Governor and Executive Council Agenda item PDF - 2026-03-25 - agenda 26

Meeting Date

2026-03-25

Attachment Kind Label

Agenda item PDF

Attachment Relation

primary_meeting_attachment

Agenda Numbers

26

Agency Names

Department Of Information Technology

Parent Meeting Title

Governor and Executive Council meeting - 2026-03-25

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B^04C71579FC4

New Hampshire

DolT

STATE OF NEW HAMPSHIRE

DEPARTMENT OF INFORMATION TECHNOLOGY

27 Hazen Drive | Concord, NH | 03301

Fax; (603) 271-1516 | TDD: (800) 753-2964

doit.nh.Qov

Denis Goulet, Commissioner

^6^MAR 2 5 2026

January 23,2026

Her Excellency, Governor Kelly A. Ayotte

and the Honorable Council

State House

Concord, New Hampshire 03301

REOUESimACTlQN

Authorize the Department of Information Technology (DolT) on behalf of the Department of

Health and Human Services, Division of Economic Stability ("Department"), to amend an existing

contract with Konica Minolta Business Solutions U.S.A, Inc. (VC #177612), Ramsey, NJ, to continue

providing maintenance, support, and operation services for the Department's electronic content

management system, known as OnBase, as wetl as perform upgrades, by exercising a contract

renewal option by increasing the price limitation by $400,000 from $532,151 to $932,151 and

extending the completion date from June 30, 2026 to June 30, 2028, effective July 1, 2026, upon

Governor and Council approval. 100% Other Funds (Agency Class 27).

The original contract was approved by Governor and Council on June 29,2022, item #77, and

amended on October 18,2023, item #46.

The agency Class 27 funds used by the Department to reimburse DolT for this contract is 66%

Federal Funds and 34% General Funds. Funds are available in the following account for State Fiscal

Year 2027 and are anticipated to be available in State Fiscal Year 2028 upon the availability and

continued appropriation of funds in the future operating budget, with the authority to adjust budget

line items within the price limitation and encumbrances between state fiscal years through the

Budget Office, if needed and justified.

01-03-03-030010-76950000 DEPARTMENT OF INFORMATION TECHNOLOGY. INFORMATION

TECHNOLOGY DEPT OF - IT FOR DHHS

State

Fiscal

Year

Class/Account Class Title Job Number Total

2027 038-509038 Technology Software 03950040 $200,000

2028 038-509038 Technology Software 03950040 $200,000

Total $400,000

EXPUNATIQN

The purpose of this request is to exercise an available contract renewal option to ensure

continued, ongoing maintenance; support; and operation of the Department's electronic content

management system, known as OnBase, for four (4) Department program areas, specifically the

Bureau of Child Support Sen/ices, Bureau of Family Assistance, Bureau of Adult and Aging Services,

and the Division for Children, Youth and Families. The electronic content management system

allows respective Department staff, statewide, to access documents and case files electronically to

"Inrtovative Technologies Today for New Hampshire's Tomorrow"

Ddcusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

Her Excellency, Governor Kelly A. Ayotte

and the Honorable Council

efficiently manage caseloads. The electronic content management system platform meets privacy

requirements and supports the Department's infrastructure.

Additionally, the Contractor will continue providing support for system enhancements and

upgrades, such as integration services into Microsoft 365 and security.

The Department will continue monitoring services to ensure:

• The system is continually meeting the needs of the Department, including data

security and privacy requirements:

• The Contractor is responsive to requests for technical assistance, system

patching, maintenance support, issue resolution, and system enhancements and

upgrades; and

• The Contractor is providing required reports and services in accordance with the

contract.

As referenced in Exhibit A, Special Provisions of the original agreement, the parties have the

option to extend the agreement for up to two (2) additional years, contingent upon satisfactory

delivery of services, available funding, agreement of the parties and Governor and Council approval.

The Department is exercising its option to renew services for two (2) years of the two (2) years

available.

Should the Governor and Council not authorize this request, the Department will not receive

necessary electronic content management system support and maintenance or have electronic

access to case files and necessary documents, which would adversely impact Department

operations and services for NH residents.

Area served: Statewide.

Source of Federal Funds: Assistance Listing Number #93.563, FAIN #2601NHSCSS.

Respectfully submitted.

Denis Goulet

Commissioner,

Department of Information Technology

Lori A. Weaver

Commissioner.

Department of Health and Human

Services

DolT #2022-0568

RID #100394, 75743

cc: Kenneth Gagne, IT Manager

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

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STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RFP-2023-DEHS-04-ONBAS-01-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RrP-2023-DEHS-04-ONBAS-01-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

INTRODUCTION

WHEREAS, pursuant to an Agreement approved by Governor and Council, as a result of REP DoIT

#2022-056 on June 29,2022, Item #77 and amended on October 18,2023, Item # 46 (herein after referred

to as the "Agreement"), Konica Minolta Business Solutions U.S.A, Inc. (hereinafter referred to as

"Contractor") agreed to supply certain services upon the terms and conditions specified in the Agreement

and in consideration of payment by the Department of Information Technology (hereinafter referred to as

"the Department"), certain sums as specified therein;

WHEREAS, pursuant to the Agreement Section 17: Amendment and the provisions of the Agreement, the

Agreement may be modified or amended only by a written instrument executed by the parties thereto and

approved by the Governor and Executive Council;

WHEREAS, the Contractor and the Department have agreed to amend the Agreement in certain respects;

WHEREAS, the Department wishes to enter into an amendment to an existing contract to clarify the

statement of work and to exercise a contract renewal option and increase the price limitation;

WHEREAS, The Contractor agrees to provide ongoing technical assistance, system patching, maintenance

support, issue resolution, and system enhancements and upgrades as needed by the Department of Health

and Human Services for its enterprise content management system, OnBase;

WHEREAS, the Department and the Contractor wish to extend the completion date from June 30, 2026 to

June 30, 2028;

WHEREAS, the Department and the Contractor wish to increase the Contract price by $400,000 to bring

the total contract price to S932,151; and

WHEREAS, the Department and the Contractor seek to clarify the Agreement.

NOW THEREFORE, in consideration of the foregoing, and the covenants and conditions contained in the

Agreement and set forth herein, the parties agree as follows:

The Agreement is hereby amended as follows:

1. Modify the New Hampshire P-37 General Provisions, Section 1.3 Contractor Name to Konica

Minolta Business Solutions U.S.A, Inc.

2. Modify the State of New Hampshire P-37 General Provisions, Section 1.7, Completion Date to June

30, 2028.

3. Modify the State of New Hampshire P-37 General Provisions, Section I. by increasing the Price

Limitation by $400,000 from $532,151 to $932,151.

S€state

Date:

Contractor's Initials:

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RFP-2023-DEHS-04-ONBAS-01-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

4. The Agreement is further amended as described in Table 1, Amendment Details, below:

TABLE 1: AMENDMENT DETAILS

Exhibit A

Special

Provisions

AMENDED TEXT

Section A.9 Modify Exhibit A - Special Provisions, by adding Section A.9, to read:

A.9 Provision 6, Compliance by Contractor with Laws and Regulations/Equal

Employment Opportunity, Paragraph 6.1, is deleted and replaced with the

following:

6.1 In connection with the performance of the Services, the Contractor shall

comply with all applicable statutes, laws, regulations, and orders of federal,

state, county or municipal authorities which impose any obligation or duty

upon the Contractor, including, but not limited to, RSA 151:21 Patients'

Bill of Rights, civil rights and equal employment opportunity laws, and the

Governor's order on Respect and Civility in the Workplace, Executive

Order 2020-01. In addition, if this Agreement is funded in any part by

monies of the United States, the Contractor shall comply with all federal

executive orders, rules, regulations and statutes, and with any rules,

regulations and guidelines as the State or the United States issue to

implement these regulations. The Contractor shall also comply with all

applicable intellectual property laws.

Exhibit B

Statement of

Work

(SOW)

AMENDED TEXT

Section 1 Modify Exhibit B - Statement of Work (SOW) Business and Technical

Requirements and Deliverables; Section 1, Statement of Work; first paragraph,

to read:

The Contractor shall perform ongoing maintenance, support, and

operation of the New Hampshire Department of Health and Human

Services' ("Department") enterprise content management system,

OnBase. As part of the scope of work, the Contractor shall provide

technical assistance, system patching, maintenance support, issue

resolution, and system upgrades and enhancements, including any

additional professional labor or consulting services as required by the

Department. This shall include upgrades to OnBase every other year,

integration services into Microsoft 365, and any needed assessments of

State (^;^|l/f^ract

Date:

Contractor's Initials:

Page 3 of?

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RFP-2023-DEHS-04-ONBAS-01-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

the current operating environment. These services must be available

during normal business hours and on an as-needed basis for emergencies

to address issues with minimal disruption to staff.

Exhibit C

Price and

Payment

Schedule

AMENDED TEXT

Section 9 Modify Exhibit C - Price and Payment Schedule; Section 9, Payment Schedule;

Paragraph 9.1.4., Software Operations, Maintenance and Support Pricing; Table

E-1.4., to read:

Table E-1.4.

SOFTWARE OPERATIONS, MAINTENANCE, AND SUPPORT PRICING

WORKSHEET

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Total

$111,632 $117,213 $123,079 $129,227 $135,688 $142,472 $759,311

Exhibit C

Price and

Payment

Schedule

AMENDED TEXT

Section 9 Modify Exhibit C - Price and Payment Schedule; Section 9, Payment

Schedule; Paragraph 9.1.6., Other Cost Pricing; Table E-1.6. to read:

Table E-1.6.

SYSTEM ENHANCEMENTS AND UPGRADES PRICING

Year 24 Year 25 Year 26 Year 27 Year 28 Total

$51,000 $0 SO $64,312 $57,528 $172,840

Exhibit C

Price and

Payment

Schedule

AMENDED TEXT

State (^f/^^ract

Date:

Contractor's Initials:

Page

S€

4 of 7

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RFP-2023-DEHS-04-ONBAS-01-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

Section 9 Modify Exhibit C - Price and Payment Schedule; Section 9, Payment

Schedule; Paragraph 9.1.7., Implementation Pricing Summary,

Implementation Cost Summary Pricing Worksheet, to read:

IMPLEMENTATION COST SUMMARY PRICING WORKSHEET

COST

TABLE

#

COST TYPE SPY 2023 SPY 2024 SPY 2025 SPY 2026 SPY 2027 SPY 2028

TOTAL

COST

I

Activities/Deliverables

/Milestones Pricing

(Total from Activity/

Deliverables/

Milestones Pricing

Worksheet)

$0 $0 $0 $0 $0 $0 $0

2

Hardware Pricing

(Total from Hardware

Pricing Worksheet)

$0 $0 $0 $0 $0 $0 $0

3

Software License

Pricing (Total from

Software License

Pricing Worksheet)

$0 $0 $0 $0 $0 $0 $0

4

Software Operations,

Maintenance, and

Support Pricing (Total

from Software

Operations,

Maintenance, and

Support Pricing

Worksheet)

$111,632 $117,213 $123,079 $129,227 $135,688 $142,472 $759,311

5

Hosting Pricing (Total

from Hosting Detail

Pricing Worksheet)

SO $0 $0 $0 $0 $0 $0

6

Other Pricing (Total

from Other Cost

Pricing Worksheet)

$0 $51,000 $0 $0 $64,312 $57,528 $172,840

Total $111,632 $168,213 $123,079 $129,227 $200,000 $200,000 $932,151

ractState

Date:

Contractor's Initials:

Page

S€

5 of?

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

5.

STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RFP-2023-DEHS-04-ONBAS-01-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

The Agreement is further amended as described in Table 2, Contract History.

TABLE 2: CONTRACT HISTORY

CONTRACT AND

AMENDMENT

NUMBER

AMENDMENT

TYPE

G&C

APPROVAL

DATE

COMPLETION

DATE

CONTRACT

AMOUNT

DoIT # 2022-056 Original

Contract

June 29,2022,

Item #77

June 30,2026 $481,151

DoIT # 2022-056A

Amendment 1

P' Amendment October 18,

2023, Item #46

June 30, 2026 $51,000

DoIT # 2022-056B

Amendment 2

2"'' Amendment TBD June 30,2028 $400,000

CONTRACT TOTAL $932,151

Contractor's Initials:

Page 6 of?

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

STATE OF NEW HAMPSHIRE

Division of Economic Stability, Bureau of Child Support Services

DoIT # 2022-056B - RFP-2023-DEHS-04-ONBAS-0I-A02

OnBase Enterprise Content Management Solution

AMENDMENT Amend B (2)

Except as provided herein, all provisions of the Agreement shall remain in full force and effect. This

Amendment shall take effect July 1, 2026, upon Governor and Council approval.

IN WITNESS WHEREOF, the parties have hereunto set their hands as of the day and year first above

written.

CONTRACTOR

DocuSigned by:

2/18/2026

Date:5r2eOOD9701D^DO..

Salvatore Errigo, President & CEO

Konica Minolta Business Solutions U.S.A., Inc.

STATE OF NEW HAMPSHIRE

^ Date: January 28, 2026

Denis Goulet, Commissioner/CIO

State of New Hampshire, Department of Information Technology

The preceding Amendment, having been reviewed by this office, is approved as to form, substance, and

execution.

Approved by the Attorney General

—DocuSlgned by:

2/19/2026

State oft^ewiflampshire. Department of JusticeRobyn Guarinipj..,.of,ney

I hereby certify that the foregoing amendment was approved by the Governor and Executive Council of

the State of New Hampshire at the Meeting on: (date of meeting)

Office of the Secretary of State

Date:

State of New Hampshire, Department of Administration

-OS

Contractor's Initials:

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

State of New Hampshire

Department of State

CERTIFICATE

1, David M. Scanlan, Secretary of State of the State of New Hampshire, do hereby certify that KONICA MINOLTA BUSINESS

SOLUTIONS U.S.A., INC. is a New York Profit Corporation registered to transact business in New Hampshire on June 11, 1999.

I further certify that all fees and documents required by the Secretary of State's office have been received and is in good standing

as far as this office is concerned.

Business ID: 316620

Certificate Number: 0007766215

IN TESTIMONY WHEREOF,

I hereto set my hand and cause to be affixed

the Seal of the State of New Hampshire,

this 30th day of January A.D. 2026.

David M. Scanlan

Secretary of State

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

CERTIFICATE OF AUTHORITY

1. Myrttia Eugene ^ hereby certify that:

(Name of the elected Officer of the Corporation/LLC; cannot be contract signatory)

1.1 am a duly elected Clerk/Secretary/Officer of Konica Minolta Business Solutions U.S.A., Inc.

(Corporation/LLC Name)

2. The following is a true copy of a vote taken at a meeting of the Board of Directors/shareholders, duly called and

held on August 23rd, 2005. at which a quorum of the Directors/shareholders were present and voting.

(Date)

VOTED: That Salvatore Errlgo, CEO & President (may list more than one person)

(Name and Title of Contract Signatory)

is duly authorized on behalf of Komca Minoin Bmmese soimion» u.s a., mc. <o enter into contracts or agreements with the State

(Name of Corporation/ LLC)

of New Hampshire and any of its agencies or departments and further is authorized to execute any and all

documents, agreements and other instruments, and any amendments, revisions, or modifications thereto, which

may in his/her judgment be desirable or necessary to effect the purpose of this vote.

3. I hereby certify that said vote has not been amended or repealed and remains in full force and effect as of the

date of the contract/contract amendment to which this certificate is attached. This authority remains valid for

thirty (30) days from the date of this Certificate of Authority. I further certify that it is understood that the State of

New Hampshire will rely on this certificate as evidence that the person(s) listed above currently occupy the

posltion(s) indicated and that they have full authority to bind the corporation. To the extent that there are any

limits on the authority of any listed individual to bind the corporatioryie-ec^ntracts with the State of New Hampshire,

all such limitations are expressly stated herein.

Dated: 2/12/2026,

^gn^urg/df Elected Officer

Nam^!^yrtha Eugene

Tine: Assistant Secretary

<■4

Rev. 03/24/20

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

CERTIFICATE OF LIABILITY INSURANCE

DATE(MM/DDAni'YY)

09/22/2026

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES

BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(le8) must have ADDITIONAL INSURED provisions or be endorsed. If

SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this

certificate does not confer rights to the certificate holder In lieu of such endorsement(s).

PRODUCER

Aon Risk Services Northeast, Inc.

New York NY Office

One Liberty Plaza

165 Broadway, Suite 3201

New York NY 10006 USA

W0.EXO; C866) 283-7122 (800) 363-0105

iiS&R^es:

iNSURER(8] AFFORDING COVERAGE NAIC#

INSURED

Konica Minolta Business Solutions

U.S.A., Inc.

Attn: tynne Ransom

500 Day Hill Road

Windsor CT 06095 USA

INSURERA; sompo America insurance Company 11126

INSURER B:

INSURER C:

INSURER 0:

INSURER Ei

INSURER Ft

g2

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COVERAGES CERTIFICATE NUMBER: 570115610969 REVISION NUMBER:

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICV PERIOD

INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,

EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested

TO IT TOUt POLICY EPF POLICV HXPTYPE OF INSURANCE POLICY NUMBER (MM/DD/YYYYI

«TGL3U045222702COMMERCIAL GENERAL LIABILITY

CUIMS-MADE OCCUR

EACH OCCURRENCE

DAMAGE TU RENTED

PREMISES (Ea occu/ranoQ)

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PERSONAL &ADV INJURY

GEN'LAGQREQATE LIMIT APPLIES PER:

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OTHER;

GENERAL AQ3REQATE

PRODUCTS ■ COMP/OPAQQ

$1,000,000

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AUTOMOBILE UABILITY COMBH^EO SINGLE UMIT

(Ea accident)

BODILY INJURY (Per person)

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HI RED AUTOS

ONLY

SCHEDULED

AUTOS

NON-OWNED

AUTOS ONLY

BODILY INJURY (Per accident)

PROPERTY DAMAGE

(Per accident)

10/01/2025 10/01/2026 $10,000,000UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-MADE

CPU4O539N0 EACH OCCURRENCE

AGGREGATE $10,000,000

DED X RETENTION 110,000

wWORKERS COMPENSATION AND

EMPLOYERS* LIABILITY y, ^

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICERAilEMBER EXCLUDED?

(Mandatory In NH)

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DESCRIPTION OF OPERATIONS below

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DESCRIPTION OP OPERATIONS / LOCATIONS / VEHICLES (ACORD101, Additional Remarks Sohodulo, may be atlaohed If more epaoo la required)

New Hampshire Department of Health & Human Services, The State of New Hampshire, Its officers and employees, as their interest

may appear are Included as Additional Insured In accordance with the policy provisions of the General Liability and umbrella

Liability policies with respect to Konica Minolta's work and/or operations. m

CERTIFICATE HOLDER CANCELLATION

The state of New Hampshire

New Hampshire Department

of Health & Human Services

129 Pleasant street

Concord NH 03301 USA

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE

EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE

POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

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ACORD 25 (2016/03)

(01988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

Docusign Envelope ID: 41A3E703-9BFA-4C32-B62B-404C71579FC4

jXcoRty CERTIFICATE OF LIABILITY INSURANCE

DATE (HM/DD/YYYY)

10/03/2025

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES

BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN8URER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcyfles) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on

this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).

PRODUCER

MARSH USA, LLC.

1166 Avenue of the Americas

New York, NY 10036

CN101223113-AWP-26-26

CONTACT

NAME:

PHONE PAX

(WO. No. Extl: (A/C. Nol;

E-MAIL

ADDRESS:

INSURER(S) AFFORDINQ COVERAQE NAIC*

INSURER A: Sompo America Insurance Company 11126

INSURED

Konica Minolta Business

Solutions, U.S.A., Inc.

500 Day Hill Road

Windsor, CT 06095

INSURER B: Arcti Insurance Company 11150

INSURER c: Endurance American Insurance Company 10641

INSURER D:.Rnmpn Amnrlca Fire A Marine Insurance Company 38997

INSURER E:

INSURER F:

COVERAGES CERTIFICATE NUMBER: NYC-010663876-22 REVISION NUMBER; 3

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD

INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,

EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR

LTR TYPE OF INSURANCE

ADbL

IN8D

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VWD POLICY NUMBER

POLICY EPF

(MM/DO/YYYYl

POLICY EXP

(MM/DD/YYYYl LIMITS

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OTHER:

PRODUCTS ■ COMP/OP AQG $

LIMIT: $ 10,000,000

A

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AUTOMOBILE LIABILITY Y ML30011364804 (AOS)

AAL30098533300(MA,TX)

Comprehensive Ded: $5,000

Collision Ded: $5,000

10/01/2025

10/01/2025

10/01/2026

10/01/2026

COMBINED SINGLE LIMIT

(Ea acoldent) $ 1,000,000

X ANY AUTO BODILY INJURY (Per pereon) $

OWNED

AUTOS ONLY

HIRED

AUTOS ONLY

SCHEDULED

AUTOS

BODILY INJURY (Per eccldeni)$

NON-OWNED

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$

UMBRELLA UAB

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WORKERS COMPENSATION

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ANYPROPRIETOn/PARTNEWEXECUTIVE j 1

OFFICER/MEMBEREXCLUDED? N

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If yes, describe under

DESCRIPTION OF OPERATIONS below

N/A

AWL30098558800(WI)

AWL30098549700(AOS)

AWL30098862700(NY)

10/01/2025

10/01/2025

10/01/2025

10/01/2026

10/01/2026

10/01/2026

X sfATUTE '

E.L. EACH ACCIDENT $ 1,000,000

E.L. DISEASE • EA EMPLOYEE $ 1,000,000

E.L. DISEASE • POLICY LIMIT $ 1,000,000

C TECH E&O EXCESS: CNX30098562600 10/01/2026 10/01/2026 LIMIT: 10,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Setieduls, may be atteohed II more apace le required)

NEW HAMPSHIRE DEPARTMENT OF HEALTH & HUMAN SERVICES, THE STATE OF NEW HAMPSHIRE, ITS OFFICERS AND EMPLOYEES AS THEIR INTEREST MAY APPEAR ARE INCLUDED AS

ADDITIONAL INSURED (EXCEPT WORKERS' COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT.

STATE OF NEW HAMPSHIRE

NEW HAMPSHIRE DEPARTMENT OF HEALTH & HUMAN SERVICES

129 PLEASANT STREET

CONCORD, NH 03301

1

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD