Extracted text (via pymupdf_layout)
2923 characters
Page 1 of 3 ARIZONA STATE CONTRACT CONTRACT RELEASE C-86-15-021-3-03 ProcureAZ Purchase Order No.: ADHS14-074958:2 Organizational Reference No.: PO0000000206 Issued: 07/08/2015 V Vendor Number: 000010983 Arizona Department of Health Services E Maricopa County Public Health S Bureau of Women and Children's Health N 4041 N. Central Avenue, #1400 H 150 N. 18th Avenue, Suite 320 Phoenix, AZ 85012 I Phoenix, AZ 85007 D US O P Email: procure@azdhs.gov R T O Contract No.: ADHS14-074958 (602) 364-1400 Title: HRPP Community Nursing MAIL INVOICE IN DUPLICATE TO: B Arizona Department of Health Services I Bureau of Women and Children's Health 150 N. 18th Avenue, Suite 320 L Phoenix, AZ 85007 L US Email: procure@azdhs.gov T O (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: 2016--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 Requisition Quantity Unit Unit Price Total Class-Item 948-64 1 PO EFFECTIVE 7/1/15 - 6/30/16 *** CONTRACT EFFECTIVE 7/1/14 - 1.00 QTR $ 76,500.00 $ 76,500.00 6/30/17 *** STATE FUNDING *** CONTRACTOR TO INVOICE ACCORDING TO CONTRACT PRICE SHEET *** THIS CONTRACT CONTAINS QUARTERLY ENCUMBRANCES *** THIS LINE TO PAY FROM GENCFH0296/ 2016 *** TOTAL CONTRACT AMOUNT = $466,200.00 *** HRPP/NICP COMMUNITY HEALTH NURSING SERVICES Class-Item 948-64 2 1.00 TOTAL $ 116,200.00 $ 116,200.00 THIS LINE TO PAY FROM FEDCFH1781 / 0916 *** FEDERAL FUNDING: MCH BLOCK GRANT CFDA 93.994 *** HRPP/NICP COMMUNITY HEALTH NURSING SERVICES Class-Item 948-64 3 1.00 TOTAL $ 44,000.00 $ 44,000.00 THIS LINE TO PAY FROM FEDCFH1787 / 0916 *** FEDERAL FUNDING: MCH BLOCK GRANT SPECIAL NEEDS CFDA 93.994 ***HRPP/NICP COMMUNITY HEALTH NURSING SERVICES Page 2 of 3 ARIZONA STATE CONTRACT CONTRACT RELEASE Class-Item 948-64 4 1.00 EA $ 76,500.00 $ 76,500.00 2ND QTR FUNDING**** TO PAY FROM GENCFH0296 2016 *******HRPP/NICP COMMUNITY HEALTH NURSING SERVICES Class-Item 948-64 5 1.00 EA $ 76,500.00 $ 76,500.00 3RD QTR FUNDING *** NON-FEDERAL FUNDING ****** THIS LINE TO PAY FROM GENCFH0296/ 2016 ******* HRPP/NICP COMMUNITY HEALTH NURSING SERVICES Class-Item 948-64 6 1.00 EA $ 121,500.00 $ 121,500.00 4TH QTR FUNDING PLUS ADDL FUNDING *** NON-FEDERAL FUNDING ****** THIS LINE TO PAY FROM GENCFH0296/ 2016 ************HRPP/NICP COMMUNITY HEALTH NURSING SERVICES TOTAL: $ 511,200.00 Approved By: Dee Vlahos Phone No.: (602) 364-1425 C-86-15-021-3-03 ATTACHED TO AND A PART OF Page 3 of 3 Purchase Order ADHS14-074958:2 HRPP Community Nursing 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