PO RE TEEN PREGNANCY PREV WITH ADHS.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS13-034430:3
Organizational Reference No.: E0218317
Issued: 02/10/2015
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Public Health Bureau of Women and Children's Health
1001 N CENTRAL AVE 150 N. 18th Avenue, Suite 320
STE 500 Phoenix, AZ 85007
Phoenix, AZ 85004 US
Email: procure@azdhs.gov
Contract No.: ADHS13-034430 (602) 364-1400
Title: Abstinence PLUS - Teen Pregnancy Prevention
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: 15-97581-43500-6811- 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 952-24
PO EFFECTIVE 1/1/15 - 12/31/15 ""* CONTRACT EFFECTIVE 1/1/13 -
12/31/17 *** STATE FUNDING * CFDA: NONE ***THIS LINE TO PAY
1 FROM 97481/ 43500/ 14 ********** CONTRACTOR TO INVOICE 1.00 TOTAL $ 214,837.00 $ 214,837,00
ACCORDING TO CONTRACT PRICE SHEET AS FOLLOWS:
PERSONNEL = $116,987.00*** ERE = $47,836.00 *** PROFESSIONAL
AND OUTSIDE SERVICES = $1,410,00 ""* TRAVEL EXPENSE =
$8,996.00*** OTHER OPERATING EXPENSE = $23,248,00 **" INDIRECT
= $16,360.00*** THIS LINE TOTAL = $214,837.00 ******—***** TOTAL
ANNUAL AMOUNT = $229,837.00 *""******"**** Teen Pregnancy Prevention
- Abstinence Plus
Class-Item 952-24
2 STATE FUNDING * CFDA: NONE THIS LINE TO PAY FROM 97581/ 1,00 TOTAL $ 15,000.00 $ 15,000,00
43500/ 15 ********** CONTRACTOR TO INVOICE ACCORDING TO
CONTRACT PRICE SHEET AS FOLLOWS: PERSONNEL = $0.00*** ERE
= $0.00*** PROFESSIONAL AND OUTSIDE SERVICES = $0.00
TRAVEL EXPENSE = $0.00 **" OTHER OPERATING EXPENSE = $0.00
**" INDIRECT = $15.000.00 THIS LINE TOTAL = $15.000.00

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
Teen Pregnancy Prevention - Abstinence Plus
TOTAL: $ 229,837.00
Approved By: Cynthia Ronquillo
Phone No.: (602) 364-1449

C-86-13-046-3-03 ATTACHED TO AND A PART OF
Purchase Order No. ADHS1-034430:03
Intergovernmental Agreement AHDS13-034430
Abstinence PLUS – Teen Pregnancy Prevention
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