PO RE HRPP NEWBORN INTENSIVER CP WITH ADHS.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS14-074958:4
Organizational Reference No.: P00000247626
Issued: 07/11/2017
Vendor Number: 000010983 Arizona Department of Health Services
Marlowe County Public Health Bureau of Women and Children's Health
4041 N. Central Avenue, #1400 150 N. 18th Avenue, Suite 320
Phoenix, AZ 85012 Phoenix, AZ 85007
US
Email: procure@azdhs.gov
Contract No.: ADHS14-074958 (602) 364-1400
Title: HRPP Community Nursing
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Bureau of Women and Children's Health
150 N. 18th Avenue, Suite 320
Phoenix, AZ 85007
US
Email: procure@azdhs.gov
(602) 364-1400
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: 2018--GENCFH0296--4341-1000--HS43010-6811-6811-PHS-WCH Payment Terms: Net 30
----HSA
Shipping Terms: N/A
Delivery Calendar Day(s) A.R.O.: 0
Item Description I Requisition Quantity Unit Unit Price Total
Class-Item 948-64
1.00 TOTAL $ 571,000.00 $ 571,000.00
PO EFFECTIVE 7/1/17 - 6/30/18 *** CONTRACT EFFECTIVE 7/1/14 -
6/30/19 *** STATE FUNDING "** THIS LINE TO PAY FROM GENCFH0296
***** HRPP/NICP COMMUNITY HEALTH NURSING SERVICES
Class-Item 948-64
2 1.00 TOTAL $ 4,000,00 $ 4,000.00
THIS LINE TO PAY FROM FEDCFH1787 *** 0918 *** FEDERAL FUNDING
*** CFDA 93.994 ******************* HRPP/NICP COMMUNITY HEALTH
NURSING SERVICES
TOTAL: $ 575,000,00
Approved By: Dee Vlahos

C-86-15-021-3-08 ATTACHED TO AND A PART OF
Purchase Order ADHS14-074958:4
High Risk Perinatal Program (HRPP)
Newborn Intensive Care Program (NICP)
IN WITNESS WHEREOF, the parties agree to enter into this Contract:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Attorney for Maricopa County
Date