DENTAL SEALANTPO119163-1 ADHS.PDF

PURCHASE ORDER
C-86-18-060-3-08
Phoenix, on 9/24/2019
Amendment request 9/24/2019 PO0000119163-MARICOPA COUNTY
SUPPLIER ORDER No. PO0000119163-1
(please refer to this number on all documents)
MARICOPA COUNTY Amendment: Amendment No.1CANCELS AND
Attn: CHERYL BUCALO REPLACES THE ORDER No.119163
Address: Legal Address Requestor: Cynthia Ronquillo
4041 N. Central Avenue, #1400 Agency: Arizona Department of Health Services
UNITED STATES Division: Public Health Prevention
PHOENIX, Arizona 8501285004 Department: ADHS BUR WOMEN CHILDRENS
Phone: 602 506-6886 HEALTH
E-mail: CHERYL.BUCALO@MARICOPA.GOV Site: ADHS PREV BWCH S Oral Health
Phone: 6023641513
Email: cynthia.ronquillo@azdhs.gov
DELIVER TO BILL TO
(unless specified differently per item)
Address: 150 N 18th Ave #320 Address: 150 N 18th Ave #260
UNITED STATES UNITED STATES
Phoenix, Arizona 85007 Phoenix, Arizona 85007
Requested Delivery Date: 9/26/2019 Payment Terms: Net 30
(Unless specified differently per item in section delivery details)
UNIT TOTAL
ITEM CODE/SKU REFERENCE AND DESCRIPTION QTY UNIT PRICE (USD)
(USD)
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PURCHASE ORDER
1 162391-12 THIS LINE ADDED VIA CHANGE ORDER * TO 2,500.00 Each 8.00 20,000.00
ADD ADDITIONAL FUNDS FOR FLUORIDE
VARNISH SERVICES * PAYS FROM
FEDPHS2162 / 0720 / 6811
2 151175-11 CONTRACT: ADHS18-175153 * THIS PO 1,154.00 Each 75.00 86,550.00
REPLACES PO33414 * PO EFFECTIVE THRU
12/31/19 * THIS LINE PAYS FROM
FEDCFH1870 / 0920 / 6811 * FEDERAL
FUNDS * CFDA: 93.994 * DENTAL SEALANT
SERVICES
3 151175-10 THIS LINE PAYS FROM OHFCFH3998 / BFY 1,226.00 Each 75.00 91,950.00
2020 / 6811 * STATE FUNDS * CFDA: NONE *
DENTAL SEALANT SERVICES
4 151175-9 THIS LINE PAYS FROM FEDCFH1870 / 0920 / 130.00 Each 30.00 3,900.00
6811 * FEDERAL FUNDS * CFDA: 93.994 *
ORAL HEALTH DATA COLLECTION, DENTAL
HYGIENIST (Per Hour, Per Provider)
5 151175-8 THIS LINE PAYS FROM FEDCFH1870 / 0920 / 135.00 Each 18.00 2,430.00
6811 * FEDERAL FUNDS * CFDA: 93.994 *
ORAL HEALTH DATA COLLECTION, DENTAL
ASSISTANT (Per Hour, Per Provider)
6 151175-7 THIS LINE PAYS FROM OHFCFH3998 / BFY 130.00 Each 30.00 3,900.00
2020 / 6811 * STATE FUNDS * CFDA: NONE *
ORAL HEALTH DATA COLLECTION, DENTAL
HYGIENIST (Per Hour, Per Provider)
7 151175-6 THIS LINE PAYS FROM OHFCFH3998 / BFY 130.00 Each 18.00 2,340.00
2020 / 6811 * STATE FUNDS * CFDA: NONE *
ORAL HEALTH DATA COLLECTION, DENTAL
ASSISTANT (Per Hour, Per Provider)
8 151175-5 THIS LINE PAYS FROM OTHCFH7722 / 0620 / 343.00 Each 30.00 10,290.00
6811 * STATE FUNDS * CFDA: NONE * ORAL
HEALTH DATA COLLECTION, DENTAL
HYGIENIST (Per Hour, Per Provider)
9 151175-4 THIS LINE PAYS FROM OTHCFH7722 / 0620 / 343.00 Each 18.00 6,174.00
6811 * STATE FUNDS * CFDA: NONE * ORAL
HEALTH DATA COLLECTION, DENTAL
ASSISTANT (Per Hour, Per Provider)
10 151175-3 THIS LINE PAYS FROM FEDCFH1870 / 0920 / 1.00 Each 13,324.00 13,324.00
6811 * FEDERAL FUNDS * CFDA: 93.994 *
CUSTOMER SATISFACTION SURVEY AND
ASSESSMENT RESULTS
11 151175-2 THIS LINE PAYS FROM FEDCFH1870 / 0920 / 1.00 Each 13,324.00 13,324.00
6811 * FEDERAL FUNDS * CFDA: 93.994 *
COST EFFECTIVENESS EVALUATION
12 151175-1 THIS LINE PAYS FROM FEDCFH1870 / 0920 / 1.00 Each 13,324.00 13,324.00
6811 * FEDERAL FUNDS * CFDA: 93.994 *
PROGRAM IMPLEMENTATION ANALYSIS AND
ASSESSMENT
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PURCHASE ORDER
Total before Tax 267,506.00 USD
Non-Taxable - 0 % 0.00 USD
Total after Tax 267,506.00 USD
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PURCHASE ORDER
DELIVERY CONDITIONS
Delivery
Date Type % Amount Item
Conditions
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PURCHASE ORDER
PURCHASE ORDER TERMS AND CONDITIONS
Revised January 10, 2011
1. Modification. No modification of the purchase order shall bind Buyer unless Buyer agrees to the modification in writing.
2. Packing and Shipping. Seller shall be responsible for industry standard packing which conform to requirements of carriers’
tariffs and ICC regulations. Containers must be clearly marked as to lot number, destination address and purchase order number.
3. Title and Risk of Loss. The title and risk of loss of the goods shall not pass to Buyer until Buyer actually received the goods at
the point of delivery.
4. Invoice and Payment. A separate invoice shall be issued for each shipment. No invoice shall be issued prior to shipment of
goods and no payment will be made prior to receipt of goods and correct invoice. Payment due dates, including discount periods,
will be computed from date of receipt of goods or date of receipt of correct invoice (whichever is later) to date Buyer's warrant is
mailed. Unless freight and other charges are itemized, any discount provided will be taken on full amount of invoice. Payment shall
be subject to the provisions of Title 35 of Arizona Revised Statutes. The Buyer's obligation is payable solely from funds
appropriated for the purpose of acquiring the goods or services referred to in this Purchase Order.
5. Inspection. All goods are subject to final inspection and acceptance by Buyer. Material failing to meet the requirements of this
Purchase Order will be held at Seller's risk and may be returned to Seller. If so returned, the cost of transportation, unpacking,
inspection, repacking, reshipping or other like expenses are the responsibility of the Seller.
6. No Replacement of Defective Tender. Every tender of goods must fully comply with all provisions of Purchase Order as the
time of delivery, quantity, quality and the like. If a tender is made which does not fully conform, it shall constitute a breach and
Seller shall not have the right to substitute a conforming tender.
7. Force Majeure. Neither party shall be held responsible for any losses resulting if the fulfillment of any terms or conditions of the
Purchase Order are delayed or prevented by any cause not within the control of the party whose performance is interfered with
and which, by the exercise of reasonable diligence, that party is unable to prevent.
8. 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 entertainment, gifts or otherwise, were offered or given by the Seller, or any agent or representative of the Seller, to
any officer or employee of the State of Arizona with a view toward securing an order or securing favorable treatment with respect
to the awarding or amending, or the making of any determinations with the respect to the performing, of such order. In the event
this Purchase Order is cancelled by Buyer pursuant to this provision, Buyer shall be entitled in addition to any other rights and
remedies to recover or withhold from the Seller the amount of the gratuity.
9. Warranties. Seller warrants that all goods delivered under this Purchase Order will conform to the requirements of this
Purchase Order (including all applicable descriptions, specifications, drawings and samples) will be free from defects in material
and workmanship and will be free from defects in design and fill for the intended purposes. Any inspection or acceptance of the
goods by Buyer shall not alter or affect the obligations of Seller or the right of Buyer under the foregoing warranties.
10. Assignment – 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 permission of Buyer.
11. Interpretation – Parole Evidence. This Purchase Order is intended by the parties as a final expression of their agreement
and is intended also as a complete and exclusive statement of the terms of their agreement. No course of prior dealings between
the parties and no usage of the trade shall be relevant to supplement or explain any term used in this Purchase Order.
Acceptance or acquiescence in a course of performance rendered under this Purchase Order shall not be relevant to determine
the meaning of this Purchase Order even though the accepting or acquiescing party has knowledge of the nature of the
performance and opportunity for objection. Whenever a term defined by the Uniform Commercial Code is used in the Purchase
Order the definition contained in the Code is to control.
12. Non-Discrimination. Seller agrees not to discriminate against any employee or applicant for employment in violation of the
terms of Federal Executive Order 11246, State Executive Order No. 2009-09 and A.R.S. Section 41-1461 et seq.
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PURCHASE ORDER
13. Indemnity. Seller agrees to indemnity and save the Buyer harmless from any loss, damage or expense whatsoever resulting
to the Buyer from any and all claims and demands on account of infringement or alleged infringement of any patent in connection
with the manufacture or use of any product included in this Purchase Order and upon written request Seller will defend at its own
cost the expense any legal action or suit against the Buyer involving any such alleged patent infringement, and will pay and satisfy
any and all judgments or decrees rendered in any against such legal actions or suits. Seller will indemnify Buyer against all claims
for damages to person or property resulting from defects in materials or workmanship.
14. Liens. All goods delivered and labor performed under this Purchase Order shall be free of all liens, and if Buyer requests, a
formal release of all liens will be delivered to Buyer.
15. Contract Number. If an Arizona contract number appears on the face of this Purchase Order, the terms of that contract are
incorporated herein by this reference.
16. Taxes. The State of Arizona is exempt from Federal Excise Tax.
17. Conflict of Interest. Pursuant of A.R.S. Section 38-511 this Purchase Order is subject to cancellation by the Buyer if any
person significantly involved in initiating, negotiating, securing, drafting or creating the contract on behalf of the state is, at any
time while the contract is in effect, an employee of any other party to the contract in any capacity or a consultant to any other party
of the contract with respect to the subject matter of the contract.
18. Remedies and Applicable Law. This Purchase Order shall be governed by, and Buyer and Seller shall have all remedies
afforded each by, the Uniform Commercial Code as adopted in the State of Arizona except as otherwise provided in this Purchase
Order or in statutes pertaining specifically to the State. This Purchase Order shall be governed by the law of the State of Arizona,
and suits pertaining to this Purchase Order may be brought only in the courts of the State of Arizona.
19. Arbitration. The parties must use arbitration as required by A.R.S. Section 12-1518.
ON BEHALF OF COUNTY
__________________________________________________
Bill Gates, Chairman, Board of Supervisors Date
APPROVED AS TO FORM
__________________________________________________
Attorney for County Date
ATTEST
__________________________________________________
Office of the Clerk of the Board Date
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