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State of Maryland Contract

AWARD

Publishing Form No. SCA941



INSTRUCTIONS

1. Fill in all blanks unless otherwise noted as being optional. Keep (DSD Use Only)

descrip- tions brief.

2. Please type all information; boxes may be checked by hand.

3. DEADLINES - See the Contract Weekly Publishing Schedule for

submission deadlines. For a copy of the Publishing Schedule,

additional blank forms, submission information, or questions, call

(410) 974-2486.

4. FAXING? - Use FAX Facts at bottom rather than a fax cover sheet.



NOTE: Completion and submission

of this form can be done

electronically using your PC and

modem. Call (410) 974-2486 for

more information. (Save a Tree)

Agency Procurement ID Number



Contact Name Contact Telephone No. Extension (Optional)

( )

Place of Performance (City, County, or Region)



Type of Procurement (Select One) Leases (Real Property) Type of Contract (Select One) Cost Plus Incentive Fee

A/E Services Maintenance Fixed Price Cost Reimbursement

Commodity/Supply Revenue Generating Cost Plus Fixed Fee Revenue Generating

Construction Services Fixed Price Incentive

Info. Processing & Telecom

Brief Description





Procurement (Select One) Sole Source Emergency NOTE:

Comp. Sealed Bidding A/E Act Intergovernmental Agreement * After unsuccessful sealed bidding

Comp. Sealed Proposals Preference Purchase Comp. Negot. * ** DHMH, DHR, DJS; see COMAR

Renewal Option Small Proc. Procedure Non-Comp. Negot. ** 21.14.01.04

Expedited

Awarded to (Name, City, State)



Contract Weekly Publication Date

Award Date (Mo/Day/Yr) Award Amount (Mo/Day/Yr) Today's Date (Mo/Day/Year)



/ / $ / / / /



FAX Facts MAIL/COURIER

US MAIL:

If you are sending more than one award or solicitation at a Contract Weekly

time, complete only the FAX Facts on the first sheet. Indi- P.O. Box 2249

cate the total number of pages sent in the NO. OF PAGES Annapolis, MD 21404-2249

area below:

COURIER:

SENT BY_______________________________ DATE___/___/___ Division of State Documents

11 Bladen Street

PHONE:___________________________ NO OF PAGES:________ Annapolis, MD 21401



SEND TO: Contract Weekly Telephone: (410) 974-2486

FAX NO.: (410) 974-2546 TDD: (410) 333-3098

MARYLAND REGISTER CONTRACT AWARD NOTICE FORM

COMPLETION INSTRUCTIONS





For any Title 21 procurement that results in a contract award in excess of $10,000, or any award,

renewal or extension of a human, social, or educational service contract with a State agency, a

political subdivision of the State, or other government, that results in a total contract price of more

than $25,000, a notice of award must be published in the Maryland Register Contract Weekly

within 30 days of the final approval of the contract.



The award notice is to be submitted along with the contract package (see contract cover sheet)

when applicable. All areas of the award notice are to be completed by the issuing unit, except

numbers 2, 12 and 14, as follows, (type all information except boxes which may be checked by

hand):



1) Agency - Health and Mental Hygiene + name of contracting unit.



2) Procurement I.D. Number - Leave blank, this number will be assigned by this office.



3) Contact Name - Name of the person at the contracting unit who can answer questions about

the solicitation, award, preparation and submission of the contract.



4)&5) Contact Telephone No. - Telephone number of the above individual and appropriate

extension if applicable.



6) Place of Performance - Place, facility, city, County, area, or region where the services are to

be performed under the contract resulting from this solicitation.



7) Type of Procurement - Enter an "X" in the box labeled Services.



8) Type of Contract - Enter an "X" in the appropriate box. If you have questions regarding what

type of contract is being submitted, call DCT at 767-5816.



9) Brief Description - A brief but complete description of the services to be performed. (Hint:

You may use the same wording as was used on the BB-4 form under Description of Service and

Purpose).



10) Procurement Method - Enter an "X" in the appropriate box. If you have questions regarding

what procurement method is being used, call DCT at 767-5816. This response should agree with

the procurement method found on the BB-4 form.



11) Awarded to - Name, City and State of the winning bidder or successful offeror.

12) Award Date - Leave blank, this office will complete with the date all approvals are obtained.



13) Award Amount - Total amount of the award. This amount should agree with the Total

Cost/Value amount shown in box 13 on the BB-4 which accompanies the contract.



14) Contract Weekly Publication Date - Leave blank, this office will complete this area.



15) Today's Date - The date that you type this form.



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