MPO20270183.PDF

BILL TO: (send invoices to
invoices@azdhs.gov)
SHIP TO
150 N. 18th Avenue, Arizona Department of Health Services
Phoenix, AZ 85007 Accounts Payable
150 N 18th Ave, Suite 530
Phoenix, AZ 85007
Manual Purchase Order
Type: Service(s) MPO #: MPO20270183
Is this a change order?: N Current Encumbrance: Original MPO #:
MPO Change Order Action: Change Amount (if
applicable):
Request Basic Information:
Requestor Email: peggy.peixoto@azdhs.gov
Location Scope (Site) ADHS PREV BWCH S Childrens Health
Bureau WCHCH
Contract No. RFGA2022-003-007
Supplier Name MARICOPA COUNTY
Supplier ID IV0000029389
Supplier Email raquel.bales@maricopa.gov
Supplier Address 4041 N CENTRAL AVE. STE. 1400, PHOENIX, AZ 85012
Date 9/29/2026
Effective Date 10/1/2026
Termination Date 1/13/2027
Line Items:
Line Quantity Description Unit Price (#) Extended Price
($)
1 Home Visiting Services $455,333.48 $455,333.48
Totals ($)
Sub Total $455,333.48
Tax $0.00
Freight $0.00
Total $455,333.48
Encumbrance Distribution:
PPC Function Object Dept. Object Unit Funding CFDA#
or Amount
BFY

2709 FEDCFH177 6811-Aid to 6800 4340 $455,333.48 93.870
0 Counties
Encumbrance Total ($) $455,333.48
GAE # 270000001086
CFDA Information (if applicable): Contractor shall comply with requirements of OMB Circular. For
grant restrictions, refer to https://www.ecfr.gov/cgi-bin/text-idx?
tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl
Federal Funding Accountability and Transparency Act
If applicable, the Contractor/Grantee shall submit to ADHS via email the Grant Reporting
Certification Form. This form and the instructions and the instructions can be downloaded below
and must be returned to the ADHS by the 15th of the month following that in which the award
was received. The form shall be completed electronically, and submitted using the steps outlined
in the Grant Reporting Certification Form Instructions and emailed to us. All required fields must
be filled including Top Employee Compensation, if applicable. Completing the Grant Reporting
Certification Form is required for compliance with the Office of Management and Budget (OMB).
Failure to timely submit the Grant Reporting Certification Form could result in the loss of funds.
This requirement applies to all subcontractors/sub-awardees utilized by the Contractor/Grantee
for amounts exceeding $30,000.00 during the term of the Award.

State of Arizona
PURCHASE ORDER TERMS AND CONDITIONS
1. Modification. No modification of the purchase order shall bind State of permission of Buyer.
Arizona Buyer (Buyer) unless Buyer agrees to the modification in 12. Third Party Antitrust Violations. Seller assigns to Buyer any claim for
writing. overcharges resulting from antitrust violations to the extent that those
2. Packing and Shipping. Seller shall be responsible for industry standard violations concern materials or services supplied by third parties to the
packing which conform to all legal requirements . Containers must Seller toward fulfillment of this Purchase Order.
be clearly marked with any required identifying information such as the 13. Interpretation – Parol Evidence / U.C.C. This Purchase Order is intended
lot number, destination address, and purchase order number. by the parties as a final expression of their agreement and is intended
3. Title and Risk of Loss. The title and risk of loss of the materials shall also as a complete and exclusive statement of the terms of their
agreement. No course of prior dealings between the parties and no
not pass to Buyer until Buyer physically receives the materials at the
course of dealing or usage of the trade shall supplement or explain any
point of delivery.
terms used in this document and no other understanding either oral or
4. Invoice and Payment. A separate invoice shall be issued for each
in writing shall be binding. Whenever a term defined by the Uniform
shipment. No invoice shall be issued prior to shipment of materials Commercial Code (U.C.C.) is used in the Purchase Order, the definition
and no payment will be made prior to receipt and acceptance of contained in the U.C.C. is to control.
materials and correct invoice. Payment due dates, including discount 14. Non-Discrimination. The Seller shall comply with State Executive Orders
periods, will be computed from date of receipt of materials or date No. 2023-09, 2023-01, 2009-09, and any and all other applicable Federal
of receipt of correct invoice (whichever is later) to date Buyer's warrant and State laws, rules and regulations, including the Americans with
as mailed. Unless freight and other charges are itemized, any discount Disabilities Act.
provided will be taken on full amount of invoice. Payment shall be 15. Indemnity. Seller agrees to indemnity and save Buyer harmless from
subject to the provisions of Title 35 of Arizona Revised Statutes (A.R.S.), any loss, damage or expense whatsoever resulting to the Buyer from
subject to the requirements and limitations of A.R.S. § 35-154. The any and all claims and demands on account of infringement or alleged
Buyer's obligation is payable solely from funds appropriated for the infringement of any patent in connection with the manufacture or use
purpose of acquiring the materials or services referred to in this of any product included in this Purchase Order and upon written
Purchase Order; should Buyer’s funding change, no legal liability on the request, Seller will defend at its own expense any legal action or suit
part of the Buyer for any payment may arise under this Purchase Order against Buyer involving any such alleged patent infringement and will
until funds are made available for performance. pay and satisfy any judgments rendered or settlements reached in any
5. Inspection. All materials are subject to final inspection and acceptance such legal actions or suits. Seller will indemnify Buyer against all claims
by Buyer. Material failing to meet the requirements of this Purchase for damages to persons or property resulting from defects in materials
Order will be held at Seller's risk and may be returned to Seller. If so or workmanship.
returned, the cost of transportation, unpacking, inspection, repacking, 16. Liens. All delivered materials and services performed under this
reshipping, or other similar expenses are the responsibility of the Seller. Purchase Order shall be free of all liens and if Buyer requests, a formal
6. No Replacement of Defective Tender. Every tender of materials release of all liens shall be delivered to Buyer.
must fully comply with all provisions of Purchase Order as the time of 17. Contract Number. If an Arizona contract number appears on the face of
delivery, quantity, quality and the like. If a tender is made which does this Purchase Order or the Purchase Order was placed against an
not fully conform, it shall constitute a breach and Seller shall not have existing Arizona contract, the terms of that contract are incorporated
herein by this reference.
the right to substitute a conforming tender.
18. Taxes. Seller shall be responsible for paying any and all applicable taxes,
7. Gratuities. The buyer may, by written notice to the Seller, cancel this
Purchase Order if it is found by Buyer that gratuities, in the form of including but not limited to state and local transaction privilege taxes.
entertainment, gifts, or otherwise, were offered or given by the Seller, 19. Conflict of Interest. Pursuant to A.R.S. § 38-511, this Purchase Order is
or any agent or representative of the Seller, to any officer or employee subject to cancellation by the buyer if any person significantly involved
of the State of Arizona with the purpose of securing an order or in initiation negotiating securing drafting or creating the contract on
securing favorable treatment with respect to the awarding or amending, behalf of the State is at any time while the contract is in effect, an
or the making of any determinations with the respect to the employee or any other party to the contract in any capacity or a
performing, of such order. In the event this Purchase Order is canceled consultant to any other party of the contract will respect to the subject
by Buyer pursuant to this provision, Buyer shall be entitled to recover or matter of the contract.
withhold from the Seller the amount of the gratuity, in addition to any 20. Remedies and Applicable Law. This Purchase Order shall be governed
by the law of the State of Arizona and suits pertaining to this Purchase
other rights and remedies available under Arizona state law.
Order may only be brought under Article 9 of the Arizona Procurement
8. Warranties. Seller warrants that all materials and services delivered
Code (A.R.S. §§ 41-2501 et seq., and the rules thereunder, A.A.C.
under this Purchase Order will conform to the requirements of this
R2-7-101 et seq.)
Purchase Order (including all applicable descriptions, specifications,
21. Books and Records. Under A.R.S. § 35-214 and § 35-215, the Seller shall
drawing and samples) will be free from defects in material and
retain all books, accounts, reports, files and other records relating to the
workmanship and will be free from defects in design and fill for the
Purchase Order for five years after completion of the Purchase Order.
intended purposes. Any inspection or acceptance of the materials These books and records shall be available at all reasonable times for
or services by Buyer shall not alter or affect the obligations of Seller or inspection and audit by the State at such state offices designated by the
the right of Buyer under the foregoing warranties. State.
9. E-Verify. In accordance with A.R.S. § 41-4401, Seller warrants 22. State Law Certifications. If Seller is a Company as defined in A.R.S. §
compliance with all Federal immigration laws and regulations relating to 35-393, Contractor Seller certifies that it shall comply with A.R.S. §
employees and warrants its compliance with Section A.R.S. § 23- 214, 35-394, regarding use of forced labor of ethnic Uyghurs, as applicable. If
Subsection A. this purchase order is over $100,000, Seller further certifies that it is not
10. Protection of State Cybersecurity Interests. Seller shall comply with currently engaged in a boycott of Israel as described in A.R.S. §§ 35-393
State Executive Order No. 2023-10, which includes, but is not limited to, et seq. and will refrain from any such boycott for the duration of this
a prohibition against (a) downloading and installing of TikTok on all Purchase Order.
State-owned and State-leased information technology; and (b) 23. Arbitration. The Buyer and Seller agree to use arbitration as required by
accessing TikTok through State information technology. A.R.S. § 12-1518.
11. Assignment and Delegation. No right or interest in this Purchase Order
shall be assigned by Seller without the written permission of Buyer, and
no delegation of any duty of Seller shall be made without written
State Procurement Office | Revision No. 3 | Revised 07-23