• Home Modification Loan Program

    Guide and Bid, Scope of Work and Contract Form

    PART I: Guide and General Terms and Conditions

    The Home Modification Loan Program (HMLP) provides funding for necessary home modification or adaptations which are required for an individual(s) in the household to assist with their ability to function daily.

    You can complete this form and find additional resources for general contractors assisting a property owner obtaining an HMLP loan here. Please read through HMLP's Frequently Asked Questions for Contractors to help assist you through this process.

    This form must be completed by a licensed and insured contractor (the "Contractor") and signed by both the Contractor and the homeowner. The document is important for the homeowner's HMLP loan application for project funding.

    This form consists of three parts:

    • Part I is a Guide and General Terms and Conditions
    • Part II is the first section of the Bid and Contract Form and required for all projects.
    • Part III is also part of the Bid and Contract Form and is made up of sub-forms. Complete only the sub-forms needed for the project.
      • Form A Ramps, Lifts and Elevators
      • Form B Exterior Modifications
      • Form C Bathroom Modifications
      • Form D Kitchen Modifications
      • Form E Permanent Adaptive Design
      • Form F Addition to Dwelling or ADU

    Please be sure to include the homeowners' name in the space provided at the bottom of each page of this form.

    A few program policies to consider:

    • Up-front payment before work starts is permitted but can be for materials only, contractors submit a detailed invoice, and this payment cannot more than 30% of total project cost.
    • HMLP only pays up-front for materials in the first invoice; all other invoices should be submitted when the work is complete.
    • A copy of the building permit will be required before any payments are made to a contractor, including up-front payments for materials.
    • Change Orders are required:
      • Any deviations in the agreed upon project scope outlined in the Contract must be submitted and approved by the owner and reviewed by the provider agency for eligibility, prior to commencing said work
      • Any change to cost or project duration should be noted
    • HMLP does not pay subcontractors directly
    • HMLP uses construction monitors to conduct an initial inspection prior to the start of construction work. The inspection is to review the project's scope of work with both the Contractor and homeowner. Once construction work is complete, the construction monitor will conduct a final inspection before the last disbursement.

    Release of Liens:

    The Contractor's application for final payment shall include a statement of release of any liens by subcontractors, laborers, or material suppliers and all other liens arising out of the work performed under this contract.

    Provision of Utilities:

    The homeowner agrees to furnish all necessary utilities, including water and power, at no charge to the Contractor during the construction period. This shall also include access to a telephone for receipt of messages and the placing of outgoing, local calls.

    Compliance with the Law:

    It is the Contractor's obligation to obtain all applicable local permits. For building construction projects, if the homeowner obtains the permits, the homeowner will not be entitled to obtain any benefit from the Guaranty Fund established under Massachusetts General Laws Chapter 142A.

    The Contractor must have a current Massachusetts construction supervisor license in accordance with the Massachusetts Building Regulations. All subcontractors must meet Massachusetts licensing requirements according to their trade.

    The Contractor and all subcontractors are required to be registered with the Massachusetts Board of Building Regulations and Standards, unless specifically exempt from registration. If the homeowner uses unregistered contractors, he/she will not be entitled to obtain any benefit from the Guaranty Fund established under MGL Chapter 142A. Inquiries concerning contractor registration can be made to:

    Office of Consumer Affairs and Business Regulation
    Ten Park Plaza, Suite 5170
    Boston, MA 02116
    Phone: (617) 973-8700

    Insurance:

    The Contractor shall carry or require that there be carried full and complete Workmen's Compensation Insurance for all of his/her employees and those of his/her subcontractors engaged in work on the Contract premises, in accordance with local and state laws governing the same.

    The amount and limits of General Liability insurance and other required insurance coverage referred to herein shall be subject to the approval of the homeowner, provided however, that the Contractor shall obtain Comprehensive General Liability Insurance Coverage protecting the homeowner in the event of bodily injury including death, and property damage arising out of the work performed by the Contractor. In addition, a certificate of Automobile Liability Insurance shall be obtained for all vehicles used in the performance of this Contract for bodily injury including death and property damage per accident.

  • Termination:
    If at any time the homeowner concludes that the work or the actions of the Contractor are:

    • not in accordance with standard professional trade practices, or
    • not in compliance with the scope of work specifications, or
    • not in compliance with the material specified in the work specifications, or
    • in violation of Contract terms, or
    • a violation of applicable state and/or federal policies, regulations and laws,

    Then the homeowner has the right to terminate this Contract, through a written notice of contract termination. 

    The Contractor may suspend or terminate this Contract by providing the homeowner with written notice for the following reasons:

    • Failure by the homeowner to pay the agreed upon fee.
    • Actions or inactions by the homeowner that seriously hinder the Contractor's ability to perform its obligations in accordance with this Agreement.
    • A resonable determination by the Contractor that the satisfactory completion of one or more of the agreed up on activities is rendered improbable, infeasible, impossible or illegal, without the fault of the Contractor, provided however that the Contractor shall first have: 
      1. advised the homeowner of the reasons for the determination, and
      2. developed and proposed such solutions as appear feasible, and
      3. sought to negotiate an amendment of the Contract with the homeowner and such efforts have not satisfactorily removed the impediment to completion.

    In the event of suspension or termination, the homeowner shall pay the Contractor for completed, approved and satisfactory work.

     

    Licenses:

    The Contractor, and any approved subcontractors, shall procure and keep current any licenses, certifications, or permits required for any activity to be undertaken as part of this Agreement, as may be required by federal, state, or local laws or regulations.


    Amendments:

    The terms of this Agreement may be modified, amended, and/or extended only by written instrument executed by both the Homeowner and the contractor.

     

    Severability:

    If any provision of this Agreement is held invalid, the remainder of the Agreement shall not be affected thereby, and all other parts of this Agreement shall, nevertheless, be in full force and effect.

     

    If you have any questions or would like further information about the HMLP requirements for this bid form, please contact the regional provider agency working directly with the homeowner on their application. 

     

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  • Home Modification Loan Program

    Guide and Bid, Scope of Work and Contract Form

    PART II: Bid, Scope of Work and Contract Form

  • This section includes:

    • Contractor License(s) and insurance information
    • List of required permits
    • Estimated Project timeline
    • Payment schedule
    • Certification Statement
  • Please Include the necessary sub-form(s) to complete the Bid, Scope of Work and Contract Form.

    • Form A Ramps, Lifts and Elevators
    • Form B Exterior Modifications
    • Form C Bathroom Modifications
    • Form D Kitchen Modifications
    • Form E Permanent Adaptive Design
    • Form F Addition to Dwelling or ADU
  • This Bid Form and Construction Contract (the “Contract”) effective this   Pick a Date* , between:              ,         at                    
    Work to be performed by:   *   *      
                      

     

  • Timeline
    Estimated Start Date:   Pick a Date*   Estimated Completion Date:   Pick a Date*   Work may not begin until both parties have received a fully executed copy of the contract and the three-day rescission period has expired.
    It is agreed between the Contractor and Homeowner that the work shall be performed while the premises are       *   

  • Labor Rates
    Please provide the hourly labor rate for any additional work that may be required/requested.
    General Contractor              *      
    Other                   
    Other                 

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Contractor Registration
                   Pick a Date   


  • *               Pick a Date   


  •              Pick a Date      
               


  • *         *                *        

  • Certification Statement

    The quality of workmanship and finish shall be, consistent with a high quality of workmanship and finish in accordance with industry standards for like projects. The Contractor warrants a) that materials furnished pursuant to the proposal and will be of first-class quality and new unless otherwise stipulated, b) that the work will conform to the requirements of all authorities having jurisdiction and, c) that the work will be free from defects and encumbrances. All work performed under the contract shall be warranted by the contractor to be free from defects in labor and materials for a period of one year following the final acceptance of the work or final payment for work under the contract.

  • 1. Part I and Part II Forms are required for HMLP funded projects.
    2. Please check which sub form(s) will be included with the HMLP Bid, Scope of Work and Contract Form:

  • 1. Part I and Part II Forms are required for HMLP funded projects.
    2. Please check which sub form(s)s will be included with the HMLP Bid, Scope of Work and Contract Form:

                      p>

  • TOTAL PROJECT COSTS (Subcontractor, Materials, Labor)
    Please note that this section automatically fills as you complete the rest of the forms.
    Form A Ramps, lifts or Elevators      
    Form B Exterior Modifications      
    Form C Bathroom Modifications      
    Form D Kitchen     
    Form E Permanent Adaptive Design      
    Form F Addition to Dwelling or ADU    
    TOTAL PROJECT COST      

  • Payment Schedule, please note the following:

    • This payment schedule will directly influence the homeowner’s HMLP loan disbursement schedule.
    • The materials payment and final payment percentages are calculated using total project cost, not the HMLP loan amount.
    • Be sure to include a project milestone for each payment. Something the homeowner can easily identify as completed, so they can request payment.
    • HMLP loans are secured using a mortgage or UCC, there are filing fees which often are paid using HMLP loan funds. These fees can range from $30– $500+.
    • Is the total project cost over the HMLP loan amount?       *   

    If so,   If over the loan maximum, the homeowner will be
    required to disburse their other funding prior to any HMLP loan funds.

  • Payment 1: If applicable, amount over loan max      
    Payment 2:     
    Description: Loan Recording Fees (range of $30-$500+ exact amount supplied by the Provider Agency)
    Payment 3:   *      
    Description: purchase of up-front materials
    Other:      
    Payment 4:     
    Description:                              
             
    Payment 5:      Description:                  Describe:     
    Final Payment (10%)   *   Description: After final HMLP inspection

    As a part of any application for payment, the Homeowner may require the Contractor to furnish releases or receipts from any and all persons performing work or supplying materials or services to the contractor, or any subcontractors, for work performed under this contract, if this is deemed necessary to protect the Homeowner's interest.

  • Contract:

    The Contract between the Homeowner and the Contractor consists of Part I Part II and Part III of the Home Modification Loan Program Scope of Work Guide and Bid and Contract Form.
  • Clear
  • Contractor's Signature

    ________________________________________________________________________________________________________________________________________________________________________________________________________
  •  - -
  • Clear
  • Homeowner #1 Signature

    ________________________________________________________________________________________________________________________________________________________________________________________________________
  • Clear
  • Homeowner #2 Signature

    ________________________________________________________________________________________________________________________________________________________________________________________________________
  •  - -
  • Resolution of Disputes
    If disputes between the Homeowner and Contractor cannot be mutually resolved, the Homeowner may initiate arbitration by right as allowed under the Home Improvement Contractor Law. If agreed to by the Homeowner, the Contractor may also resolve disputes through formal arbitration. If the Homeowner agrees to an alternative dispute resolution process as initiated by the Contractor, the following must be signed by both parties:

    The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws, Chapter 142A.

       
    Pick a Date   
       
    Pick a Date   

    Notice: The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the Contractor. The Homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties.   

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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Form A: Ramps, Lifts or Elevators

    • Ramp 
    • Ramp #2 (if applicable) 
    • Ramp #3 (if applicable) 
    • Porch Landing 
    • Wheelchair Lift (interior or exterior) 
    • Wheelchair Lift #2 (interior or exterior) (if applicable) 
    • Stairlift (interior or exterior) 
    • Stairlift #2 (interior or exterior) 
    • Elevator 
    • SUBTOTAL Costs: Ramp, Lift, or Elevator 
    •  
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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Form B: Exterior Modifications

    • Exterior Doorway 
    • Location:          
                

    • Walkway 
    • Location:                                 
         

    • Driveway 
    • Fence 
    • Other Exterior Modifiations 
    • Subtotal Costs: Exterior Modifications 
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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Form C: Bathroom Modifications

  • Prep and Paint
    Please indicate: Does the scope of work include                         
    Material Cost:      Is this an allowance?         

  • Bathroom Doorway
    Current dimension of doorway:      
    If widened, new dimensions      Material cost:      
    Is this an allowance?         

  • Bathroom Sink
    What are the dimensions (height, depth, knee clearance, clear floor space)?       Will there be a cabinet below the sink?         Material cost:      Is this an allowance?         

  • Bathroom Sink Faucet
                          
    Material cost:        Is this an allowance?         

  • Shower/Tub
    What are the dimensions?      
    Is the unit to be installed               
       
    Will the shower include a built-in seat?         
    Material TypeManufacturer   Model      Material cost:            Is this an allowance?         

  • Shower/Tub Fixtures
                       Material cost:      Is this allowance?         

  • Shower/Grab Bars
    How many will be installed near the shower/tub?   
    Will additional wall backing or supports be required?         
    Has the homeowner identified where these should be installed?       
    Material cost:      Is this allowance?         

  • Toilet
    Please describe the turn radius around the toilet:      
    Will the toilet be:         
    Material cost:      Is this allowance?         

  • Toilet Grab Bars
    How many will be installed near the toilet?      
    Will additional wall backing or supports be required?          
    Has the homeowner identified where these should be installed?       
    Material cost:      Is this allowance?         

  • Additional Grab Bars
    Location(s)      Quantity        
    Material cost:      Is this allowance?         

  • List of Bathroom Accessories (towel bars, medicine cabinets, shower current rod or glass doors)
          
    Material cost(s):      

  • Other Bathroom Modifications
    Please describe:      Materials:      
    Material cost:      Is this allowance?         

  • Subtotal Costs Bathroom Modifications
    Subtotal Material Cost:  
    Subtotal Labor Cost:   
    Subtotal Electrical Cost:   
    Performed by subcontractor?         
    Subtotal Plumbing Cost:   
    Performed by subcontractor?         

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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Additional Form C: Bathroom Modifications

  • Prep and Paint
    Please indicate: Does the scope of work include                         
    Material Cost:      Is this an allowance?         

  • Bathroom Doorway
    Current dimension of doorway:      
    If widened, new dimensions      Material cost:      
    Is this an allowance?         

  • Bathroom Sink
    What are the dimensions (height, depth, knee clearance, clear floor space)?       Will there be a cabinet below the sink?         Material cost:      Is this an allowance?         

  • Bathroom Sink Faucet
                          
    Material cost:        Is this an allowance?         

  • Shower/Tub
    What are the dimensions?      
    Is the unit to be installed               
       
    Will the shower include a built-in seat?         
    Material TypeManufacturer   Model      Material cost:      Is this an allowance?         

  • Shower/Tub Fixtures
                       Material cost:      Is this allowance?         

  • Shower/Tub Grab Bars
    How many will be installed near the shower/tub?   
    Will additional wall backing or supports be required?         
    Has the homeowner identified where these should be installed?       
    Material cost:      Is this allowance?         

  • Toilet
    Please describe the turn radius around the toilet:   
    Will the toilet be:         
    Material cost:      Is this allowance?         

  • Toilet Grab Bars
    How many will be installed near the toilet?   
    Will additional wall backing or supports be required?          
    Has the homeowner identified where these should be installed?       
    Material cost:      Is this allowance?         

  • Additional Grab Bars
    Location:         Quantity:   
    Material cost:      Is this allowance?         

  • List of Bathroom Accessories (towel bars, medicine cabinets, shower current rod or glass doors)
    Please list:   
    Material cost(s):      

  • Other Bathroom Modifications
    Please describe:          Materials:     
    Material cost:      Is this allowance?         

  • Subtotal Costs Additional Bathroom Modifications
    Subtotal Material Cost:   
    Subtotal Labor Cost:   
    Subtotal Electrical Cost:   
    Performed by subcontractor?         
    Subtotal Plumbing Cost:    
    Performed by subcontractor?         

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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Form D: Kitchens

  • Prep and Paint
    Please indicate: Does the scope of work include             
    Material Cost:      Is this an allowance?         

  • Cabinets
    Number of wall cabinets:      
    Height of wall cabinets:      
    Wall Cabinet Cost:    

    Number of base cabinets:         
    Height of base cabinets:       
    Base cabinet cost:     

    Please describe hardware:   
    Please describe any special features (drop-down shelves, pull-out shelves, etc)
    Total cabinet cost:   
    Is this an allowance?             

  • Countertop
    Material type: Dimensions:     
    Countertop height above finished floor:         
    Will the countertops be adjustable?       
    Will there be an area for food prep where someone can sit?        
    Material Cost:      Is this an allowance?         

  • Kitchen Sink
    Sink height:Sink depth:         
    Will there be a cabinet under the sink?       
    Material Cost:      Is this an allowance?         

  • Kitchen Faucet
                         
    Material Cost:      Is this an allowance?         

  • Appliances (funded by HMLP must be EnergyStar certified) No gas appliances are permitted.

    Appliances type   
    Manufacturer  
    Model:        
    Material cost:      

    Appliances type: 
    Manufactuerer:     
    Model:            
    Material cost:   

    Appliances type: 
    Manufacturer:    
    Model:      
    Material cost:    

    Appliances type:   
    Manufacturer: 
    Model:       
    Material cost:    

    Please describe other kitchen modifications:
       
    Material Cost:      Is this an allowance?         

  • Subtotal Costs Kitchen Modifications
    Subtotal Material Cost:   
    Subtotal Labor Cost: 
    Subtotal Electrical Cost:     
    Performed by subcontractor?         
    Subtotal Plumbing Cost:   
    Performed by subcontractor?         

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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Form E: Permanent Adaptive Design Features

    • Interior Doorway(s) Modification 
    • Total # of doorway(s) to be modified:   
      Location of doorway(s) to be modified:   
      Width of modified doorway(s):      
      Will any thresholds be removed?                
      If yes, is any flooring patching required and be included?                 
      Material cost per doorway:  
      Total Cost:      Is this an allowance?         

    • Central Air Conditioning (funded by HMLP must be EnergyStar certified) 
    • Manufacturer:      Model:    
      Required ductwork:      
      Briefly describe any electrical work required:
         
      Electrical cost: Performed by subcontractor?              
      Total Material Cost:            

    • Laundry 
    • Briefly describe the scope of work:   
      Materials:   
      Will the laundry facilities be moved?              
      Will the existing appliances be used?        
      Total Material Cost:       

    • Appliances (funded by HMLP must be EnergyStar certified)  
    • Appliances type:      
      Manufacturer:  
      Model:       
      Material cost:   

      Appliances type: 
      Manufacturer:     
      Model:         
      Material cost:   

    • Adaptive and Safety Design Modifications 
    • Window locks
      Quantity:     Cost   

      Specialized door locks
      Quantity:    Cost:     

      Alarm system
      Manufacturer    Model #:      
      Quantity:    Cost:

      Security lighting  
      Quantity:      
      Cost:    

    • Other Adaptive and Safety Design Modifications 
    • Please describe:   
      Materials:
      Material cost:      Is this an allowance?         

    • Subtotal Costs: Form E Permanent Adaptive Design Features 
    • Subtotal Costs
      Subtotal Material Cost:   
      Subtotal Labor Cost:   
      Subtotal Electrical Cost:   
      Performed by subcontractor?         
      Subtotal Plumbing Cost:   
      Performed by subcontractor?         

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  • Home Modification Loan Program

    Part II: Bid, Scope of Work and Contract Form

    Form F: Addition to Dwelling or ADU

    Contractors must include project blueprints or plans sufficient for obtaining municipal permits for any project that includes an increase in the livable square footage of a dwelling or the creation of an accessory dwelling unit (ADU).

    HMLP requires that any addition to dwelling or ADU project be fully electric unless it will tie into an existing HVAC system that uses fossil fuels. ADU projects also should use solar energy whenever possible, and owners must submit proof that they considered solar.

    Please use the bathroom and kitchen sub-forms to provide the details for these spaces.

    • Masonry/Landscaping 
    • Briefly describe:   
      Materials:   Material cost:    
      Is this an allowance?         

    • Foundations/footing/slab 
    • Briefly describe:   
      Materials:  Material cost:    
      Is this an allowance?         

    • Roofing 
    • Briefly describe:   
      Materials:  Material cost:    
      Is this an allowance?         

    • Siding 
    • Briefly describe:      
      Materials: 
      Material cost:     Is this an allowance?         

    • Carrying beam/Lally column 
    • Briefly describe:      
      Materials:   
      Material cost:   Is this an allowance?         

    • Framing 
    • Briefly describe:      
      Materials:   Material cost:   
      Is this an allowance?         

    • Windows (funded by HMLP must be Energy Star certified) 

    • Number of windows:      
      Size of Windows:       
      Manufacturer:    Model:    
      Material cost:    Is this an allowance?         

    • Insulation (funded by HMLP must be Energy Star certified) 
    • Manufacturer:        Model: Quantity:     
        Material cost:    Is this an allowance?         

    • Doors (exterior doors must be Energy Star certified) 
    • Number of interior doors:      
      Number of exterior doors:   
      For exterior doors only: Manufacturer:   Model:     
      Material cost:     Is this an allowance?         

    • Flooring (include joists and subflooring) 
    • Briefly describe:      
       Flooring materials:    Square footage:    
      Material cost:    Is this an allowance?         

    • Sheetrock/Plaster  
    • Briefly describe: 
      Material cost:    Is this an allowance?         

    • Finish Carpentry  
    • Briefly describe:  
      Material cost:   Is this an allowance?         

    • Prep and Paint 
    •       
      Material cost:   Is this an allowance?         

    • HVAC (funded by HMLP must be Energy Star certified) 
    • Briefly describe: Materials:     Material cost:
         Is this an allowance?         

    • Electrical 
    •       
      Existing panel capacity:      
      Please describe: (please note if this includes bathroom & kitchen) Materials:     
      Material cost:   Is this an allowance?         

    • Plumbing 
    • Briefly describe (please note if this includes bathroom & kitchen)
         Materials   
      Material cost:   Is this an allowance?         

    • Other 
    • Briefly describe:  Materials:    
      Material cost:   Is this an allowance?         

    • Subtotal Form F: Addition to Dwelling or ADU 
    • Subtotal Costs
      Subtotal Material Cost:   
      Subtotal Labor Cost:   
      Subtotal Electrical Cost:   
      Performed by subcontractor?         
      Subtotal Plumbing Cost:   
      Performed by subcontractor?         

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  • Once you have completed the form, click "Submit" to generate a final PDF. 

    Please print the PDF to sign and collect signatures from the homeowner(s).

    The homeowner(s)will submit the signed form with their loan application.

     

    Click the "Save" button to receive a link to your online form, which you can return to and complete later.

  • Should be Empty: