PO RE IMMUNIZATION SERVICES WITH ADHS_8.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS13-041805:8
Organizational Reference No.: E0189915
Issued: 08/29/2014
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Public Health Epidemiology and Disease Control Immunization
1001 N CENTRAL AVE Program
STE 500 150 N. 18th Avenue, Suite 120
Phoenix, AZ 85004 Phoenix, AZ 85007
US
Email: procure@azdhs.gov
Contract No.: ADHS13-041805 (602) 364-3630
Title: Maricopa County Filth Dept. - Immunization Services
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Epidemiology and Disease Control Immunization
Program
150 N. 18th Avenue, Stile 120
Phoenix, AZ 85007
US
Email: procure@azdhs.gov
(602) 364-3630
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: 14-99486-54010-6811----------- Payment Terms: Net 30
Shipping Terms:
Solicitation (Bid) No.: Delivery Calendar Day(s) A,R.O.: 0
Item Description 1 Requisition Quantity Unit Unit Price Total
Class-Item 948-92
1 1.00 TOTAL $ 116,651,00 $ 116,651.00
Immunization Program PO for the delivery of Seasonal Pan Flu
Immunization Services & Activities necessary to aid Mancopa County Health
Dept. PO Period thru 12/31/14. Contract# ADHS13-041805 Contract period
12/31/2017. CFDA# 93.268
TOTAL: $ 116,651,00
Approved By: Myra Chavez
Phone No.: (602) 364-3649

C-86-13-074-3-05 Immunization Services
ADHS13-041805
IN WITNESS WHEREOF, the parties agree to enter into this Agreement:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Deputy Attorney for Maricopa County
Date