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ARIZONA STATE CONTRACT Page 1 of 1 CONTRACT RELEASE ProcureAZ Purchase Order No.: ADHS14-053007:6 Organizational Reference No.: E0220280 Issued: 02/20/2015 Vendor Number: 000010983 Arizona Department of Health Services Maricopa County Public Health Bureau of Nutrition and Physical Activity 1001 N CENTRAL AVE 150 N. 18th Avenue, Suite 310 STE 500 Phoenix, AZ 85007 Phoenix, AZ 85004 US Email: procuregazdhs.gov Contract No.: ADHS14-053007 (800) 252-5942 Title: EMNP FY 15 Maricopa County MAIL INVOICE IN DUPLICATE TO: Arizona Department of Health Services Accounts Payable Services 1740 West Adams #301 Phoenix, AZ 85007 • US Email: INVOICESgazdhs.gov (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: 14-97481-44010-6811- --------- Payment Terms: Net 30 Shipping Terms: Solicitation (Bid) No.: Delivery Calendar Day(s) A.R.O.: 0 Item Description I Requisition ' Quantity Unit Unit Price Total Class-Item 952-26 1 3100.00 YR $ 1.25 $ 3,876.00 Maricopa County Public Health will provide nutrition education and issue FMNP checks to WIC clients. TOTAL: $ 3,875.00 Approved By: America Coles Phone No,: (602) 542-2878 C-86-14-023-3-03 ATTACHED TO AND A PART OF Purchase Order ADHS14-053007:6 Farmer’s Market Nutrition Program Service Combined WIC Services, Breastfeeding Peer Counseling, Farmer’s Market Nutrition Program 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 Chairman, Board of Supervisors Date ATTEST: Clerk of the Board Date APPROVED AS TO FORM: Attorney for Maricopa County Date