PO0000462966-3_CTR046941_-_HRPP_CHN.PDF

PURCHASE ORDER
Page 1 of 2
Phoenix, on 4/11/2023
Maricopa County- CTR046941 - HRPP CHN ** CO3 TO ADD FUNDS TO PO462966-MARICOPA COUNTY
ITEM
CONTRACT 
ID
CODE/SKU
REFERENCE AND DESCRIPTION
QTY
UNIT
UNIT 
PRICE 
(USD)
TOTAL 
(USD)
SUPPLIER
MARICOPA COUNTY
Attn: Mrs. CHERYL BUCALO
Address: Legal Address
4041 N. Central Avenue, #1400
UNITED STATES
PHOENIX, Arizona  85012 
Phone: 602 506-6886
E-mail: CHERYL.BUCALO@MARICOPA.GOV
DELIVER TO 
(unless specified differently per item)
Address: 150 N 18th Ave #310
UNITED STATES
Phoenix, Arizona  85007 
Deliver To: 
Requested Delivery Date: 7/21/2022
(Unless specified differently per item in section delivery details)
BILL TO
Address: 150 N 18th Ave #530
UNITED STATES
Phoenix, Arizona  85007 
Payment Terms: Net 30
ORDER No. PO0000462966-3
(please refer to this number on all documents)
Amendment: CANCELS AND REPLACES THE 
ORDER No.522488
Requestor: Mitchell Goldberg
Agency: Arizona Department of Health Services
Division: Public Health Prevention
Department: ADHS BUR WOMEN CHILDRENS 
HEALTH
Site: ADHS PREV BWCH S Childrens Health
Phone: 
Email: mitchell.goldberg@azdhs.gov

PURCHASE ORDER
Page 2 of 2
1
CTR046941-
4
638332-4
L4: CO3 TO ADD FUNDING THRU 
06/30/2023 ** GENCFH0296/2023/6811/ 
4341
1.0000
Each
126,778.960
0
126,778.96
2
CTR046941-
3
620115-3
L3: CO2 LINE ** PAYS FROM 
GENCFH0296/2023/6811
150 N 18th Ave #320
85007 Phoenix
Arizona UNITED STATES
1.0000
Each
95,000.0000
95,000.00
3
CTR046941-
3
567812-2
L2: CO1 LINE ** PAYS FROM 
FEDCFH1782/0923/6800
150 N 18th Ave #320
85007 Phoenix
Arizona UNITED STATES
1.0000
Each
79,846.0400
79,846.04
4
CTR046941-
3
544107-1
L1: CONTRACT: CTR046941 * PO 
EFFECTIVE 7/1/22 - 6/30/23 * PAYS FROM 
GENCFH0296 / BFY 2023 / 6811 * STATE 
FUNDS * CFDA: NONE * COMMUNITY 
NURSING SERVICES
150 N 18th Ave #320
85007 Phoenix
Arizona UNITED STATES
1.0000
Each
301,625.000
0
301,625.00
Total before Tax
  603,250.00 USD
Non-Taxable - 0 %
0.00 USD
Total after Tax
603,250.00 USD
IN WITNESS WHEREOF, the parties agree to enter into this Agreement: 
FOR AND ON BEHALF OF 
MARICOPA COUNTY: 
 
 
________________________ 
 
Clint Hickman, Chairman, Board of Supervisors
_____________ 
 
Date 
ATTEST: 
 
 
 
 
________________________ 
 
Juanita Garza, Clerk of the Board 
_____________ 
 
Date 
APPROVED AS TO FORM: 
________________________ 
 
Deputy Attorney for Maricopa County 
_____________ 
 
Date