PO486153-1 - CTR048567.PDF

Maricopa County — Formal (2023-03-01)

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PURCHASE ORDER
Page 1 of 5
Phoenix, on 1/24/2023
MARICOPA COUNTY PUBLIC HEALTH DEPARTMENT  CTR048567  **CO TO ADD FUNDING ON 
PO486153**-MARICOPA COUNTY
ITEM
CONTRACT 
ID
CODE/SKU
REFERENCE AND DESCRIPTION
QTY
UNIT
UNIT 
PRICE 
(USD)
TOTAL 
(USD)
1
CTR048567-
1
611649-2
CO TO ADD FUNDING THROUGH 
06/30/2023  **LOTCFH4179/2023**
1.0000
Each
90,000.0000
90,000.00
2
CTR048567-
1
576725-1
PO EFFECTIVE FROM 09/30/2022 
THROUGH 09/29/2023  *PAYS FROM 
FEDCFH7904/6811/0923*  CFDA 93.110
1.0000
Each
337,500.000
0
337,500.00
Total before Tax
  427,500.00 USD
Non-Taxable - 0 %
0.00 USD
Total after Tax
427,500.00 USD
SUPPLIER
MARICOPA COUNTY
Attn:  DAVID BRUCE
Address: Legal Address
301 W. Jefferson Ave
UNITED STATES
PHOENIX, Arizona  85003 
Phone: 6025066979
E-mail: DAVID.BRUCE@MARICOPA.GOV
DELIVER TO 
(unless specified differently per item)
Address: 150 N 18th Ave #320
UNITED STATES
Phoenix, Arizona  85007 
Deliver To: 
Requested Delivery Date: 
(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. PO0000486153-1
(please refer to this number on all documents)
Amendment: CANCELS AND REPLACES THE 
ORDER No.486153
Requestor: Rebecca Hernandez
Agency: Arizona Department of Health Services
Division: Public Health Prevention
Department: ADHS BUR WOMEN CHILDRENS 
HEALTH
Site: ADHS PREV BWCH S Womens Health
Phone: 
Email: rebecca.hernandez@azdhs.gov
    C-86-20-043-3-04

PURCHASE ORDER
Page 2 of 5
DELIVERY CONDITIONS
Delivery 
Conditions
Date
Type
%
Amount
Item
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:
 
________________________ 
 
Attorney for Maricopa County 
_____________  
Date