PURCHASE ORDERS RE IMMUNIZATION SVCS WITH ADHS.PDF

ARIZONA STATE CONTRACT Page 1 of 2
CONTRACT RELEASE
)3-674/- 5_0 1
C- S6 -
ProcureAZ Purchase Order No.: ADHS13-041805:2
Organizational Reference No.: E0120326
Issued: 07131/2013
,
Vendor Number: 000010983 Arizona Department of Health Services
Marloopa County Public Health S Epidemiology and Disease Control Immunization
501 N. 44th Street, #200 H Program
Phoenix, AZ 85008 150 N. 18th Avenue, Suite 120
p Phoenix, AZ 85007
US
Email: procure@azdhs.gov
T
0
Contract No,: ADHS13-041805 (602) 364-3630
Title: Immunization Services
MAIL INVOICE IN DUPLICATE TO:
B Arizona Department of Health Services
Epidemiology and Disease Control Immunization
Program
t 150 N. 18th Avenue, Suite 120
L Phoenix, AZ 85007
US
T 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.
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
Immunization Program - CONTRACT ADHS13-041805 - CONTRACT END
DATE - 12/31/2017. PO Period thru 12/31/2013. CFaNft 93.268 PO for the
delivery of Immunization services and activities as follows;
* Salary/Fringe - YEARLY $50,000.00
* Immunization visit for children zero (0) to eighteen (18) years of age -
UNIT RATE $50.00
* Immunization Completion for children zero (0) to eighteen (18) years of
1 age - UNIT RATE $100.00 1.00 TOTAL $ 657,796.00 $ 657,796.00
* Perinatal Hepatitis ES Case Management - Prenatal - UNIT RATE $300.00
* Perinatal Hepatitis B Case Management - Postnatal - UNIT RATE $200.00
* School/Children [DR Management-Preparation and submittal - UNIT
RATE $250.00
* Immunization Visit for adults nineteen (19) years of age and older - UNIT
RATE $50.00
* Immunization Visit for Flu Vaccine, in children and adults - UNIT RATE
$50.00

TOTAL: $ 65T796 DO
c_86-13-67q
Approved By: Myra Chavez
Phone No.: (602) 364-3649

ARIZONA STATE CONTRACT Page 1 of 1
CONTRACT RELEASE
c-a9-13-0711-3-
ProcureAZ Purchase Order No.: ADHS13-041805:3
Organizational Reference No,: E0128956
Issued: 09/20/2013
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Pubic Health Epidemiology and Disease Control Immunization
501 N. 44th Street, #200 Program
17.) Phoenix, AZ 85008 150 N. 18th Avenue, Suite 120
Phoenix, AZ 85007
US
Email: procure@azdhs.gov
Contract No.: ADHS13-041805
Title: Maricopa County Immunization Svcs (602) 364-3630
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Epidemiology and Disease Control immunization
Program
150 N. 18th Avenue, Suite 120
Phoenix, AZ 85007
US
Email: procuregazdhs.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: 13-99386-54010-6811- ------- --- Payment Terms: Net 30
Shipping Terms:
Solicitation (Bid) No.: Delivery Calendar Day(s)A.R.O.: 0
Item Description Requisition _ Quantity Unit Unit Price Total
Class-Item 948-92
PO for the delivery of Seasonal Pan Flu immunization Services & Activities 1.00 TOTAL $ 111,982 00 3 111,982.00
necessary to aid Marlcopa County Health Dept. PO period thru 12/31/13.
CONTRACT# ADHS13-041805 Contract Period thru 12/31/2017, CEDA#
93.268.
TOTAL: $ 111,982.00
Approved By: Myra Chavez
Phone No.: 602) 364-3649

Page 1 of 2
ARIZONA STATE CONTRACT
CONTRACT RELEASE
i3-07q=7)-0 I
ProcureAZ Purchase Order No.: ADHS13-041805:4
Organizational Reference No.: E0129110
Issued: 09/23/2013
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Public Health Epidemiology and Disease Control Immunization
501 N. 44th Street, #200 Program
Phoenix, AZ 85008 150 N. 18th Avenue, Suite 120
Phoenix, AZ 85007
us
Email: procure@azdhs.gov
Contract No.: ADHS13-041805 (602) 364-3630
Title: Maricopa County Immunization Services
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Epidemiology and Disease Control Immunization
Program
150 N. 18th Avenue, Suite 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: 13-99386-54000-6811- Payment Terms: Net 30
Shipping Terms:
Solicitation (Bid) No.: Delivery Calendar Day(s) A.R.O.: 0
,
Item Description j Requisition Quantal/ Unit Unit Price Total
Class-Item 948-92
Immunization.. CONTRACT ADHS13-041805 - CONTRACT END DATE -
12/31/2017. PO Period thru 12/31/2013. CFDA# 93.268 PO for the delivery
of Immunization services and activities as follows;
* Salary/Fringe - YEARLY $50,000.00
* Immunization visit for children zero (0) to eighteen (18) years of age -
• UNIT RATE $50.00
* Immunization Completion for children zero (0) to eighteen (18) years of
age-UNIT RATE $100.00 1.00 TOTAL $ 717,817.00 $ 717,817.00
* Pen natal Hepatitis B Case Management - Prenatal - UNIT RATE $300.00
* Perinatal Hepatitis B Case Management - Postnatal - UNIT RATE $200.00
* School/Children 1DR Management-Preparation and submittal - UNIT
RATE $250.00
' Immunization Visit for adults nineteen (19) years of age and older - UNIT
RATE $50.00
' Immunization Visit for Flu Vaccine, in children and adults - UNIT RATE
$50.00

C-y6-13-0
TOTAL: $717817.00
Approved By: Myra Chavez
Phone No.: (602) 364-3649

C-86-13-074-3-01 ATTACHED TO AND A PART OF
Immunization Servives
Contract No. ADHS13-041805,
Purchase Order No. ADHS13-041805:2
Purchase Order No. ADHS13-041805:3
Purchase Order No. ADHS13-041805:4
IN WITNESS WHEREOF, the parties agree to enter into this Contract:
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