09.06.22 FIN Shared Services Municipality Committment Statement — File 22-1441

Massachusetts Department of Public Health Office of Local and Regional Health Public Health Excellence Grant Program for Shared Services RFR #214333 Municipality Statement of Commitment Working Name of Shared Services Arrangement or Name of Lead Municipality or Agency: City of Somerville Municipality submitting this form: Somerville Each municipality should complete a Municipality Statement of Commitment form and return to the lead municipality or agency. Check each box below to affirm that your municipality understands and intends to Cooperate with the lead municipality/agency to ensure compliance with the scope of services for the Public Health Excellence Grant Program for Shared Services. Use funds provided under this program only to augment rather than replace current municipal funding for public health staff or services. Form must be signed by a municipal chief executive and board of health chair (see note below). Name~ MayorofSomerville Date 7/12[22 Ka(aBattantyn: Name Brian Green{ Title Chair, BOH -------- Date 7/12/22 -~--- Please provide a brief explanation if this form has not been signed by the date agreed upon with your OLRH Program Coordinator: The grant and all relevant paperwork was put on hold during the time the City's Health and Human Services Director was vacant. Note for the lead municipality/agency: This form must scanned and sent by e-mail on or before the date agreed upon with your OLRH Program Coordinator to: [email removed]