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Page 1 of 2 ARIZONA STATE CONTRACT CONTRACT RELEASE C-86-14-023-3-08 RrocureAZ Purchase Order No,: ADHS14-053007:15 Organizalional Reference No.: P00000089545 Issued: 03/17/2016 Vendor Number: 000010983 Arizona Department of Health Services Maricopa County Public Health '...' Bureau of Nutrition and Physical Activity 4041 N, Central Avenue, #1400 trP 150 N. 18th Avenue, Suite 310 Phoenix, AZ 85012 Phoenix, AZ 85407 h ' US f Email: procuretgazdhs.gov '11 , Contract No ADHS19-053007 (8001252-5942 Title: FMNP FY 16 Marlcopa County Health Department MAIL INVOICE IN DUPLICATE TO: Arizona Department of Health Services Accounts Payable Services 1740 West Adams #301 •' Phoenix, AZ 85007 us v---..i Email: INVOICES@azdhs.gov u „ (602) 542-0781 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—LOTCFH9190-4410—HS4250-LOTWIC-HS25000-6811--PHS- Payment Terms: Net 30 NPA---- ----- -I-ISA • Shipping Terms: . Delivery Calendar Day(s) ARO.: 0 item Description I.., Requisition Quantity . Unit Unit Price Total Class-Item 962-26 1 4035,00 EACH $ 1.25 $ 5,04315 Farmer's Market Nutrition Program Services (FMNPS): WIC FMNP Check , Issuance $1.25 per Participant TOTAL: $ 5,093,75 Approved By: America Wes Phone No.: (602) 542-2878 Page 2 of 2 ATTACHED TO AND A PART OF: Purchase Order ADHS14-053007:15 Farmers Market Nutrition Program C-86-14-023-3-08 IN WITNESS WHEREOF, the parties agree to enter into this Agreement and its Amendments: 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