS
TRAINING
For DPH Employees