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STATE OF HAWAII
<br />CONTRACT FOR GOODS AND SERVICES
<br />(IN THE FOLLOWING CATEGORIES: EXEMPT; SMALL PURCHASE;
<br />SOLE SOURCE; OR EMERGENCY)
<br />This Contract, executed on the respective dates indicated below, is effective as of
<br />The STATE's Notice to Proceed
<br />, between Department of Health
<br />State of Hawaii ( "STATE "), by its
<br />(Insert name of state department, agency, board or commission)
<br />Director, Executive Office on Aging
<br />(livers title of person signing for State)
<br />(hereafter also referred to as the HEAD OF THE PURCHASING AGENCY or designee ( "HOPA ")),
<br />whose address is 250 South Hotel Street Suite 406 Honolulu, Hawaii 96813
<br />and County of Hawaii
<br />("CONTRACTOR), a government entity
<br />(Insert corporation, partnership, joint venture, sole proprietorship or other legal form of the Contractor)
<br />under the laws of the State of Hawaii , whose business address and federal
<br />and state taxpayer identification numbers are as follows: 1055 Kino'ole Street Suite 101 Hilo, Hawaii
<br />96720 -3853 Federal Tax I.D. #99- 6000567 State Tax I.D. #W40793866 -01
<br />RECITALS
<br />A. The STATE is in need of the goods and services, or both, described in this
<br />Contract and its attachments. The CONTRACTOR RACTOR is agreeable to providing the goods and services,
<br />or both, as the case may be.
<br />B. This Contract is for (check one box):
<br />® (1) A procurement expenditure of public funds for goods or services,
<br />or both, that is otherwise exempt from public bidding as set forth in section 103D -102, Hawaii
<br />Revised Statutes ( "HRS "), and chapter 3 -120, Hawaii Administrative Rules ( "HAR "); or
<br />; or
<br />❑ (2) A small purchase procurement of goods or services, or both, as set forth
<br />in section 103D -305, HRS, and subchapter 8, chapter 3 -122, HAR; or
<br />❑ (3) A sole source procurement of goods or services, or both, as set forth
<br />in section 103D -306, HRS, and subchapter 9, chapter 3 -122, HAR; or
<br />❑ (4) An emergency procurement of goods or services, or both, as set forth
<br />in section 103D -307, HRS, and subchapter 10, chapter 3 -122, HAR.
<br />C. Money is available to fund this Contract pursuant to:
<br />(1) Item F -24, ACT 162, 2009 HSL 510
<br />((dentify stale spaces)
<br />or (2) #90DR0036/01 and #1L0CMS030434/01
<br />(Idenhfyfederal sources)
<br />or both, in the following amounts: State $ 50,000.00
<br />Federal $ 217,922.00
<br />D. Pursuant to
<br />Section 349 -3, FIRS , the STATE
<br />(Legal authority to enter into this Contract)
<br />is authorized to enter into this Contract.
<br />E. The agency's Chief Procurement Officer is Aaron S. Fujioka
<br />who ❑ has approved this procurement or ® is not required to approve this procurement.
<br />NOW, THEREFORE, in consideration of the promises contained in this Contract, the
<br />STATE and the CONTRACTOR agree as follows:
<br />1. Scope of Services. The CONTRACTOR shall, in a proper and satisfactory
<br />manner as determined by the STATE, provide all the goods or services, or both, set forth in Attachment -
<br />S 1, which is made a part of this Contract.
<br />AG -002 Rev 07/24/2006
<br />EXHIBIT "1"
<br />1
<br />HA- ADRChd - 2010 -N
<br />
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