**[Model Intergovernmental Cooperation Act Agreement]{.underline}.**

MEMORANDUM OF UNDERSTANDING

THROUGH WHICH

***\[name of State or local agency\]***

IS PURCHASING

***\[state what they are purchasing\]***

FROM

***\[name of your operating unit\]***

U.S. DEPARTMENT OF COMMERCE

**Agreement No.\_\_\_**

1\. [PARTIES AND PURPOSE]{.underline}

This Memorandum of Understanding (MOU) establishes an agreement between
the ***\[name of other party\]*** and ***\[name of DOC office\]***, U.S.
Department of Commerce (DOC), through which ***\[name of other
party\]*** will pay ***\[name of DOC office\]*** for ***\[provide a
general description of the good/service for which the other party is
paying\].***

2\. [AUTHORITY]{.underline}

The authorities for ***\[name of other party\]*** and DOC to enter into
this agreement are:

> \(1\) the Intergovernmental Cooperation Act, 31 U.S.C. \' 6505, and
>
> \(2\) ***\[set forth the other party\'s legal authority under which it
> is making the purchase for goods/or services, i.e., the programmatic
> authority to which the purchase is related\].***

3\. [TERMS AND CONDITIONS]{.underline}

***\[State the terms and conditions of the agreement, i.e., what it is
specifically that the other party is purchasing, delivery requirements,
and the amount that your office will receive as payment.\]***

***\[Name of your office\]*** will achieve full cost recovery for the
goods and services it is providing under this agreement**.**

4\. [TRANSFER OF FUNDS]{.underline}

***\[Explain the details of how the other party will pay for the
goods/services, e.g., whether payments will be monthly, quarterly, in
advance, etc.\]***

5\. [OMB CIRCULAR A-97 CERTIFICATION]{.underline}

As required by OMB Circular A-97, ***\[name of other party\]***
certifies that the services being requested pursuant to this agreement
cannot be procured reasonably and expeditiously by it through ordinary
business channels.

6\. [CONTACTS]{.underline}

The contacts of each party to this agreement are:

> ***\[Name of DOC contact\]***
>
> ***\[title of DOC contact\]***
>
> ***\[Address of DOC contact person\]***
>
> Agency DUNS Number:
>
> phone:***\[phone number of DOC contact person\]***
>
> fax : ***\[fax number of DOC contact person\]***
>
> E-mail: ***\[E-mail address of DOC contact person\]***
>
> ***\[Name of other party\'s contact person\]***
>
> ***\[title of other party\'s contact person\]***
>
> ***\[address of other party\'s contact person\]***
>
> Agency DUNS Number ***\[if applicable\]***:
>
> phone:***\[phone number of other party\'s contact person\]***
>
> fax : ***\[fax number of other party\'s contact person\]***
>
> E-mail: ***\[E-mail address of other party\'s contact person\]***

The parties agree that if there is a change regarding the information in
this section, the party making the change will notify the other party in
writing of such change.

7\. [DURATION OF AGREEMENT, AMENDMENTS AND MODIFICATIONS]{.underline}

This agreement will become effective when signed by all parties. The
agreement will terminate on ***\[date\]***, but may be amended at any
time by mutual consent of the parties.

***\[NOTE: If the agreement will last longer than 3 years, the following
sentence should be included in the agreement: \"The parties will review
this agreement at least once every three years to determine whether it
should be revised, renewed, or canceled.\"\]***

Any party may terminate this agreement by providing \_\_\_ days written
notice to the other party. This agreement is subject to the availability
of funds.

8\. [RESOLUTION OF DISAGREEMENTS]{.underline}

Should disagreement arise on the interpretation of the provisions of
this agreement, or amendments and/or revisions thereto, that cannot be
resolved at the operating level, the area(s) of disagreement shall be
stated in writing by each party and presented to the otherparty for
consideration. If agreement on interpretation is not reached within
thirty days, the parties shall forward the written presentation of the
disagreement to respective higher officials for appropriate resolution.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***\[signature of person who has authority to bind other party to the
agreement\]***

***\[typed name\]***

***\[typed title\]***

***\[typed name of other party\]***

***\[typed address of other party\]***

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***\[date\]***

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***\[signature\--must be an official with authority to sign***

***\"Intergovernmental Cooperation Act\" Agreements\]***

***\[typed name\]***

***\[typed title\]***

***\[typed office at DOC\]***

U.S. Department of Commerce

***\[typed address\]***

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***\[date\]***