Common use of Contract Format Clause in Contracts

Contract Format. (Check all that apply) X TBR Standard Format Vendor Generated Contract reviewed by TBR Contracts Drafted by TBR/Not Standard Format Renewal or Modification of Existing Agreement Start Date: 08/10/2022 End Date: 08/10/2025 Total Number of Renewals (if a renewal or change to an existing contract, please indicate renewals remaining): 0 Type: Revenue Expenditure X No Cost Payment Frequency: As Invoiced Amount per Year: 0 Funding Source: Not Applicable Amount w/all renewals: 0 If not solely funded by Institution or Department, provide detail: n/a If State funds, list FOAP to be charged (i.e. 110001-200230-74490-470): n/a Lease: yes no Non-debarment Verification (▇▇▇.▇▇▇.gov): Yes no ▇ ▇ ▇▇▇▇▇: yes no Non-debarment Verification Date: 07/27/2022 X Procurement Method: N/A Available for System- Wide Use: No If Other, list eligible entities: n/a Ethnicity: (SA) State Agency If yes, designated contract monitor (individual responsible for ensuring receipt of goods/services and liaison with the vendor): ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Monitor’s email address: ▇▇▇▇▇▇▇.▇▇▇▇▇▇▇@▇▇▇.▇▇▇ annually If yes, monitoring frequency: Contract requires monitoring? yes or X no Not applicable Articulation of Information Technology-Related Programs**** Delivered at the Tennessee Colleges of Applied Technology to be Applied Toward

Contract Format. (Check all that apply) X TBR Standard Format Vendor Generated Contract reviewed by TBR Contracts Drafted by TBR/Not Standard Format Renewal or Modification of Existing Agreement Start Date: 08/10/2022 08/22/2022 End Date: 08/10/2025 08/22/2025 Total Number of Renewals (if a renewal or change to an existing contract, please indicate renewals remaining): 0 Type: Revenue Expenditure X No Cost Payment Frequency: As Invoiced Amount per Year: 0 Funding Source: Not Applicable Amount w/all renewals: 0 If not solely funded by Institution or Department, provide detail: n/a If State funds, list FOAP to be charged (i.e. 110001-200230-74490-470): n/a Lease: yes no Non-debarment Verification (▇▇▇.▇▇▇.gov): Yes no ▇ ▇ ▇▇▇▇▇: yes no Non-debarment Verification Date: 07/27/2022 08/08/2022 X Procurement Method: N/A Available for System- Wide Use: No If Other, list eligible entities: n/a Ethnicity: (SA) State Agency If yes, designated contract monitor (individual responsible for ensuring receipt of goods/services and liaison with the vendor): ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ Monitor’s email address: ▇▇▇▇▇▇▇.▇▇▇▇▇▇▇@▇▇▇.▇▇▇ annually one-time If yes, monitoring frequency: Contract requires monitoring? yes or X no Not applicable Articulation of Information Technology-Related Programs**** Delivered Administrative Office Technology at the Tennessee Colleges of Applied Technology to be Applied Toward

Contract Format. (Check all that apply) X TBR Standard Format Vendor Generated Contract reviewed by TBR Contracts Drafted by TBR/Not Standard Format Renewal or Modification of Existing Agreement Start Date: 08/10/2022 08/09/2022 End Date: 08/10/2025 08/09/2025 Total Number of Renewals (if a renewal or change to an existing contract, please indicate renewals remaining): 0 Type: Revenue Expenditure X No Cost Payment Frequency: As Invoiced Amount per Year: 0 Funding Source: Not Applicable Amount w/all renewals: 0 If not solely funded by Institution or Department, provide detail: n/a If State funds, list FOAP to be charged (i.e. 110001-200230-74490-470): n/a Lease: yes no Non-debarment Verification (▇▇▇.▇▇▇.gov): Yes no ▇ ▇ ▇▇▇▇▇: yes no Non-debarment Verification Date: 07/27/2022 07/26/2022 X Procurement Method: N/A Available for System- Wide Use: No If Other, list eligible entities: n/a Ethnicity: (SA) State Agency If yes, designated contract monitor (individual responsible for ensuring receipt of goods/services and liaison with the vendor): ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ n/a Monitor’s email address: ▇▇▇▇▇▇▇.▇▇▇▇▇▇▇@▇▇▇.▇▇▇ annually If yes, monitoring frequency: Contract requires monitoring? yes or X no Not applicable Articulation of Information Patient Care Technology-Related Programs**** /Medical Assistant Program Delivered at the Tennessee Colleges of Applied Technology to be Applied Toward