Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date:
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: Prompt Payment. The State will pay the Contractor pursuant to Minn. Stat. § 16A.124, which requires payment within 30 days following receipt of an undisputed invoice, or merchandise or service, whichever is later. Terms requesting payment in less than 30 days will be changed to read “Net 30 days.” Notwithstanding the foregoing, the State may pay the Contractor in advance for purchases as allowed pursuant to Minn. Stat. §16A.065. The payment for each order will only be made for goods received or services actually performed that have been accepted by the ordering entity, and meet all terms, conditions, and specifications of the Contract and the ordering document. Invoicing. At a minimum the invoice must meet the requirements found on Exhibit D which provides a list of minimum invoice requirements.
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: Prompt Payment. The State will pay the Contractor pursuant to Minn. Stat. § 16A.124, which requires payment within 30 days following receipt of an undisputed invoice, or merchandise or service, whichever is later. Terms requesting payment in less than 30 days will be changed to read “Net 30 days.” Notwithstanding the foregoing, the State may pay the Contractor in advance for purchases as allowed pursuant to Minn. Stat. §16A.065. The payment for each order will only be made for goods received or services actually performed that have been accepted by the ordering entity, and meet all terms, conditions, and specifications of the Contract and the ordering document. Invoicing. The invoice must be in the same format as the sample invoice form approved as Exhibit D, Supplement 1 with the Contract, unless an alternative format is approved in writing by the State Authorized Representative, or delegate. See Exhibit D, Supplement 1 for a list of minimum invoice requirements.
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: Prompt Payment and Invoicing. Prompt Payment. The State will pay the Contractor pursuant to Minn. Stat. § 16A.124, which requires payment within 30 days following receipt of an undisputed invoice, or merchandise or service, whichever is later. Terms requesting payment in less than 30 days will be changed to read “Net 30 days.” Notwithstanding the foregoing, the State may pay the Contractor in advance for purchases as allowed pursuant to Minn. Stat. §16A.065. The payment for each order will only be made for goods received or services actually performed that have been accepted by the ordering entity, and meet all terms, conditions, and specifications of the Contract and the ordering document. Invoicing. The invoice must be in the same format as the sample invoice form approved as Exhibit D, Supplement 1 with the Contract, unless an alternative format is approved in writing by the State Authorized Representative, or delegate. See Exhibit D, Supplement 1 for a list of minimum invoice requirements. Assignment, Amendments, Waiver, and Contract Complete.
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: This purchase order (PO) incorporates by reference all terms, conditions, and specifications of the Draft Contract attached to SWIFT Event [#####]. In case of a conflict of terms, the order of precedence shall be: First this PO and second the Draft Contract.
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: Distribution: Agency Contractor State’s Authorized Representative – photo copy The payment for each order will only be made for goods received or services actually performed that have been accepted by the ordering entity, and meet all terms, conditions, and specifications of the Contract and the ordering document.
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: HIPAA Consent Do these tests require HIPAA consent to release data to organization in addition to patient? [Indicate “Yes” or “No”. ] At Home, Vendor Proctored $89 $19.95 At Home, Employer Proctored or Self Administered $89 $19.95 Bulk Order, Employer Proctored, Self Administered, or vendor proctored $39.95 N/A Bulk Order, Individual Return $39.95 $19.95 Antigen (Bulk Order), Employer Proctored or Self-Administered $19.95 N/A Antigen (Bulk Order), Vendor Proctored $19.95 N/A Program Administration Fees (dashboards, IT set-up, per person testing fee) N/A N/A Training N/A Included N/A Vendors please add any notes you have about your pricing. For instance, minimum quantities ordered, cost of individual return bags, etc.)
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: Prompt Payment. The State will pay the Contractor pursuant to Minn. Stat. § 16A.124, which requires payment within 30 days following receipt of an undisputed invoice, or merchandise or service, whichever is later. Terms requesting payment in less than 30 days will be changed to read “Net 30 days.” Notwithstanding the foregoing, the State may pay the Contractor in advance for purchases as allowed pursuant to Minn. Stat. §16A.065. The payment for each order will only be made for goods received or services actually performed that have been accepted by the ordering entity, and meet all terms, conditions, and specifications of the Contract and the ordering document.
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: Distribution: Agency Contractor State’s Authorized Representative – photo copy Prompt Payment. The State will pay pursuant to Minn. Stat. § 16A.124, which requires payment within 30 days following receipt of an undisputed invoice, or merchandise or service, whichever is later. Notwithstanding the foregoing, the State may pay the Contractor in advance for purchases as allowed pursuant to Minn. Stat. §16A.065. The payment for each order will only be made for goods received or services actually performed that have been accepted by the ordering entity, and meet all terms, conditions, and specifications of the Contract and the ordering document. Invoicing. The invoice must be in the same format as the sample invoice form submitted with the solicitation response and approved as an attachment with the Contract, unless an alternative format is approved in writing by the Contract Administrator. Each invoice should at a minimum include:
Commissioner of Administration As delegated to The Office of State Procurement. Print name: Print name: Signature: Signature: Title: Date: Title: Date: HIPAA Consent Do these tests require HIPAA consent to release data to organization in addition to patient? [Indicate “Yes” or “No”. ] Bulk Order, Employer Proctored or Self Administered $74.50-81 (depending on volume) $25 per shipment Bulk Order, Vendor Proctored $50 Included for weekday bulk return shipments of greater than 20 samples Program Administration Fees (dashboards, IT set-up, per person testing fee) N/A N/A Training N/A Included N/A Vendors please add any notes you have about your pricing. For instance, minimum quantities ordered, cost of individual return bags, etc.)
