CITY OF SOMERVILLE_BOH Tobacco Award — File 25-1162

• STANDARD CONTRACT FORM This form must be signed with an authorized signature, dated and returned via email scan. Do not use correction fluid anywhere on the forms. All attachments must be completed for your contract package to be processed. • CONTRACTOR AUTHORIZED SIGNATORY LISTING (CASL) The Department of Public Health has moved to an annual Contractor Authorized Listing (CASL) Form for signing contracts. The CASL form will be filled out annually in lieu of having to submit a CASL form with every new contract or amendment. Enclosed please find a Standard Contract package for you to review, sign and return via email scan. Please take note of the following: If you have any questions about your contract package, please contact Please sign with an authorized signature and return the contract package via email scan to ttttttttttttttttttttttttttttttttt no later than close of business Sincerely, Bureau Director Acceptable forms of Authorized signatures: 1. Traditional hand drawn “wet signature” (ink on paper); 2. Scan Copy of hand drawn signature 3. Electronic signature that is either: a. Hand drawn using a mouse or finger if working from a touch screen device; b. An uploaded picture of the signatory’s hand drawn signature 4. Electronic signatures affixed using a digital tool such as Adobe Sign or DocuSign Please Note: The typed text of a signature even in computer-generated cursive script, or an electronic symbol, are not acceptable forms of electronic signature. Allysia Peng at Allysia.Peng@mass.gov. Ruth Blodgett Bureau of Community Health and Prevention Allysia Peng at Allysia.Peng@mass.gov, 06/20/2025.

Award Letter Additional Information Contract ID#: INTF2903P01190128214 FAIN ID#: 1B08TI087044 DATE: 7/23/2024

COMMONWEALTH OF MASSACHUSETTS | STANDARD CONTRACT FORM This form is jointly issued and published by the Office of the Comptroller, the Executive Office for Administration and Finance, and the Operational Services Division as the default contract for all Commonwealth Departments when another form is not prescribed by regulation or policy. The Commonwealth deems void any changes made on or by attachment (in the form of addendum, engagement letters, contract forms or invoice terms) to the terms in this published form or to the Standard Contract Form Instructions and Contractor Certifications, the Commonwealth Terms and Conditions, the Commonwealth Terms and Conditions for Human and Social Services or the Commonwealth IT Terms and Conditions which are incorporated by reference herein. Additional non-conflicting terms may be added by Attachment. Contractors are required to access forms at macomptroller.org/forms or mass.gov/lists/osd-forms. CONTRACTOR INFORMATION Contractor Legal Name Legal Address As entered on Form W-9 or Form W-4 Contract Manager Name Phone Email Vendor Code VC Vendor Code Address ID e.g. “AD001”. Note: The Address ID must be set up for Electronic Funds Transfer (EFT) payments. AD COMMONWEALTH INFORMATION MMARS Code Business Mailing Address Billing Address If Different Phone Email Fax MMARS Doc ID(s) RFR/Procurement or Other ID Number Procurement or Exception Type (Check one option only) Statewide Contract (OSD or an OSD-designated department.) Collective Purchase (Attach OSD approval, scope, and budget.) Department Procurement - Includes all Grants 815 CMR 2.00. (Attach Solicitation Notice or RFR, and Response or other procurement supporting documentation.) Emergency Contract (Attach justification for emergency, scope, and budget.) Contract Employee (Attach Employee Status Form, scope, and budget.) Interim Contract with new Contractor (Attach justification for Interim Contract and updated scope/budget.) Other Procurement Exception (Attach authorizing language, legislation with specific exemption or earmark, and exception justification, scope, and budget.) Current Contract End Date PRIOR to Amendment Amendment Amount Or Enter “No Change” Amendment Type (Check one option only. Attach details of amendment changes.) Amendment to Date, Scope, or Budget (Attach updated scope and budget.) Interim Contract with Current Contractor (Attach justification for Interim Contract and updated scope/budget.) Contract Employee (Attach any updates to scope or budget.) Other Procurement Exception (Attach authorizing language/justification and updated scope/budget.) The Standard Contract Form Instructions and Contractor Certifications and the following document are incorporated by reference into this Contract and are legally binding (Check ONE option): Commonwealth Terms and Conditions Commonwealth Terms and Conditions for Human and Social Services Commonwealth IT Terms and Conditions The Department certifies that payments for authorized performance accepted in accordance with the terms of this Contract will be supported in the state accounting system by sufficient appropriations or other non-appropriated funds, subject to intercept for Commonwealth owed debts under 815 CMR 9.00. Rate Contract (No Maximum Obligation). (Attach details of all rates, units, calculations, conditions or terms and any changes if rates or terms are being amended.) Maximum Obligation Contract. Total maximum obligation for total duration of this contract (or new total if contract is being amended): $ Commonwealth payments are issued through Electronic Funds Transfer (EFT) 45 days from invoice receipt. See Prompt Pay Discounts Policy. Contractors requesting accelerated payments must identify a PPD as follows: Statutory/legal Ready Payments (M.G.L. c. 29, § 23A) If PPD percentages are left blank, identify reason: Agree to standard 45-day cycle Only initial payment Payment issued within: 10 days % PPD. 15 days % PPD. 20 days % PPD. 30 days % PPD. Enter the Contract title, purpose, fiscal year(s) and a detailed description of the scope of performance or what is being amended for a Contract Amendment. Attach all supporting documentation and justifications. Does the Supplier Diversity Program apply? YES NO If YES, the Contractor’s annual SDP commitment for this Contract is If NO, and the department is an Executive Department, enter the appropriate exemption: The Department and Contractor certify for this Contract, or Contract Amendment, that Contract obligations: 1. may be incurred as of the Effective Date (latest signature date below) and no obligations have been incurred prior to the Effective Date. 2. may be incurred as of , 20 , a date LATER than the Effective Date below and no obligations have been incurred prior to the Effective Date. 3. were incurred as of , 20 , a date PRIOR to the Effective Date below, and the parties agree that payments for any obligations incurred prior to the Effective Date are authorized to be made either as settlement payments or as authorized reimbursement payments, and that the details and circumstances of all obligations under this Contract are attached and incorporated into this Contract. Acceptance of payments forever releases the Commonwealth from further claims related to these obligations. Contract performance shall terminate as of , 20 , with no new obligations being incurred after this date unless the Contract is properly amended, provided that the terms of this Contract and performance expectations and obligations shall survive its termination for the purpose of resolving any claim or dispute, for completing any negotiated terms and warranties, to allow any close out or transition performance, reporting, invoicing or final payments, or during any lapse between amendments. Notwithstanding verbal or other representations by the parties, the “Effective Date” of this Contract or Amendment shall be the latest date that this Contract or Amendment has been executed by an authorized signatory of the Contractor, the Department, or a later Contract or Amendment Start Date specified above, subject to any required approvals. The Contractor certifies that they have accessed and reviewed all documents incorporated by reference as electronically published and the Contractor makes all certifications required under the Standard Contract Form Instructions and Contractor Certifications under the pains and penalties of perjury, and further agrees to provide any required documentation upon request to support compliance, and agrees that all terms governing performance of this Contract and doing business in Massachusetts are attached or incorporated by reference herein according to the following hierarchy of document precedence, the applicable Commonwealth Terms and Conditions, this Standard Contract Form, the Standard Contract Form Instructions and Contractor Certifications, the Request for Response (RFR) or other solicitation, the Contractor’s Response (excluding any language stricken by a Department as unacceptable, and additional negotiated terms, provided that additional negotiated terms will take precedence over the relevant terms in the RFR and the Contractor’s Response only if made using the process outlined in 801 CMR 21.07, incorporated herein, provided that any amended RFR or Response terms result in best value, lower costs, or a more cost effective Contract. Signature Date Print Name Print Title Signature Date Print Name Print Title Fax TERMS AND CONDITIONS COMPENSATION (Check ONE option) PROMPT PAYMENTDISCOUNT (PPD) Updated 11/22/2024 CONTRACT AMENDMENT NEW CONTRACT BRIEF DESCRIPTION OF CONTRACT PERFORMANCE or REASON FOR AMENDMENT SUPPLIER DIVERSITY PROGRAM (SDP) PLAN ANTICIPATED START DATE (Complete ONE option only.) CONTRACT END DATE CERTIFICATIONS AUTHORIZING SIGNATURE FOR THE CONTRACTOR Signature and date must be captured at time of signature. AUTHORIZING SIGNATURE FOR THE COMMONWEALTH Signature and date must be captured at time of signature. Department Contract Manager Name CITY OF SOMERVILLE 847,618.06 SDP Plan Info pending IT system upgrades. tlos@somervillema.gov 617-625-6600X VC6000192138 26 93 HIGHLAND AVE SOMERVILLE, MA 02143 001 25 Tina Los [phone removed] [phone removed] 190128 250 Washington Street, Boston MA 02108 DPH Allysia.Peng@mass.gov Allysia Peng Department of Public Health Renewal with Maximum Obligation Change 07/01 INTF2903P01190128214 06/30/2025 $110,280.00 06/30 Katjana Ballantyne Mayor City of Somerville

Scope of Services Contract ID#: Created 7/11/2011/Updated Oct 7, 2011 FY26 – MO Increase/Renewal Board of Health (BOH) programs will be responsible for promoting health equity, addressing health inequities, and use a health equity lens while implementing this scope of service. Strategies carried out by BOH programs will also be consistent with best practices around tobacco prevention and control and should focus on policy, systems, and environmental change strategies to reduce the prevalence of tobacco use, prevent youth initiation of smoking, and reduce exposure to secondhand smoke INTF2903P01190128214 Contract Amendment - Increase

Sub Recipient Notification The purpose of this communication is to fulfill the requirement established in 2 CFR 200. 331 (a) Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Your organization is receiving this communication because it receives federal funds from DPH in the form of a sub-award, and DPH’s relationship with your organization is defined as a sub-recipient relationship. A sub recipient is defined as a non-federal entity that receives a sub-award from a pass-thru-entity to carry out part of a federal program; but does not include an individual that is a beneficiary of such program. A sub-recipient may also be a recipient of other federal awards directly from a federal awarding agency. The attached report identifies information that DPH is required to provide to all entities that meet the description of a sub-recipient. This communication will be sent: 1. Whenever federal sub-awards are a part of the contractual relationship between DPH and the entities that it contracts with to provide services; and 2. Whenever the amount of those federal sub-awards change during the course of the contractual relationship. Your organization may have other contracts with DPH that are not sub-awards because they do not include federal funds. This communication does not pertain to any state funds your organization may have received from DPH. Your organization’s contract may be a combination of federal and state funds. In this case, this communication only pertains to the federal funds portion of your contract. For a list of other requirements and information that your organization is required to adhere to as a sub-recipient of DPH, please see: 1. Commonwealth of Massachusetts Standard Contract form; 2. Purchase of Service – Attachment 3 - Fiscal Year Program Budget (if applicable); 3. The appropriate Commonwealth Terms and Conditions; and 4. The Request for Response (RFR) and related documents. Please be advised that DPH should have access to your organization’s records and financial statements as is necessary to meet the requirements of this sub-award. Contract Number: INTF2903P01190128214 Vendor Name - FEIN: CITY OF SOMERVILLE - 046001414 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2019 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2018 06/30/2019 $47,356.00 Grand Total of 2019 $47,356.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2020 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2019 06/30/2020 $47,000.00 Grand Total of 2020 $47,000.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2021 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2020 06/30/2021 $47,000.00 Page 1 Of 2

Grand Total of 2021 $47,000.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2022 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2021 06/30/2022 $47,000.00 Grand Total of 2022 $47,000.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2023 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2022 06/30/2023 $47,000.00 Grand Total of 2023 $47,000.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2024 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2023 06/30/2024 $55,140.00 2024 93.959 4512-9058 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2023 06/30/2024 $0.00 Grand Total of 2024 $55,140.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2025 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2024 06/30/2025 $55,140.00 Grand Total of 2025 $55,140.00 Fiscal Year CFDA Appropriation Grant Name Agency Name Start Date End Date Amount 2026 4512-9069 SUBSTANCE ABUSE PREVENTION & TREATMENT BLOCK GRANT SAMHSA 07/01/2025 06/30/2026 $55,140.00 Grand Total of 2026 $55,140.00 Page 2 Of 2

Department of Public Health Department of Public Health New Budget Only Workbook Should be saved as .XLSM file Format (workbook contains MACROS) Vendor Name DPH Bureau/Program Name Fiscal Year 2026 RFR# 190128 FTE NEW BUDGET Brief Justification $ $ $ $ $ $ $ $ $ - $ SUB TOTAL 0.00 $ - Fringe Benefits #DIV/0! $ - 1. TOTAL PROGRAM STAFF $ - Program Component New Budget $ $ $ $ $ $ $ $ $ $ $ 2. TOTAL NON PERSONNEL $ - 3. OCCUPANCY Program Facility $ - $ - 3. TOTAL OCCUPANCY $ - SUB TOTAL: 1 + 2 + 3 $ - Administrative Support Max Cap Amount: #DIV/0! 4. AGENCY ADMIN. SUPPORT $ - 5.PROGRAM SUPPORT* $ TOTAL 1+ 2 + 3 + 4 + 5 $ - Enter the total dollar amount of Administrative Support (the percentage will be calculated) *Program Support: This component is for direct administrative program support that is associated with a single program(s) and NOT allocated across programs as an indirect cost or identified in admin support. Facility Operations, Maint. and Furn. Brief Justification Consultant: Individual Consultant: Organization Subcontractors (Attach Subcontractor Identification List For Direct or Non-Direct Care Services 2. NON PERSONNEL (Consultants - Consultant worksheet required), subcontractors, supplies, Brief Justification Enter the total dollar amount of Fringe Benefits (the percentage will be calculated) CITY OF SOMERVILLE BCHAP/Tobacco Enforcement Vendor Code Today's Date VC6000192138 06/12/25 Contract Number INTF2903P01190128214 Program Component 1. Program Staff

CONTRACT ID: FISCAL YEAR: PROJECT DELIVERABLE* KEY DATE* PROJECT DELIVERABLE COST* $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ TOTAL CONSULTANTS** $0.00 * List Project Deliverables for each Consultant, the dates and cost of the deliverable when completed ** This amount should equal the total amount you have allocated for CONSULTANTS in your budget PLEASE NOTE: This worsheet is not needed for SUBCONTRACTORS PLEASE NOTE: Only fill out this worksheet if you listed CONSULTANTS in your budget 2026