subcontract between management sciences...

Subcontract 001_HDP

SUBCONTRACT

between

MANAGEMENT SCIENCES FOR HEALTH INC.

and

HEALTH DEVELOPMENT & PERFORMANCE

Subcontract Number 001

This subcontract is made and entered into by and between Management Sciences For Health, a nonprofit corporation organized and existing under the laws of Massachusetts with a principal place of business at 784 Memorial Drive, Cambridge, Massachussetts, 02139, USA, and a project office at Ntaruka Street, Kiyovu, Kigali: PO Box 371, Kigali, Rwanda ("MSH" or "the Contractor"), and Health Development & Performance asbl (HDP asbl) with a principal place of business at Remera, City of Kigali, Rwanda ("The Subcontractor"). WHEREAS, the Contractor has been awarded Contract/grant No GHS-I-02-03-00030-00 and Task Order No GHS-I-02-03-00030-00 with an effective date of September 9, 2005 by the United States Agency for International Development (USAID) to carry out the quarterly Community Based counter-verification exercises according to the National counter - verification protocol for Performance-Based Financing . WHEREAS, the Subcontractor is willing to provide such services; and WHEREAS, representatives of the Contractor and Subcontractor possess proper and sufficient authority to so agree; NOW THEREFORE, in consideration of these premises and the mutual promises that follow in Sections B through J of the subcontract, the parties hereto have executed this subcontract on the day and year specified below. THIS SUBCONTRACT CONSTITUTES THE ENTIRE AGREEMENT BY THE PARTIES WITH RESPECT TO THE MATTERS HEREIN. No other agreement, oral or written, shall be deemed to bind the parties with respect to the subject matter of this subcontract. FOR MANAGEMENT SCIENCES FOR HEALTH :

Name: Sharon M. O’Daniel Title: Contract Officer

Date

FOR HEALTH DEVELOPMENT & PERFORMANCE

Name: Christian Habineza Title: Director of HDP

Date

Subcontract 001_HDP

TABLE OF CONTENTS

COVER AND SIGNATURE PAGE ......................................................................................................................... 1 Table of Contents ............................................................................................................................................ 2

SECTION B: SUPPLIES OR SERVICES AND PRICES/COSTS ................................................................... 3 B.1 PURPOSE .............................................................................................................................. 3 B.2 SUBCONTRACT TYPE AND CONTRACT SERVICES ................................................................ 3 B.3 OBLIGATED AMOUNT ........................................................................................................... 3 SECTION C: STATEMENT OF WORK .................................................................................................. 4 SECTION D: PACKAGING AND MARKING .......................................................................................... 6

SECTION E: INSPECTION AND ACCEPTANCE ..................................................................................... 6 E.1 CLAUSES INCORPORATED BY REFERENCE .......................................................................... 6 E.2 INSPECTION AND ACCEPTANCE ........................................................................................... 6 E.3 MONITORING AND EVALUATION ......................................................................................... 6

SECTION F: DELIVERIES OR PERFORMANCE ..................................................................................... 8 F.1 CLAUSES INCORPORATED BY REFERENCE .......................................................................... 8 F.2 PERIOD OF PERFORMANCE ................................................................................................... 8 F.3 DELIVERY SCHEDULE ........................................................................................................... 8 F.4 REPORTS & DELIVERABLES OR OUTPUTS .............................................................................. 8 F.5 PERFORMANCE STANDARDS ................................................................................................. 8

SECTION G: CONTRACT ADMINISTRATION DATA ............................................................................ 9 G.1 ADMINISTRATIVE CONTRACTS OFFICE ................................................................................ 9 G.2 TECHNICAL DIRECTIONS ..................................................................................................... 9 G.3 PAYING OFFICE ................................................................................................................... 9 G.4 PAYMENT ............................................................................................................................ 9

SECTION H: SPECIAL CONTRACT REQUIREMENTS ......................................................................... 10 H.1 CLAUSES INCORPORATED BY REFERENCE ......................................................................... 10 H.2 DRUG TRAFFICKING .......................................................................................................... 10 H.3 TERRORIST FINANCING ....................................................................................................... 11 H.4 FOREIGN DELEGATIONS TO INTERNATIONAL CONFERENCES ............................................... 11 H.5 LOWER TIERED SUBCONTRACTING .................................................................................... 11 H.6 PHARMACEUTICALS ........................................................................................................... 11 H.7 ORGANIZATION ELIGIBLE FOR ASSISTANCE (ACQUISITION) (JUNE 2005) ........................... 11

H.8 CONDOMS ACQUISITION (JUNE 2005)…………………………………………………..11 H.9 PROHIBITION ON THE PROMOTION OR ADVOCACY OF THE LEGALIZATION OR PRACTICE ..... 11 OF PROSTITUTION OR SEX TRAFFICKING H.10 VOLUNTARY POPULATION ACTIVITIES (MARCH 19) …………………………………… .12 H.11 TAXES ............................................................................................................................... 12 H.12 KEY PERSONNEL…………………………………………………………………….....12

SECTION I: CONTRACT CLAUSES ................................................................................................... 14 I. 1 CLAUSES INCORPORATED BY REFERENCE ........................................................................ 14 I. 2 CLAUSES INCORPORATED BY REFERENCE ......................................................................... 17 I. 3 COMMUNICATION PRODUCTS ............................................................................................ 17

SECTION J: ATTACHMENTS ............................................................................................................ 18

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SECTION B: SUPPLIES OR SERVICES AND PRICES/COSTS B.1 PURPOSE This subcontract is in support of the Rwandan HIV-Performance Based Financing project awarded to Management Sciences for Health under contract number GHS-I-02-03-00030-00. The purpose of this subcontract with HDP is to ensure grass-roots, community level mobilization of organizations and stakeholders for the implementation of the National Counter-verification protocol. HDP, with its wide experience in community work, will organize and coordinate community based surveys for PBF quantity verifications and report its findings to MSH for further use. B.2 SUBCONTRACT TYPE AND SERVICES This is a fixed-price subcontract. For providing the technical services described in Section C: Statement of Work and completing the deliverables described in Section F.3: Deliverables, MSH will pay the Subcontractor the fixed price of Fifty-three Million Two Hundred Five Thousand Six Hundred Four Rwandan Francs (53,205,604 Rwandan Francs). B.3 OBLIGATED AMOUNT This subcontract is 100% obligated at 53,205,604 Rwandan Francs for the performance period specified in Section F.2 herein.

[End of Section B]

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SECTION C: STATEMENT OF WORK Performance-Based Financing (PBF) has been rolled out nationwide in Rwanda, in phases, from January 1, 2006 to April 1, 2008. Various PBF models exist; for the District Hospitals; for the Health Centers and for MOH Head Quarter Staff. A model for Community PBF is being designed, and a model for Tertiary Hospitals will also be created. This sub-agreement is focused on strengthening the Monitoring and Evaluation aspects of the national Health Center PBF model. The Health Center model is a contracting-in arrangement, whereby the Government of Rwanda and partners purchase services through a newly created administrative arrangement. This model is governed in all transparency at the district level through a steering committee with formalized meetings in which civil society sits alongside district authorities, district health managers, and partners. The Health Center PBF model is based on decentralized governance at the district level, a separation of functions, and a system of internal controls by the district for the volume of services and the quality of services, which together determine the final performance of each health center. The system of internal controls is reinforced by specifically designated technical assistants, drawn from a pool of Ministry of Health, bilateral partners, and implementing agency technical staff. This is the so-called ‘extended team’. On top of the internal controls and existing checks and balances, a system of external controls, i.e., from outside the district has been piloted. National protocols for external counter-verification of the volume of services using community client surveys and for counter-verifying the quality of services have been drawn up. For the counter-verification of the quality of services, extended team members will be used. For the counter-verification of the volume of services, a third party agency will be engaged. This third party agency, Health Development & Performance asbl (HDP) 1 was formed by former staff and managers of the Rwandan Branch of the Dutch PVO CORDAID after the ending of CORDAID Rwanda operations in 2007. CORDAID had been instrumental in introducing PBF in the western province of Rwanda since 2002 in what was, at the time, a pilot initiative. The results that were achieved later on proved to be critical in the MOH decision to make PBF a national policy. The CORDAID experience has been published in the international peer-reviewed literature.2 CORDAID Rwanda converted, through technical assistance of CORDAID/Netherlands, into the local NGO HDP, capturing the entire former CORDAID Rwanda team. HDP has been selected by MSH, in close collaboration with the CAAC/MOH, to act as the operational agency for carrying out the national quantity counter-verification protocol. By involving the CAAC/MOH closely, in particular related to the budget assumptions underlying the negotiated fixed price, a degree of sustainability has been built into this exercise; it is foreseen that the CAAC/MOH, after the end of this current contract, will take over the financing of this activity. The national quantity counter-verification protocol is based on a multi-stage random sampling of health centers, services and clients, once per quarter. Once per quarter, the following cycle of activities will take place, and form part of the required deliverables, to be reported upon in the survey report (see attachment 2): (i) Contacting MSH and the CAAC/MOH to determine conjointly and transparently the districts, health

centers and PMA and HIV services that will be analyzed, using random sampling software. The principle is to use random selection software for randomly selecting districts, health centers and

1 http://www.hdp-rw.org/ ‘asbl’ stands for ‘association sans but lucratif’ or ‘Not for Profit Organization’ 2 Soeters, R., Habineza, C., Peerenboom, P.B., (2006), Performance-based financing and changing the district health system: experience from Rwanda. Bulletin of the World Health Organization, 84, 6

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indicators, however, the CAAC/MOH and MSH retain the right to change or direct HDP to target certain districts, health centers or indicators.

(ii) First contact by HDP with the selected districts, district authorities (district director of health; district hospital management) and health center management to explain the purpose of the surveys and to ensure their buy-in and participation in the surveys and to discuss the dissemination of the results;

(iii) First contact by HDP with the grass root organizations present in the catchment areas of the selected health facilities, in case of presence of organizations of People Living with HIV, priority will be given to these organizations for use during the community client surveys. HDP will select surveyors from these grass root organizations, in collaboration with the grass root organization. HDP will not use second tier sub-contracts; HDP will be using a fee-per-well completed survey questionnaire to remunerate the surveyors;

(iv) Training of selected surveyors, at least five per health center; (v) Random sampling of the register books for the randomly chosen PMA and HIV indicators; for each

service, for the six months preceding the survey, 15 cases will be randomly selected from each register book, using the register book as the template (see annex for details). In case no HIV services are available, two additional PMA services will be selected at random; approximately 750 provider-client contacts will be sampled and clients will be traced in the community;

(vi) Monitoring and Evaluation of the surveys by HDP staff; (vii) Data compilation and analysis, using statistical software such as EPI Info 2000 or SPSS, with technical

support from MSH will be carried out; (viii) Discussion of preliminary results with MSH and the CAAC; (ix) Contacting the districts to share the results in their next District PBF Steering Committee Meetings; (x) Contacting the Health Centers and the Grass Root Organizations to share the results in a plenary; (xi) A report of no more than 15 pages, excluding annexes, in French or in English language, which includes

a description of the restitution of the findings in the District Steering Committees and the Health Centers and Grass Root Organizations, will be drawn up and submitted to MSH and the CAAC; the specifications of this report are in Attachment 2.

[End of Section C]

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SECTION D: SECTION D: PACKAGING AND MARKING D.1 AIDAR 752.7009 MARKING (JAN 1993)

(a) It is USAID policy that USAID-financed commodities and shipment containers, and project construction sites and other project locations be suitably marked with the USAID emblem. Shipping containers are also to be marked with the last five digits of the USAID financing document number. As a general rule, marking is not required for raw materials shipped in bulk (such as coal, grain, etc.), or for semi finished products which are not packaged.

(b) Specific guidance on marking requirements should be obtained prior to procurement of commodities to be shipped, and as early as possible for project construction sites and other project locations. This guidance will be provided through the cognizant technical office indicated on the cover page of this contract, or by the Mission Director in the Cooperating Country to which commodities are being shipped, or in which the project site is located.

(c) Authority to waiver requirements is vested with the Regional Assistant Administrators, and with Mission Directors.

A copy of any specific marking instructions or waivers from marking requirements is to be sent to the Contracting Officer; the original should be retained by the Contractor. SECTION E: INSPECTION AND ACCEPTANCE E. 1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (JUN 1988) The following contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAR “52.252-2 CLAUSES INCORPORATED BY REFERENCE” in Section I of this contract. See FAR 52.252-2 for an internet address (if specified) for electronic access to the full text of a clause. I. FEDERAL ACQUISITION REGULATION (48 CFR CHAPTER 1) CLAUSES Number Title Date 52.246-4 Inspection of Services- Fixed Price Aug 1996 E.2 INSPECTION AND ACCEPTANCE The Contractor's inspection and acceptance of services, reports and other required deliverables or outputs shall take place at: MSH, Ntaruka Street, Kiyovu, P O Box 371, Kigali, Rwanda Or at any other location where the services are performed and reports and deliverables or outputs are produced or submitted. The MSH HIV/PBF Technical Director has authority to inspect and accept all services, reports and required deliverables or outputs. Proof of final acceptance of the deliverables will be in writing, either through paper copy or email, by the MSH HIV/PBF Technical Director. E.3 MONITORING AND EVALUATION

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The multi-stage random sampling selection as described in annex, will be carried out on location at the CAAC/MOH, in presence of a CAAC representative, an MSH representative, and other agency representatives as deemed necessary by the CAAC. HDP shall, prior to starting its quarterly surveys, submit a written activity calendar to MSH and the CAAC. When HDP, due to circumstances, deviates from this activity calendar, it has to notify MSH and the CAAC in writing (which can be through email), at least 24 hours in advance of any changes. MSH retains the right to adapt the multi-stage random sampling protocol, according to perceived needs, and eventual changes or adaptations to the national protocol. MSH and the CAAC retain the right to participate in any aspect of the surveys without prior notification of HDP staff.

[End of Section E]

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SECTION F: DELIVERIES OR PERFORMANCE F.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (JUN 1988) The following Subcontract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAD “52.252-2 CLAUSES INCORPORATED BY REFERENCE” in Section I of this contract. See FAR 52.252-2 for an internet address (if specified) for electronic access to the full text of a clause. FEDERAL ACQUISITION REGULATION (48 CFR CHAPTER 1) CLAUSES Number Title Date 52.242-15 Stop-Work Order Apr 1989 Alternate I (April 1984) 52.247-34 F.O.B. Destination Nov 1991 52.248-48 F.O.B. Destination—Evidence of Shipment Feb 1999 F.2 PERIOD OF PERFORMANCE The period of performance for this subcontract is from September 1st 2008 to August 31st 2009. The Contractor may extend the term of this contract by written notice to the Subcontractor. F.3 DELIVERABLES

1. One Counter-Verification Report per quarter (see Attachment Two for Reporting Specifications). See table below for Submission Deadlines.

Survey Deadline of Submission3Q08 December 15, 2008 4Q08 March 1, 2009 1Q09 June 1, 2009 2Q09 August 31st, 2009

F.4 REPORTS AND DELIVERABLES OR OUTPUTS The Subcontractor shall credit USAID/ MSH in all public forums, correspondence or public endeavors supported in whole or in part under this subcontract. [End of Section F]

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SECTION G: CONTRACT ADMINISTRATION DATA G.1 ADMINISTRATIVE CONTRACTS OFFICE The Administrative Contracts Office is: Mr Ismael A. Sued Contract Specialist Ntaruka Street, Kiyovu, Kigali PO Box 371 Kigali, Rwanda G.2 TECHNICAL DIRECTIONS Performance of the work herein shall be subject to the technical directions of the MSH HIV/PBF Technical Director or delegate. As used herein, "Technical Directions" are directions to the Subcontractor which amplify project descriptions, inputs, activities and objectives, suggest project directions, or otherwise inform and complete the general scope of the work. "Technical Directions" must be within the terms of this subcontract, and shall not change or modify them in any way. G.3 The paying office for this subcontract is: MSH Rwanda HIV – PBF Project Ntaruka Street, Kiyovu, Kigali PO Box 371 Kigali, Rwanda G.4 PAYMENT

1. Payment will be made upon receipt and acceptance of the Deliverables described in Section F.3 above in accordance with the following payment schedule.

No Deliverable Fixed Price Payment (FRW) 1 2008 Quarter 3 Counter Verification Report 13,301,401 2 2008 Quarter 4 Counter Verification Report 13,301,401 3 2009 Quarter 1 Counter Verification Report 13,301,401 4 2009 Quarter 2 Counter Verification Report 13,301,401

2. Payment for deliverables described in Section F.3 under this subcontract will be made within 30 days of

receipt of an original invoice from the Subcontractor. In no event will the Subcontractor be reimbursed for costs in excess of the total fixed amount of 53,205,604.

3. Payments shall be made to the Subcontractor by way of bank transfer.

4. All invoices must reference the subcontract number noted on page one of this subcontract. Please use the invoice format included as Attachment Five.

[End of Section G]

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SECTION H: SPECIAL CONTRACT REQUIREMENTS H.1 NOTICE LISTING CONTRACT CLAUSES INCORPORATED BY REFERENCE

The following Subcontract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAD “52.252-2 CLAUSES INCORPORATED BY REFERENCE” in Section I of this contract. See FAR 52.252-2 for an internet address (if specified) for electronic access to the full text of a clause. Number Title Date 752.7027 Personnel Dec 1990

H.2 DRUG TRAFFICKING

Section 487 of the Foreign Assistance Act requires MSH to take reasonable steps to ensure that MSH is not providing assistance to or through convicted narcotics violators and/or probable drug traffickers. ADS 206 and State Department Regulations provide for a process of screening potential aid recipients and obtaining certifications from them before committing funds for recipients who are covered by the regulations. These regulations apply to assistance from USAID through MSH when it affects countries that are designated as major drug producers or major drug transit points. Subcontracts under $100,000 are not subject to the procedures unless the contractor has reason to believe the potential recipient may be involved in drug trafficking. MSH must obtain signed certifications from key personnel of the subcontractor affirming that they have not, in the last 10 years, been convicted of narcotics violations and are not involved in drug trafficking. The certification procedure also applies to individuals receiving participant training or scholarships and to both U.S. and non-U.S. NGOs, PVOs, and firms. It does not apply to foreign governments and PIOs. The subcontractor agrees that this subcontract may be terminated and MSH may seek refunds for drug-related offenses. The subcontractor promises to ensure that the assistance is not diverted to drug traffic.

H.3 TERRORIST FINANCING

The Subcontractor is reminded that U.S. Executive Orders and U.S. law prohibits transactions with, and the provision of resources and support to, individuals and organizations associated with terrorism. It is the legal responsibility of the Subcontractor to ensure compliance with these Executive Orders and laws. This provision must be included in all lower-tiered subcontracting or assistance/grant instruments issued under this subcontract. Section 2339A of the Title 18 of the United States Code prohibits the provision of the material or resources for terrorist acts. Section 2339B of Title 18 of the United States Code prohibits the provision of material support or resources to designated foreign terrorist organizations, and requires any U.S. financial institution that becomes aware that it has possession of, or control over, any funds in which a designated foreign terrorist organization, or its agent, has an interest, to retain possession of, or maintain control over, such funds and report to the Secretary of the Treasury the existence of such funds. OMB has approved the Agency’s information collection request under the Paperwork reduction Act allowing USAID to require applicants for assistance to give a certification that they do not support terrorism.

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MSH must obtain signed certification from both U.S. and non-U.S. organizations that they have not “engaged in terrorist activity”. This certification is an express term and condition of the agreement and any violation of it shall be grounds for unilateral termination of the agreement by MSH prior to the end of its term.

H.4 FOREIGN GOVERNMENT DELEGATIONS TO INTERNATIONAL CONFERENCES

Funds in this contract may not be used to finance the travel, per diem, hotel expenses, meals, conference fees or other conference costs for any member of a foreign government's delegation to an international conference sponsored by a public international organization, except as provided in ADS Mandatory Reference "Guidance on Funding Foreign Government Delegations to International Conferences [http://www.info.usaid.gov/pubs/ads/300/refindx3.htm] or as approved by the [CO/AO/CTO].

H.5 LOWER TIERED SUBCONTRACTING.

Approval must be obtained from MSH before the Subcontractor enters into a lower tiered subcontract. The request for approval should document the competition process that was used to select a lower tiered subcontractor, the subcontractor's proposed scope of work, and a detailed budget.

H.6 PHARMACEUTICALS

Pharmaceuticals are a restricted commodity under USAID funding. No costs for the purchase of pharmaceuticals shall be paid under this subcontract.

H.7- “ORGANIZATIONS ELIGIBLE FOR ASSISTANCE (ACQUISITION) (JUNE 2005)

An organization that is otherwise eligible to receive funds under this contract to prevent, treat, or monitor HIV/AIDS shall not be required to endorse or utilize a multisectoral approach to combating HIV/AIDS, or to endorse, utilize, or participate in a prevention method or treatment program to which the organization has a religious or moral objection.

H.8- CONDOMS (ACQUISITION) (JUNE 2005) Information provided about the use of condoms as part of projects or activities that are funded under this contract shall be medically accurate and shall include the public health benefits and failure rates of such use and shall be consistent with USAID’s fact sheet entitled, “USAID: HIV/STI Prevention and Condoms. This fact sheet may be accessed at: http://www.usaid.gov/our_work/global_health/aids/TechAreas/prevention/condomfactsheet.html

H.9 -“PROHIBITION ON THE PROMOTION OR ADVOCACY OF THE LEGALIZATION OR

PRACTICE OF PROSTITUTION OR SEX TRAFFICKING (ACQUISITION) (JUNE 2005)

(a) This contract is authorized under the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 (P.L. 108-25). This Act enunciates that the U.S. Government is opposed to prostitution and related activities, which are inherently harmful and dehumanizing, and contribute to the phenomenon of trafficking in persons. The contractor shall not use any of the funds made available under this contract to promote or advocate the legalization or practice of prostitution or sex trafficking. Nothing

Subcontract 001_HDP

in the preceding sentence shall be construed to preclude the provision to individuals of palliative care, treatment, or post-exposure pharmaceutical prophylaxis, and necessary pharmaceuticals and commodities, including test kits, condoms, and, when proven effective, microbicides.

(b) Except as provided in the second sentence of this paragraph, as a condition of entering into this contract or subcontract, a non-governmental organization or public international organization contractor/subcontractor must have a policy explicitly opposing prostitution and sex trafficking. The following organizations are exempt from this paragraph: the Global Fund to Fight AIDS, Tuberculosis and Malaria; the World Health Organization; the International AIDS Vaccine Initiative; and any United Nations agency.

(c) The following definition applies for purposes of this provision: Sex trafficking means the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act. 22 U.S.C. 7102(9).

(d) The contractor shall insert this clause in all subcontracts. (e) Any violation of this clause will result in the immediate termination of this contract by USAID.”

H.10 VOLUNTARY POPULATION PLANNING ACTIVITIES (JUNE 2008)

(a) Requirements for Voluntary Sterilization Program. None of the funds made available under this contract shall be used to pay for the performance of involuntary sterilization as a method of family planning or to coerce or provide any financial incentive to any individual to practice sterilization. (b) Prohibition on Abortion-Related Activities. (1) No funds made available under this contract will be used to finance, support, or be attributed to the following activities: (i) procurement or distribution of equipment intended to be used for the purpose of inducing abortions as a method of family planning; (ii) special fees or incentives to any person to coerce or motivate them to have abortions; (iii) payments to persons to perform abortions or to solicit persons to undergo abortions; (iv) information, education, training, or communication programs that seek to promote abortion as a method of family planning; and (v) lobbying for or against abortion. The term “motivate”, as it relates to family planning assistance, shall not be construed to prohibit the provision, consistent with local law, of information or counseling about all pregnancy options. (2) No funds made available under this contract will be used to pay for any biomedical research which relates, in whole or in part, to methods of, or the performance of, abortions or involuntary sterilizations as a means of family planning. Epidemiologic or descriptive research to assess the incidence, extent or consequences of abortions is not precluded. (c) The contractor shall insert this provision in all subcontracts.

H. 11 TAXES

Any taxes required to be paid by HDP as a result of this subcontract will be the responsibility HDP. MSH shall have no liability for taxes owed by HDP as a result of this subcontract.

H.12 KEY PERSONNEL

Due to the highly specialized nature of the work, key personnel of HDP that will be involved in organizing these surveys have been identified for this subcontract. Changes to key personnel can only take place with written, prior approval by the MSH HIV/PBF Contracts Specialist.

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These key personnel are: 1. Ms Tatiana UZAMUKUNDA. 2. Mr. Bernard NSENGIYUMVA

[End of Section H]

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SECTION I: CONTRACT CLAUSES I. 1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (JUN 1988 The following contract clauses pertinent to this section are hereby incorporated by reference (by Citation Number, Title, and Date) in accordance with the clause at FAD “52.252-2 CLAUSES INCORPORATED BY REFERENCE” in Section I of this contract. Upon request, the MSH Contract Specialist will make the full text available. Also, the full text of a clause may be accessed electronically at the following addresses: http:/www.arnet.gov/far http:/www.arnet.gov This subcontract incorporates one or more clauses by reference with the same force and effect as if they were given in full text. Unless specified otherwise, the following changes in reference points are made hereby to the cited clauses incorporated in this subcontract: FEDERAL ACQUISITION REGULATION (48 CFR CHAPTER 1) CLAUSES AND AID ACQUISITION REGULATION (48 CFR CHAPTER 7) CLAUSES FAR/AIDAR Clause Read as a. Contractor Subcontractor b. Contract Subcontract c. Any reference to the MSH Government, AID, etc. d. Subcontractor Lower-tiered Subcontractor e. Subcontract Lower-tiered Subcontract Complete copies of these documents may be purchased from the Superintendent of Documents, Government Printing Office, Washington, D.C. 20402. NUMBER TITLE DATE FEDERAL ACQUISITION REGULATION (48 CFR Chapter 1) 52.202-1 DEFINITIONS JUL 2004 52.203-3 GRATUITIES APR 1984 52.203-5 COVENANT AGAINST CONTINGENT FEES APR 1984 52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO JUL 1995 THE GOVERNMENT 52.203-7 ANTI-KICKBACK PROCEDURES JUL 1995 52.203-8 CANCELLATION, RESCISSION, AND RECOVERY JAN 1997 OF FUNDS FOR ILLEGAL OR IMPROPER ACTIVITY 52.203-10 PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR JAN 1997 IMPROPER ACTIVITY 52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE SEP 2005 CERTAIN FEDERAL TRANSACTIONS 52.204-4 PRINTED OR COPIED DOUBLE-SIDED AUG 2000 ON RECYCLED PAPER 52.209-6 PROTECTING THE GOVERNMENT'S INTEREST JAN 2005 WHEN SUBCONTRACTING WITH CONTRACTORS DEBARRED, SUSPENDED, OR PROPOSED FOR

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DEBARMENT 52.215-2 AUDIT AND RECORDS--NEGOTIATION JUN 1999 52.215-8 ORDER OF PRECEDENCE--UNIFORM CONTRACT OCT 1997 FORMAT

52.215-19 NOTIFICATION OF OWNERSHIP CHANGES OCT 1997 52.216-7 ALLOWABLE COST AND PAYMENT DEC 2002 52.217-2 CANCELLATION UNDER MULTIYEAR CONTRACTS OCT 1997 52.217-8 OPTION TO EXTEND SERVICES NOV 1999 52.219-4 NOTICE OF PRICE EVALUATION PREFERENCE JAN 1999 FOR HUBZONE SMALL BUSINESS CONCERNS (JUL 2005) 52.222-1 NOTICE TO THE GOVERNMENT OF LABOR FEB 1997 DISPUTES 52.222-6 DAVIS-BACON ACT JUL 2005 52.222-9 APPRENTICES AND TRAINEES JUL 2005 52.223-6 DRUG-FREE WORKPLACE MAY 2001 52.225-13 RESTRICTIONS ON CERTAIN FOREIGN FEB 2006 PURCHASES 52.225-14 INCONSISTENCY BETWEEN ENGLISH VERSION FEB 2000 AND TRANSLATION OF CONTRACT 52.227-2 NOTICE AND ASSISTANCE REGARDING PATENT AUG 1996 AND COPYRIGHT INFRINGEMENT 52.227-14 RIGHTS IN DATA--GENERAL JUN 1987 52.227-16 ADDITIONAL DATA REQUIREMENTS JUN 1987 52.228-7 INSURANCE--LIABILITY TO THIRD PERSONS MAR 1996 52.230-6 ADMINISTRATION OF COST ACCOUNTING APR 2005 STANDARDS

52.232-1 PAYMENTS APR 1984 52.232-9 LIMITATION ON WITHHOLDING OF PAYMENTS APR 1984 52.232-17 INTEREST JUN 1996 52.232-18 AVAILABILITY OF FUNDS APR 1984 52.232-22 LIMITATION OF FUNDS APR 1984 52.232-23 ASSIGNMENT OF CLAIMS JAN 1986 52.233-1 DISPUTES JUL 2002 52.233-3 PROTEST AFTER AWARD AUG 1996 ALTERNATE I (JUN 1985)

52.237-8 RESTRICTION ON SEVERANCE PAYMENTS TO OCT 1995 FOREIGN NATIONALS 52.237-9 WAIVER ON LIMITATION ON SEVERANCE OCT 1995 ALTERNATE I (JUN 1985)

52.242-1 NOTICE OF INTENT TO DISALLOW COSTS APR 1984 52.242-3 PENALTIES FOR UNALLOWABLE COSTS MAY 2001 52.242-4 CERTIFICATION OF FINAL INDIRECT COSTS JAN 1997 52.242-13 BANKRUPTCY JUL 1995 52.243-01 CHANGES – FIXED PRICE AUG 1987 ALTERNATE I APR 1984 52.244-2 SUBCONTRACTS AUG 1998 ALTERNATE II (AUG 1998) 52.244-5 COMPETITION IN SUBCONTRACTING DEC 1996 52.244-6 SUBCONTRACTS FOR COMMERCIAL ITEMS FEB 2006 AND COMMERCIAL COMPONENTS 52.245-5 GOVERNMENT PROPERTY (FIXED PRICE) MAY 2004

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52.246-25 LIMITATION OF LIABILITY--SERVICES FEB 1997 52.247-63 PREFERENCE FOR U.S.-FLAG AIR CARRIERS JUN 2003 52.247-64 PREFERENCE FOR PRIVATELY OWNED U.S.-FLAG FEB 2006 COMMERCIAL VESSELS 52.247-67 SUBMISSION OF COMMERCIAL TRANSPORTATION FEB 2006 BILLS TO THE GENERAL SERVICES ADMINISTRATION FOR AUDIT 52.248-1 VALUE ENGINEERING FEB 2000 52.249-2 TERMINATION (FIXED PRICE) MAY 2004

52.249-8 DEFAULT (FIXED PRICE SUPPLY AND SERVICE) APR 1984 52.253-1 COMPUTER GENERATED FORMS JAN 1991 52.246-1 CONTRACTOR INSPECTION REQUIREMENTS APR 1984 52.246-4 INSPECTION OF SERVICES - FIXED PRICE AUG 1996 52.252-2 CLAUSES INCORPORATED BY REFERENCE FEB 1998 A.I.D. ACQUISITION REGULATION (48 CFR CHAPTER 7) CLAUSES 752.202-1 DEFINITIONS 752.211-70 LANGUAGE AND MEASUREMENT JUN 1992 752.225-70 SOURCE, ORIGIN, AND NATIONALITY 752.225-71 LOCAL PROCUREMENT FEB 1997 752.226-3 LIMITATIONS ON SUBCONTRACTING JUN 1993 752.228-7 INSURANCE-LIABILITY TO THIRD PERSONS 752.231-71 SALARY SUPPLEMENTS FOR HG EMPLOYEES OCT 1998

752.245-5 GOVERNMENT PROPERTY – (FIXED PRICE) DEC 1989 752.245-71 TITLE TO AND CARE OF PROPERTY

752.7001 BIOGRAPHICAL DATA JUL 1997 752.7002 TRAVEL AND TRANSPORTATION JAN 1990 752.7005 SUBMISSION REQUIREMENTS FOR DEVELOPMENT EXPERIENCE DOCUMENTS 752.7006 NOTICES APR 1984 752.7007 PERSONNEL COMPENSATION JUL 1996 752.7008 USE OF GOVERNMENT FACILITIES OR APR 1984 PERSONNEL

752.7009 MARKING AND COMPLIANCE WITH THE USAID GRAPHICS STANDARDS MANUAL

752.7013 CONTRACTOR-MISSION RELATIONSHIPS OCT 1989 752.7014 NOTICE OF CHANGES IN TRAVEL REGULATIONS JAN 1990 752.7018 HEALTH AND ACCIDENT COVERAGE FOR JAN 1999 USAID PARTICIPANT TRAINEES 752.7019 PARTICIPANT TRAINING JAN 1999 752.7023 REQUIRED VISA FORM FOR USAID APR 1984 PARTICIPANTS 752.7025 APPROVALS APR 1984 752.7031 LEAVE AND HOLIDAYS OCT 1989 752.7034 ACKNOWLEDGEMENT AND DISCLAIMER DEC 1991

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I.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This Subcontract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contract Specialist will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address (es): http://www.arnet.gov/far 752.242-70 Periodic Progress Reports See CIB 98-21. I.3 COMMUNICATIONS PRODUCTS (OCT 1994) (a) Definition - Communications products are any printed materials (other than non-color photocopy material), photographic services or video production services. (b) Standards - USAID has established standards for communications products. These standards must be followed unless otherwise specifically provided in the contract or approved in writing by the contracting officer. (c) Communications products which meet any of the following criteria are not eligible for USAID financing under this agreement unless specifically authorized in the contract or in writing by the contracting officer:

(1) All communications materials funded by operating expense account fund (2) Any communication products costing over $25,000, including the costs of both preparation and execution. For example, in the case of a publication, the costs will include research, writing and other editorial services (including any associated overhead), design, layout and production costs. (3) Any communication products that will be sent directly to, or likely to be seen by, a Member of Congress or Congressional staffer; and (4) Any publication that will have more than 50 percent of its copies distributed in the United States (excluding copies provided to CDIE and other USAID/W offices for internal use.

(d) The initial proposal must provide a separate estimate of the cost of every communications product as defined in paragraph (a) above (not just those which meet the criteria in paragraph (d)) which is anticipated under the contract. Each estimate must include all of the costs associated with preparation and execution of the product. Any subsequent request for approval of a covered communication product must the same type of cost information.

(End of Section I)

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SECTION J: LIST OF ATTACHMENTS

Attachment One: National Quantity Counter-Verification Protocol Attachment Two: Reporting Schedule and Report Specifications Attachment Three: Certification Regarding Terrorist Financing Implementing E.O.13224 (Revision

2) Attachment Four: Key Individual Certification/Narcotics Offenses and Drug Trafficking Attachment Five: Standard invoice format

[End of Section J]

Subcontract 001_HDP

Attachment One:

Protocol

For a

Community Survey for Reported Quantity Performance

In

………………….District

1. This protocol will be applied to the quantity results obtained by …………Health Center.

2. The protocol will be applied for approved results reported during a preceding six-

month period.

3. The organization carrying out the third party evaluation, has been mandated by the CAAC/MOH to organize such an evaluation, following the below protocol. This mandated organization is called the ‘Agency’.

4. The following steps will be followed:

The Agency will contact the Director of Health/President of the PBF steering committee for a meeting, present in the meeting will be a representative of the Agency, the president of the PBF steering committee or his or her designate, and the director of the hospital or his or her designate

The excel sheet in Annex QUAL_1 will be used to list in alphabetical order the names of the health centers. These names will have the same order as in the quarterly invoice produced by the PBF BDD. The health facilities will be numbered.

20% (twenty percent) of health facilities will be chosen randomly, using the Random Generator of Microsoft Excel3. In case decimals appear, the figure is rounded upwards. For instance, when a district has 9 health centers, then 9/5 = 1.8, therefore 2 health centers will be drawn randomly.

The Random generator4 is used as follows: in the first row fill in 1 to ‘the number of health facilities’, in the case of Gicumbi, which has 20 health facilities, the figures are 1 to 20. Then, the ‘integer’ button is clicked. A number is generated, which is marked in Annex QUAL_1, next to the health facility in question, using a color, for instance red. This process is repeated until the 20% of health facilities have been randomly chosen.

3 http://www.ablebits.com/excel-random-generator-assistant-free-addins/index.php?r1=OMP&r2=randomgen 4 If in case the random generator does not work, or is not available, use any other appropriate method, such as for instance using numbered pieces of paper.

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The chosen Health Facilities are indicated in the column ‘choix’ in the table QUAL_1.

Then using QUAL_3 and the Random Generator chose 20% of the PMA indicators rounding upwards, i.e. three indicators. When HIV services are available, also choose two indicators from the list of HIV indicators with the same methodology. When HIV services are not available, select two additional PMA indicators (bringing the total PMA indicators selected to five in the absence of HIV services).

For each of the chosen indicators, the evaluation team will travel to the selected health facilities, and sample randomly from the primary register books related to the sampled indicator.

For selecting the sample in the register book: 1. Determine the exact number of remunerated indicators over the

preceding six month period. This can be through extracting from the PBF BDD using an excel pivot, or by counting the number of acts in the individual monthly reports (through the web application);

2. Divide this number by 15. This will give you the sampling frame for this indicator;

3. Arriving at the health center find the primary register related to this indicator;

4. Verify, e.g. through the serial numbers, whether the totals match; 5. Ask anybody a number between one and 10. Start with this

number as from the date of sampling. E.g. you sample January 1st to June 30th; the number provided by e.g. the cleaning lady or a patient is ‘6’, then start with the sixth entry in the register book. Then count 15 entries, each time using the sampling frame. For instance: when the total number of acts was 567 over six months, then the sampling frame is 38, and the following numbers are then selected: 6; 44; 82; 120; 158; 196; 234; 272; etc till you have 15 samples. You can also generate a random number using Random Generator.

6. When sampling HIV data and you sample a client with a positive test result, skip this client and then take the next negative result.

7. Collect the information related to these 15 clients using the Data_Collection_1 template. Using a small notebook would be the most efficient, with each page one client/service.

8. Transpose data from the Data_Collection_1 form to the Data_Collection_2 form. Only name and location data are provided here; the surveyors have to find the client, and then ask questions related to (i) date of visit; (ii) type of service used and (iii) satisfaction.

9. Let the grass-root organizations find these clients in the community.

10. Compile data. This can be done manually in Excel, or using a statistical program like SPSS or EPI Info;

11. Keep survey data sheets for at least two years.

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The meeting ends with (i) an agreement on the chosen health facilities; (ii) a decision how to move forward, for instance which grass-root organization to use, see point five below- and (iii) a timeframe in which the community survey ought to have taken place. Always involve USF and Hospital staff (district PBF steering committee members) in these surveys.

Figure: the XL Random Number Generator

5. Guidelines on using community organizations for counter-verification of quantity

data: a) Contact a suitable organization (e.g. a CHW cooperative or an

organization of People Living with HIV) for each Health Center that has been chosen. When doing a counter-verification for HIV, an organization of People Living with HIV should be contacted, who besides the HIV indicators can also do the PMA;

b) Members that will be used need to be literate (Kinyarwanda); c) The first time, these members need to be trained. MSH can assist with

providing the field-tested curriculum; d) Best to agree on a pay-per-case basis: for each well-filled questionnaire. e) Always provide feed-back to these partner-organizations on their

performance, the results obtained, and ensure that when results are presented in the PBF district steering committees, a representative of this partner organization is present.

Next steps:

6. A short maximum fifteen-page report will be written by the Agency on the results of this community survey. A section should also summarize the qualitative feedback of clients on the services received. This report will be submitted to the District PBF Steering Committee members at least one week prior to the first District Comite de Pilotage meeting following this evaluation. Transmission is by

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email, the District Director of Health is responsible for sending hard copies to those members who do not have an email address. The CAAC/MOH must be copied on all such reports.

Proposed interpretation of results:

7. The report’s findings will be discussed in the district PBF steering committee. When multiple patients or clients cannot be found in the community without any good reason (a good reason would for instance be: (i) from another district or (ii) moved to another location or (iii) died), the steering committee might either decide on sanctions (as described in the purchase contracts) or decide to investigate the matter deeper.

8. Further guidelines on how to interpret results will be issued by the CAAC/MOH

in the near future.

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Annex QUAL_1. Table of listed Health Facilities

No Centre de Sante Choix1 Centre de Sante A2 Centre de Sante B3 etc456789

1011121314151617181920

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Annex QUAL_3. Table with the list of PMA and HIV indicators

No Paquet Minimum des Activites Choix1 CPC - Nouveaux cas2 CPN - Femmes avec 4 visites3 CPN – VAT 2 - 54 CPN - 2ème prise de Sulfadoxine5 Suivi de la croissance : enfant de 11 a 59 mois consultés (CS)6 Suivi de la croissance : enfant de 11 a 59 mois consultés (PNBC)7 Malnutris : Hospitalise sortant guéri ou réfère8 P.F : Nouvelle utilisatrice9 P.F : Utilisatrice en fin du mois

10 Vaccination : Enfant complètement Vaccine11 Accouchement assiste au CS12 Accouchement: reference d'urgence pour accouchement13 References pour malnutrition severe14 Refeences d'urgence

No VIH Choix1 VCT- clients testes2 PMTCT: nombre de couples testés pour le VIH3 PMTCT: nombre de femmes VIH+ sous traitement ARV pendant le travail4 PMTCT : Enfants exposés testés pour VIH5 Soins : Nombre de clients VIH+ testés pour CD4 chaque six-mois6 Soins : Nombre de clients VIH+ traités aux CTX chaque mois7 VIH prevention: Nombre des femmes VIH+ qui utilisent le PF8 TB/MST: Nombre des patients VIH+ qui ont etes examines pour TB

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Questionnaire

Use the official questionnaire designed to be used for data entry in EpiInfo, in French and Kinyarwanda, found below. ________________________________________________________________________

Questionnaire d’enquête dans la communauté (FR) v080924

Nom de l’enquêteur Province District Centre de santé Nom de la personne qui a tire l’échantillon Nom de l’association Nom et Prénom du Client Secteur Cellule Chef de Famille

Date de visite de l’enquêteur (jj-mm-aa) La nommée…………………………………… est-elle reconnu(e) ? (Oui/Non)

Si la précédente personne existe, qui a confirmé son existence ? Lui-même ? Oui/Non

Un membre de la famille? Oui/Non Le responsable du village? Oui/Non ;

Autre : Avez-vous consulte le centre de sante de :……………………(Oui/Non)

Si oui, quel service avez-vous consulte?1 PMA : Consultation

Générale

2 PMA : CPN 3 PMA : PEV 4 PMA : Nutrition 5 PMA : Accouchement

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6 PMA : PF 7 PMA : Références 8 VIH : VCT 9 VIH : PMTCT

10 VIH : ARV 11 VIH : Soins Palliatifs

Si oui, quant est ce que vous avez été en consultation ou reçu le service ? (jj-mm-aa)

Y’a-t-il des propositions de solution pour l’amélioration de la qualité des services dans votre formation sanitaire ?

Au cas ou les services CPN, PF ou Accouchements sont utilisées : demandez les questions suivantes :

CPN

Est-ce que la carte CPN existe ? (Oui/Non) Si Oui : Quel est son numéro ?

PF Est-ce que la carte CPN existe ? (Oui/Non) Si Oui : Quel est son numéro ?

Accouchement A quel date avez vous accouche (mentionne mois et année minimum)?

Avez-vous accouché un garçon ou une fille? Nom de l’enquêteur: Date et signature

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Questionnaire d’enquête dans la communauté (Kinyarwanda) v080924

Izina ry ‘umuntu wakoze iperereza Intara Akarere Ikigo nderabuzima Izina ry’umugenzuzi Izina ry’ishyirahamwe Amazina yombi Umurenge Akagari Umukuru

w’umuryangu

Itariki y’isura (umunsi w’isura – ukwezi - umwaka) A.Ese uyu …………………………………… arazwi? (Yego/ Oya)

Niba azwi ninde wabyemeje?

We ubwe Yego/Oya Umuntu wo mu muryang o. Yego/Oya

Umuyobozi w’umudugudu ? Yego/Oya Abandi :

Mbese mwaba mwarisuzumishije mu ivuriro ry:…………………( Yego/ oya)

Niba ari yego; Mwisuzumishije iki? 1 Kwisuzumisha 2 Gusumisha inda 3 Gukingira 4 Gupimusha abana 5 Kubyarira kwa muganga (Maternite) 6 Service yo kuringaniza urubyaro (PF) 7 Kohereza mu bitaro 8 Gupimisha ibizami by’agako gatera sida

(VCT)

9 Gupimisha ibizami by’agako gatera sida ku babyeyi (umugore n’umugabo)

(PMTCT)

10 Imiti igabanya ubukana (ARV) 11 Gufasha abafite ubwandu (Soins

Palliatifs)

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Niba ari yego ;Mwisuzumishije ryari? Italiki………/ukwezi……./umwaka

Mutange ibyifuzo ivuriro ryanyu ryakurikiza kugirango rirusheho kunoza imikorere mu bijyanye no kwizumisha

Niba mwarasuzumishije inda, mwararinganije urubyaro, mwarabyaye : baza ibibazo bikukira :

Mwarasuzumishije inda

Umubyeyi afite agakarita yahawe no kwa muganga ?Yego/Oya

Nimero : Mwararinganije urubyaro

Umubyeyi afite agakarita yahawe no kwa muganga ?Yego/Oya

Nimero : Mwarabyaye

Niba aribyo, mwabyaye ryari? Itariki…………ukwezi………umwaka

Mwabyaye Umuhungu/ Umukobwa Izina ryumuntu wakoze iperereza Itariki n’umukono

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ATTACHMENT TWO: REPORTING SCHEDULE and REPORT SPECIFICATIONS

Report Submission Schedule

Survey Deadline of Submission Report3Q08 December 15, 2008 4Q08 March 1, 2009 1Q09 June 1, 2009 2Q09 August 31st, 2009

Report Specifications Each of the below elements 1 to 4, including their sub points, should be met, in order for a report to be considered by the MSH HIV/PBF Technical Director. The MSH HIV/PBF Technical Director retains the right to reject a report if it (i) does not respond to the specifications 1 to 4 with their sub points below, (ii) deviates from the prevailing national protocol without prior written approval from the MSH HIV/PBF Technical Director and (iii) if the report is submitted more than three weeks after its deadline (specified in the schedule above), without prior written approval from the MSH HIV/PBF Technical Director.

1. Each Report should be in French or English language and submitted in 3 copies; 2 for MSH and 1 for the CAAC/MOH. If the report is in the French Language, then in that case the Summary should be both in French and in English.

2. The main report, excluding annexes and literature references, should not be more than 15 pages,

Times New Roman 12, single spaced.

3. The Main report should contain:

a) Short Summary (half page) b) Description of the Methodology, and reasons for eventual adaptation or deviation from

the protocol (half page) c) Description of the selection process of grass root organization and surveyors (1 page) d) Description of the survey with the results of at the least 750 client community

interviews carried out according to the protocol in attachment I. e) Description of the findings f) Description of the dissemination process (four District PBF Steering Committees; Health

Center Managements; Grass Root Organizations) g) Conclusions and Recommendations

4. Annexes should contain, at the least:

a) Listing of the selected district, health centers and health service indicators b) Listing of the people involved (central; district; health facility; grass root organization,

including their contact information such as mobile telephone numbers) c) AOB

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ATTACHMENT THREE:

Certification Regarding Terrorist Financing Implementing E.O.13224 (Revision 2)

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ATTACHMENT FOUR: Key Individual Certification Narcotics Offenses and Drug Trafficking I hereby certify that within the last ten years: 1. I have not been convicted of a violation of, or a conspiracy to violate, any law or regulation of the United States or any other country concerning narcotic or psychotropic drugs or other controlled substances. 2. I am not and have not been an illicit trafficker in any such drug or controlled substance. 3. I am not and have not been a knowing assistor, abettor, conspirator, or colluder with others in the illicit trafficking in any such drug or substance. Signature: ____________________________ Date: ____________________________ Name: ____________________________ Title/Position: ____________________________ Organization: ____________________________ Address: ____________________________ ____________________________ Date of Birth: ____________________________ NOTICE: 1. You are required to sign this Certification under the provisions of 22 CFR Part 140, Prohibition on Assistance to Drug Traffickers. These regulations were issued by the Department of State and require that certain key individuals of organizations must sign this Certification. 2. If you make a false Certification you are subject to U.S. criminal prosecution under 18 U.S.C. 1001.

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ATTACHMENT FIVE: INVOICE FORMAT

(*Note: invoice should be on the Subcontractor’s letterhead)

The Subcontractor will submit to MSH one original copy in the following format: Date: Contract No: Invoice Number: Submitted to: Management Sciences for Health (MSH) Attention: Mr Ismael Amri SUED, Contracts Specialist Submitted by: (Name) (Address) This invoice is for (description of services): Total Amount of Invoice: RWF ______________

Total Amount of Fixed Price Subcontract: RWF____________

Total Amount Paid to Date (not including this invoice): RWF____________

Balance of total Fixed Price Subcontract: RWF____________ The undersigned hereby certifies: (i) this invoice and any attachments have been prepared from the books and records of the Subcontractor in accordance with the terms of this subontract, and to the best of my knowledge and belief, that they are correct, that the sum claimed under this contract is proper and due, that all the costs of contract performance (except as herewith reported in writing) have been paid or will be paid currently by MSH when due in the ordinary course of business, that the work reflected by the costs above has been performed, that the quantities and amounts involved are consistent with the requirements of this subontract, that all required MSH Contract Officer approvals have been obtained, and (ii) appropriate refund to MSH will be made promptly upon request in the event of disallowance of costs not allowable under the terms of this subontract. Signature: _____________________________ Date: ___________________