CONTRACT AMENDMENT RE PROP 201 WITH ADHS.PDF

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ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS12-022013:3
Organizational Reference No.: E0178697
Issued: 07/11/2014
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Public Health EDC - Office of Inspection and Compliance
4041 N Central Avenue, Suite 1400 150 N. 18th Avenue, Suite 130
Phoenix, AZ 85012 Phoenix, AZ 85007
US
Email: Harrnony.duood@azdhs.gov
Contract No.: ADHS12-022013 L (602) 364-3138
Title: Prop 201 - 2015 Smoke Free - Maricopa County
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
EDC - Office of Inspection and Compliance
150 N. 18th Avenue, Suite 130
Phoenix, AZ 85007
US
Email: Harmony.duport@azdhs.gov
(602) 364-3138
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: 15-86507-55100-6811- Payment Terms: TBD
Shipping Terms: TBD
Solicitation (Bid) No.: Delivery Calendar Day(s) A.R.O.: 0
Item Description I Requisition Quantity Unit Unit Price Total
Class-Item 948-34
Bureau of Epidemiology and Disease Control
Office of Inspection and Compliance
Prop 201 Smoke Free Arizona
1 Contract # ADHS12-022013 through 6130/17 1.00 YR $ 904,613.00 $ 904,613,00
Purchase Order period 7/1/14 - 6130/15
Quarterly @ $226,153.25
PO Total $904,613
No CFDA Number
TOTAL: $ 904,613,00
Approved By: Nancy Flores
Phone No.: (602) 364-3292

C-86-12-086-3-02 Prop 201 - ADHS12-022013:3
IN WITNESS WHEREOF, the parties agree to enter into this Agreement:
FOR AND ON BEHALF OF
MAR ICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Deputy Attorney for Maricopa County
Date