Matters ▸ Attachment
2026FIFAPublicHealth_FEC_Award — File 26-1130
Enclosed please find an Engagement Contract package for you to review and sign via DocuSign. Please
take note of the following:
•
NEW ENGAGEMENT CONTRACT/AMENDMENT/RENEWAL FORM
This form must be signed with an authorized signatory, dated, and returned via DocuSign.
All attachments must be completed for your contract package to be processed.
If you have programmatic questions about your engagement contract package, please contact your Bureau
Program Manager
Please sign with an authorized signatory and return the contract package via DocuSign no later than close of
business on
The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
250 Washington Street, Boston, MA 02108
MAURA T. HEALEY
Governor
KIMBERLEY DRISCOLL
Lieutenant Governor
Attn:
R/E: Contract #:
KIAME MAHANIAH, MD, MBA
Secretary
ROBERT GOLDSTEIN, MD, PhD
Commissioner
Tel: [phone removed]
www.mass.gov/dph
06/18/2026
CITY OF SOMERVILLE
93 HIGHLAND AVE
SOMERVILLE, MA 02143
Lauren Mahoney
INTF1200P01236938373
The Massachusetts Department of Public Health, DPH Offices is awarding you an engagement contract in
accordance with RFQ# 262369380326 - Local Public Health Funding for FIFA 2026 World Cup Community
Events. The engagement contract will be in effect through 09/30/2026.
Diana Acosta at Diana.C.Acosta@mass.gov.
6/22/2026.
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
Sincerely,
Bureau Director
Sam Wong
Office of Local and Regional Health
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
Award Letter Additional Information
Contract ID#: INTF1200P01236938373
This will be a special circumstance that there will be only one payment voucher due to time constraints of FIFA events.
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
DPH MASTER AGREEMENT ENGAGEMENT FORM
Vendor Code:
Vendor Email:
Procurement No:
Bureau:
Engagement Contract ID:
Vendor Name:
Vendor Contact:
Master Agreement Id:
Procurement Name:
New
Dates of Service:
Anticipated Start Date*:
End Date:
Total Engagement Maximum Obligation
attached Vendor response
RFQ
NOI
Confidentiality Agreement
Amendment
Original Start Date:
Current End Date:
New End Date:
Current Total Engagement Maximum Obligation
Engagement Amendment Amount (+ or -)
New Total Engagement Maximum Obligation
DPH MA PP Budget Attached
Expenditures must be made in accordance with the approved budget for this engagement and the terms and conditions of the
procuring agency’s RFR and contract.
Periodic Scheduled Payment Installments: Payments will be made upon the submission of a payment voucher(s) that are
complete and that include appropriate documentation in accordance with the terms of the service scope and governing contract.
Expenditure Reporting: Triannual or quarterly narrative reports and expenditure reports
Funding: Funding for this engagement is subject to the appropriation of funds by the Massachusetts legislature or the federal government for the
year(s) in which services are delivered.
Changes to Scope and /or Terms: Any changes to this engagement must be agreed upon in writing by both parties.
Termination: The Department, upon prior written notice, may terminate this engagement without cause and without penalty, or may terminate or
suspend an engagement if the vendor breaches any material term or condition or fails to perform or fulfill any material obligation required by this
engagement, or in the event of an elimination of an appropriation or absence of sufficient funds for the purposes of an engagement, or in the event
of an unforeseen public emergency mandating immediate department action.
Vendor Authorized Signature
_______________________________________________
Authorized Vendor Signature and Date
_______________________________________________
Print Name and Title
Department Authorized Signatures
__________________________________________________
Authorized DPH Bureau Representative Signature and Date
__________________________________________________
Print Name and Title
* The effective start date of this Engagement or Amendment shall be the latest date this document has been executed by an authorized
signatory of the Vendor, the Department or a later Engagement or Amendment start date specified above
NOI
RFQ
Amendment Type:
DPH Program Manager Email:
DPH Program Manager:
PUBLIC HEALTH SERVICES AT THE LOCAL AND REGIONAL LEVEL
INTF1200P01236938373
236938
VC6000192138
DPH Offices
$14,974.64
Diana.C.Acosta@mass.gov
262369380326
09/30/2026
Diana Acosta
CITY OF SOMERVILLE
07/01/2026
lmahoney@somervillema.gov
MUNICIPALPHSERVICES0
Lauren Mahoney
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
Scope of Services
Contract ID#:
Created 7/11/2011/Updated Oct 7, 2011
New Contract
INTF1200P01236938373
Local Public Health Funding for FIFA 2026 World Cup Community Events
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
Contract Conditions
Contract ID#:
Provider Name:
Signature:
Date:
_____________________________________________
___________________
CITY OF SOMERVILLE
We have read and will adhere and comply to the requirements in the attached Contract Conditions and Attachments.
INTF1200P01236938373
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
CONDITIONS
City of Somerville
RFQ File Name/Title: Local Public Health Funding for FIFA 2026 World Cup Community
Events RFQ File Number: 262369380326
FIFA 2026 World Cup public viewing or fan-based community events (e.g. watch parties-
organized public viewing events where matches are shown in parks, community centers, or
other public spaces) in need of one-time funding (up to $15,000 per community event ) to
support local public health (LPH), including but not limited to: LPH staffing, translation,
supplies, and handwashing station rentals.
Allowable Expenses • Local public health staffing beyond existing staffing levels (e.g.
overtime or consultants) to support FIFA community events. For example, contracted
inspectors to inspect increased food truck presence. • Condoms • Aloe vera lotion/cream •
Rental of handwashing stations • Cooling/misting tents • Contracted inspectors •
Translation services Municipalities may propose additional allowable expenses in their
responses with justification;
All proposed expenses are subject to OLRH final approval.
All requested costs must be related to FIFA community events.
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
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
2027
RFR#
RFQ 262369380326
FTE
NEW BUDGET
Brief Justification
$
$
$
$
$
$
$
$ -
$
SUB TOTAL
0.00
$ -
Fringe Benefits
#DIV/0!
1. TOTAL PROGRAM STAFF
$ -
Program Component
New Budget
$
$
$ 14,974.64
water, hand sanitizer, sunscreen packets, bug repellant for community FIFA events (see quote)
$
$
$
$
$
$
$
2. TOTAL NON PERSONNEL
$ 14,974.64
3. OCCUPANCY
Program Facility
$ -
$ -
3. TOTAL OCCUPANCY
$ -
SUB TOTAL: 1 + 2 + 3
$ 14,974.64
Administrative Support
Max Cap Amount: 0.00%
4. AGENCY ADMIN. SUPPORT
$ -
5.PROGRAM SUPPORT*
$
TOTAL 1+ 2 + 3 + 4 + 5
$ 14,974.64
City of Somerville, HHS
Office of Local and Regional Health FIFA Community Events
Vendor Code
Today's Date
VC6000192138
06/12/26
Contract Number
INTF1200P01236938373
Program Component
1. Program Staff
2. NON PERSONNEL (Consultants - Consultant worksheet required), subcontractors, supplies,
Brief Justification
Enter the total dollar amount of Fringe Benefits (the percentage will be calculated)
Consultant: Individual
Consultant: Organization
Subcontractors (Attach Subcontractor Identification List For Direct or Non-Direct Care Services
public health supplies
Brief Justification
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.
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB
PAYMENT VOUCHER - 1
The Commonwealth of Massachusetts
Department /Organization Name
Office of the Comptroller
Revision Date 8/22/95 by VG
Document ID
Trans
Dept
R/Org
Number
PV Date
Acctg Prd
BFY
Vendor Name and Address
Action(E)
Sch Pay Date
Off Liab Acct
Vendors’ Certification
NAME:
I certify that the goods were shipped or the
ADDRESS:
service rendered as set forth below.
Ref Doc ID
(Please sign in ink)
Document Total
Stxt
Payment Ref Number
Emp
Vendor Code
Reference Order
Line
Quantity
Description
Amount
REFERENCE DOC ID
LN
Trans
Dept
R/Org
Number
Line
Dept
Approp
Sub
Org
S/Org
Obj
Prog
Ty
Proj/Cl/Grc
Actv
Rpfg
Fund
BS Acct
Payment Reference Number
Description
MSA#
Line #
Disc
Quantity
Line Amount
I/D
P/F
Dates of Service
TO THE COMPTROLLER OF THE COMMONWEALTH OF MASSACHUSETTS:
INSTRUCTIONS
I hereby certify under the penalties of perjury that all laws of the Commonwealth governing disbursements of public funds and the regulations thereof have been complied with and observed.
TO VENDORS
Prepared By:
Title:
Date:
• Sign Payment Voucher
• Direct inquires to state
organization
• Retain copy
Entered By:
Title:
Date:
Pg
of
The undersigned authorized signatory approving this document certifies that this document and any attachments are accurate and complete and comply with all applicable general and special laws and regulations.
Approved By:
Title:
Date
Phone #:
DPH/OFF
PRC
DPH
OFF
INTF1200P01236938373 - 1
$14,974.64
INTF1200P01236938373 - 1
PRC
DPH
OFF
INTF1200P01236938373 - 1
VC6000192138
$14,974.64
Local Public Health Funding for FIFA 2026 World Cup Community Events
CITY OF SOMERVILLE
93 HIGHLAND AVE SOMERVILLE, MA 02143-
1740
Docusign Envelope ID: 043A87E0-04E0-8237-8036-49E30D309BEB