PO RE FARMERS MARKET NP WITH ADHS.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS14-053007:20
Organizational Reference No.: PO0000206917
Issued: 03/07/2017
V Vendor Number: 000010983 Arizona Department of Health Services
E Maricopa County Public Health S Bureau of Nutrition and Physical Activity
N 4041 N. Central Avenue, #1400 H 150 N. 18th Avenue, Suite 310
Phoenix, AZ 85012 I Phoenix, AZ 85007
D US
O P Email: procure@azdhs.gov
R
T
O
Contract No.: ADHS14-053007 (800) 252-5942
Title: Maricopa FFY 2017 FMNP Services
MAIL INVOICE IN DUPLICATE TO:
B Arizona Department of Health Services
I AP Services
150 N 18th Avenue, Ste 260
L Phoenix, AZ 85007
L US
Email: INVOICES@azdhs.gov
T
O
(602) 542-6354
Release Instructions
TERMS AND CONDITIONS set forth in our Bid, Quotation, or Purchase Order
are incorporated herein by reference and become a part of this order.
Account Code: 2017--LOTCFH4190--4410--HS4250-LOTWIC-HS25000-6811---PHS- Payment Terms: Net 30
NPA------------HSA
Shipping Terms:
Delivery Calendar Day(s) A.R.O.: 0
Item Description Requisition Quantity Unit Unit Price Total
Class-Item 952-26
1 1996.00 EACH $ 1.25 $ 2,495.00
WIC FMNP CHECK ISSUANCE PER PARTICIPANT $1.25
Class-Item 952-26
2 500.00 EACH $ 1.25 $ 625.00
WIC FMNP CHECK ISSUANCE PER PARTICIPANT $1.25
Class-Item 952-26
3 1000.00 EACH $ 1.25 $ 1,250.00
WIC FMNP CHECK ISSUANCE PER PARTICIPANT $1.25

TOTAL: $ 4,370.00
Approved By: America Coles
Phone No.: (602) 542-2878

C-86-14-023-3-14 ATTACHED TO AND A PART OF
Purchase Order ADHS14-053007:20
Farmer’s Market Nutrition Program Service
Combined WIC Services
ADHS14-053007
IN WITNESS WHEREOF, the parties agree to enter into this Contract and its
Amendments:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Denny Barney
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Attorney for Maricopa County
Date