Original Contract # Amendment # Max. Contract $ Contract Contact Person Contact Telephone STATE OF CONNECTICUT PURCHASE OF SERVICE CONTRACT (“POS”, “Contract” and/or “contract”) Effective December 1, 2017 The State of Connecticut Street: City: State: CT Zip: Tel#: and/or Contract with: (“Agency” “Department”), hereby enters into a Contractor’s Name: Street: City: State: Zip: Tel#: FEIN/SS#: of services outlined in Part I. The Agency and the Contractor shall (“Contractor”), for the provision The Contractor shall comply with the terms and conditions set forth collectively be referred to as “Parties”. in this Contract as follows: This Contract is in effect from / / through / / . Contract Term / Effective Date Statutory The Agency is authorized to enter into this Contract pursuant to § of the Connecticut Authority General Statutes (“C.G.S.”). Contractor IS or IS NOT a set aside Contractor pursuant to C.G.S. § 4a-60g. Set-Aside Status The parties, by mutual agreement, may amend Part I of this contract only by means of a Contract written instrument signed by the Agency and the Contractor, and, if required, approved by Amendment the Office of the Connecticut Attorney General. Part II of this Contract may be amended only in consultation with, and with the approval of, the Office of the Connecticut Attorney General and the State of Connecticut, Office of Policy and in Management (“OPM”) accordance with the section in this Contract concerning Contract Amendments. All notices, demands, requests, consents, approvals or other communications required or permitted to be given or which are given with respect to this Contract shall be deemed to have been effected (collectively called “Notices”) at such time as the Notice is hand-delivered, placed in the U.S. mail, first class and postage prepaid, return receipt requested, sent by email, or placed with a recognized, overnight express delivery service that provides for a return receipt. All such Notices shall be in writing and shall be addressed as follows: If to the Agency: State of Connecticut, If to the Contractor: Attention: Attention:
Original Contract # Amendment # Max. Contract $ Contract Contact Person Contact Telephone STATE OF CONNECTICUT PURCHASE OF SERVICE CONTRACT (“POS”, “Contract” and/or “contract”) Effective December 1, 2017 The State of Connecticut Street: City: State: CT Zip: Tel#: (“Agency” and/or “Department”), hereby enters into a Contract with: Contractor’s Name: Street: City: State: Zip: Tel#: FEIN/SS#: (“Contractor”), for the provision of services outlined in Part I. The Agency and the Contractor shall collectively be referred to as “Parties”. The Contractor shall comply with the terms and conditions set forth in this Contract as follows: Contract Term / Effective Date This Contract is in effect from / / through / / . Statutory Authority The Agency is authorized to enter into this Contract pursuant to § of the Connecticut General Statutes (“C.G.S.”). Set-Aside Status Contractor IS or IS NOT a set aside Contractor pursuant to C.G.S. § 4a-60g. Contract Amendment The parties, by mutual agreement, may amend Part I of this contract only by means of a written instrument signed by the Agency and the Contractor, and, if required, approved by the Office of the Connecticut Attorney General. Part II of this Contract may be amended only in consultation with, and with the approval of, the Office of the Connecticut Attorney General and the State of Connecticut, Office of Policy and Management (“OPM”) in accordance with the section in this Contract concerning Contract Amendments. All notices, demands, requests, consents, approvals or other communications required or permitted to be given or which are given with respect to this Contract (collectively called “Notices”) shall be deemed to have been effected at such time as the Notice is hand-delivered, placed in the U.S. mail, first class and postage prepaid, return receipt requested, sent by email, or placed with a recognized, overnight express delivery service that provides for a return receipt. All such Notices shall be in writing and shall be addressed as follows: If to the Agency: State of Connecticut, Attention: If to the Contractor: Attention:
POS_Part_II_Dec_1_2017_Locked_in_Word.docx