Certification Regarding Use of State Funds. If Party is an employer and this Agreement is a State-funded grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization.
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 6-9-2014 ATTACHMENT F AGENCY OF HUMAN SERVICES’ CUSTOMARY CONTRACT PROVISIONS
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 9-3-2014 ATTACHMENT E BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (“Agreement”) is entered into by and between the State of Vermont Agency of Human Services operating by and through its Department of Vermont Heath Access (“Covered Entity”) and Pacific Health Policy Group (“Business Associate”) as of February 2, 2015 (“Effective Date”). This Agreement supplements and is made a part of the Contract to which it is an attachment. Covered Entity and Business Associate enter into this Agreement to comply with standards promulgated under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), including the Standards for the Privacy of Individually Identifiable Health Information, at 45 CFR Parts 160 and 164 (“Privacy Rule”), and the Security Standards, at 45 CFR Parts 160 and 164 (“Security Rule”), as amended by Subtitle D of the Health Information Technology for Economic and Clinical Health Act (HITECH), and any associated federal rules and regulations. The parties agree as follows:
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 9-3-2014 ATTACHMENT E BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (“Agreement”) is entered into by and between the State of Vermont Agency of Human Services, operating by and through its Mt. Ascutney (“Covered Entity”) and Mt. Ascutney Hospital and Health Center (“Business Associate”) as of October 1, 2014 (“Effective Date”). This Agreement supplements and is made a part of the contract/grant to which it is attached. Covered Entity and Business Associate enter into this Agreement to comply with standards promulgated under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), including the Standards for the Privacy of Individually Identifiable Health Information, at 45 CFR Parts 160 and 164 (“Privacy Rule”), and the Security Standards, at 45 CFR Parts 160 and 164 (“Security Rule”), as amended by Subtitle D of the Health Information Technology for Economic and Clinical Health Act (HITECH), and any associated federal rules and regulations. The parties agree as follows:
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 9-3-2014 ATTACHMENT E BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement (“Agreement”) is entered into by and between the State of Vermont Agency of Human Services, operating by and through its Department of Vermont Health Access (“Covered Entity”) and Little Rivers Health Care, Inc. (“Business Associate”) as of October 1, 2014 (“Effective Date”). This Agreement supplements and is made a part of the contract/grant to which it is attached. Covered Entity and Business Associate enter into this Agreement to comply with standards promulgated under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), including the Standards for the Privacy of Individually Identifiable Health Information, at 45 CFR Parts 160 and 164 (“Privacy Rule”), and the Security Standards, at 45 CFR Parts 160 and 164 (“Security Rule”), as amended by Subtitle D of the Health Information Technology for Economic and Clinical Health Act (HITECH), and any associated federal rules and regulations. The parties agree as follows:
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 11-7-2012 ATTACHMENT D MODIFICATION OF CUSTOMARY PROVISIONS OF ATTACHMENT C OR ATTACHMENT F 1. In addition to the insurance requirements contained in Attachment C, Section 7, Contractor agrees to procure and maintain: Umbrella policy providing excess limits over the primary general liability, automobile liability and employer’s liability policies in an amount not less than $10 million per occurrence and in the aggregate. Contractor shall name the State of Vermont and its officers and employees as additional insureds for liability arising out of this Agreement.
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. (End of Standard Provisions) ATTACHMENT “G” State of New Hampshire State of New Hampshire Division of Plant and Property Management Bureau of Purchase and Property 00 Xxxxxxx Xxxxxx, Xxxxx House Annex Concord, NH 03301-6398
Certification Regarding Use of State Funds. If Party is an employer and this Agreement is a State-funded grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. Contract #32114 Amendment #1 B. Good Standing Certification (Act 154 of 2016): If this Agreement is a State-funded grant, Party hereby represents: (i) that it has signed and provided to the State the form prescribed by the Secretary of Administration for purposes of certifying that it is in good standing (as provided in Section 13(a)(2) of Act 154) with the Agency of Natural Resources and the Agency of Agriculture, Food and Markets, or otherwise explaining the circumstances surrounding the inability to so certify, and (ii) that it will comply with the requirements stated therein. (End of Standard Provisions) Xxxxxxxx #00000 Xxxxxxxxx #0 Xxxxxxxxxx X0: Form Statement of Work RFP (SOW-RFP) STATE OF VERMONT - STATEMENT OF WORK (SOW) Request for Proposal (RFP) IT Service Category: Request for Proposal Month DD, YYYY CIO APPROVAL This SOW RFP is approved for issuance by the Vermont Chief Information Officer/Secretary of the Agency of Digital Services. CIO Approval Date ADMINISTRATIVE INFORMATION AGENCY/DEPT RESPONSIBILITY FOR SOW-RFP AND SOW AGREEMENT Name the person/s and Agency/Dept. This SOW RFP is being issued in accordance with the Master Agreement between the Contractor and the State of Vermont, Department of Buildings and General Services, Office of Purchasing and Contracting. After an evaluation of Contractor’s response to this SOW RFP, the Contracting Agency may elect to enter into a specific SOW Agreement which will outline all SOW Agreement requirements and payment provisions. SOW PROPOSAL SUBMISSIONS All SOW Proposals are due no later than: (Date) and Time Proposals must be submitted by email to: XXX.XXXxxxxxxxxxxxxxXxxxxxxxxxx@xxxxxxx.xxx. The email submission must reference the procurement name “SOW-RFP Project Name”. • The SOW RFP Response is to be submitted to the contact set forth above via e-mail as four attachments. The “subject” line in the e-mail submission shall state the SOW- RFP Project Name. The first file, to be submitted in Word and pdf formats, will be the technical response to this SOW-RFP and titled, “SOW-RFP Project Name Technical”. The second file, to be submitted in Word or Excel and pdf formats, will be the financial response to this SOW-RFP and titled, “SOW-RFP Project Name Financi...
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 11-7-2012 ATTACHMENT E BUSINESS PARTNER AGREEMENT This Business Partner Agreement (“Agreement”) is entered into by and between the State of Vermont, Agency of Human Services operating by and through its Department of Vermont Health Access (“DVHA”) and Association of Africans Living in Vermont (“Business Partner”) as of July 1, 2013 (“Effective Date”). This Agreement supplements and is made a part of the Grant to which it is attached. DVHA and Business Partner (”the Parties”) agree to comply with the terms of this Agreement and the standards promulgated under the Patient Protection and Affordable Care Act of 2010 (Public Law 111-148) as amended by the Health Care and Education Reconciliation Act (Public Law 111-152), and referred to collectively as the Affordable Care Act (ACA), and 45 CFR §155.260, “Privacy and security of personally identifiable information.” Business Partner information that constitutes protected health information (PHI) may have additional standards to which the Business Partner must adhere, which would be set out in a separate agreement.
Certification Regarding Use of State Funds. In the case that Party is an employer and this Agreement is a State Funded Grant in excess of $1,001, Party certifies that none of these State funds will be used to interfere with or restrain the exercise of Party’s employee’s rights with respect to unionization. State of Vermont – Attachment C Revised AHS – 6-9-2014 (End of Standard Provisions) This amendment consists of 12 pages. Except as modified by this amendment and any previous amendments, all provisions of this contract, (#26095) dated shall remain unchanged and in full force and effect. E-SIGNED by Xxxxxxx Xxxxxx on 2014-07-09 11:57:11 GMT By the STATE OF VERMONT By the CONTRACTOR E-SIGNED by Xxxx Xxxxxx on 2014-07-09 14:17:14 GMT XXXX XXXXXX, COMMISSIONER 000 Xxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxx, XX 00000-0000 Phone: 000-000-0000 Email: xxxx.xxxxxx@xxxxx.xx.xx XXXXXXX XXXXXX, PRESIDENT 00 Xxxxxxxxx Xxxxxx Needham, MA. 02492 Phone: 000-000-0000 Email: xxxxxxx@xxxxxx-xxxxxx.xxx Date: Signature: July 09, 2014 Date: Signature:
