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C-86-18-060-3-06 PURCHASE ORDER Phoenix, on 7/9/2019 OOH - Dental Sealant Services - CO1 Cancel BFY19 / Add BFY2020 funds PO0000033414-MARICOPA COUNTY SUPPLIER ORDER No. PO0000033414-1 (please refer to this number on all documents) MARICOPA COUNTY Amendment: Amendment No.1CANCELS AND Attn: CHERYL RENTSCHELER REPLACES THE ORDER No.33414 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: HEALTH E-mail: CHERYLRENTSCHELER@MAIL.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: 2/21/2019 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) Page 1 of 6 PURCHASE ORDER 1 122255-18 THIS LINE ADDED VIA CHANGE ORDER TO 130.00 Each 18.00 2,340.00 REPLACE BFY19 WITH BFY2020 FUNDS * PAYS FROM OHFCFH3998 / BFY 2020 / 6811 * ORAL HEALTH DATA COLLECTION, DENTAL ASSISTANT 2 122255-17 THIS LINE ADDED VIA CHANGE ORDER TO 130.00 Each 30.00 3,900.00 REPLACE BFY19 WITH BFY 2020 FUNDS * PAYS FROM OHFCFH3998 / BFY2020 / 6811 * ORAL HEALTH DATA COLLECTION, DENTAL HYGIENIST 3 122255-16 THIS LINE ADDED VIA CHANGE ORDER TO 1,226.00 Each 75.00 91,950.00 REPLACE BFY19 WITH BFY 2020 FUNDS * PAYS FROM OHFCFH3998 / BFY2020 / 6811 * DENTAL SEALANT SERVICES 4 46166-15 CONTRACT: ADHS18-175153 ** PO 820.00 Each 75.00 61,500.00 EFFECTIVE 1/1/19 - 12/31/19 ** TO PAY FROM OHFCFH3998 / 2019 / 6811 ** THIS LINE TOTAL: $138,000.00 ** DENTAL SEALANT SERVICES 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATES 5 46166-14 THIS LINE TO PAY FROM FEDCFH1870 / 0920 3,067.00 Each 75.00 230,025.00 / 6811 ** THIS LINE TOTAL: $230,025.00 ** DENTAL SEALANT SERVICES 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATESCommentaire : FFATA REPORTING REQUIRED 6 46166-12 THIS LINE TO PAY FROM FEDCFH1870 / 0920 152.00 Each 30.00 4,560.00 / 6811 ** THIS LINE TOTAL: $4,560.00 **ORAL HEALTH DATA COLLECTION, DENTAL HYGIENIST (Per Hour, Per Provider) 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATES 7 46166-11 THIS LINE TO PAY FROM FEDCFH1870 / 0920 152.00 Each 18.00 2,736.00 / 6811 ** THIS LINE TOTAL: $2,736.00 **ORAL HEALTH DATA COLLECTION, DENTAL ASSISTANT (Per Hour, Per Provider) 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATES 8 46166-10 THIS LINE TO PAY FROM FEDCFH1870 / 0920 1.00 Each 13,324.00 13,324.00 / 6811 ** THIS LINE TOTAL: $13,324.00 ** CUSTOMER SATISFACTION SURVEY AND ASSESSMENT RESULTS 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATES 9 46166-9 THIS LINE TO PAY FROM FEDCFH1870 / 0920 1.00 Each 13,324.00 13,324.00 / 6811 ** THIS LINE TOTAL: $13,324.00 ** COST EFFECTIVENESS EVALUATION 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATES 10 46166-8 THIS LINE TO PAY FROM FEDCFH1870 / 0920 1.00 Each 13,324.00 13,324.00 / 6811 ** THIS LINE TOTAL: $13,324.00 ** PROGRAM IMPLEMENTATION ANALYSIS AND ASSESSMENT Page 2 of 6 PURCHASE ORDER 150 N 18th Ave Ste 320 85007 Phoenix Arizona UNITED STATES Total before Tax 436,983.00 USD Non-Taxable - 0 % 0.00 USD Total after Tax 436,983.00 USD Page 3 of 6 PURCHASE ORDER DELIVERY CONDITIONS Delivery Date Type % Amount Item Conditions Page 4 of 6 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. Page 5 of 6 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. IN WITNESS WHEREOF, the parties agree and approve: FOR AND ON BEHALF OF MARICOPA COUNTY By_________________________________ Bill Gates, Chairman, Board of Supervisors __________________________________ Date APPROVED AS TO FORM:________________________________________________ Attorney for County Date ATTEST:______________________________________________________________ Office of the Clerk of the Board Date Page 6 of 6