PO RE STD IPP TESTING WITH ADHS.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No,: FIG052195:6
Organizational Reference No.: E0228380
Issued: 04/0312015
Vendor Number: 000010983 Arizona Department of Health Services
Marl cope County Public Health Office of Disease Integration and Services
1001 N CENTRAL AVE, STE 500 150 N. 18th Avenue, Suite 110
Phoenix, AZ 85004 Phoenix, AZ 86007
US
Email: maria.thomas@azdhs.gov
Contract No.: HG052195 (602) 364-3601
Title: STD-MARICOPA IPP 2015-1st Half
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Office of Disease Integration and Services
150 N. 18th Avenue, Suite 110
Phoenix, AZ 85007
US
Email: marla.thomas@azdhs.gov
(602) 364-3601
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: 15-99505-52300-6811- Payment Terms:
Shipping Terms:
Solicitation (Bid) No.: Delivery Calendar Day(s) A.R.O.: 0
Item Description 1 Requisition Quantity Unit Unit Price Total
Class-Item 952-49
1 Utilization of County Lab: IPP Testing 1671.01 EA $ 11.30 $ 18,882.41
OFFICE of DISEASE INTEGRATION and SERVICES
PO EFFECTIVE thru JUNE 30, 2015
CONTRACT# HG052195
_ CFDA# 93.977
TOTAL: $ 18,882.41
Approved By: Leticia Medina
Phone No.: (602) 364-4666

C-86-10-120-3-11 ATTACHED TO AND A PART OF
Purchase Order HG052195:6
STD-MARICOPA IPP 2015-1ST Half
IN WITNESS WHEREOF, the parties agree to enter into this Contract 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