P O RE NEONATAL INTENSIVE CARE WITH ADHS.PDF
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CONTRACT RELEASE ProcureAZ Purchase Order No.: ADI-IS11-006208:6 Organizational Reference No.: E0115926 Issued: 07/11/2013 Vendor Number: 000010983 Arizona Department of Health Services Maricopa County Public Health Bureau of Women and Children's Health 501 N. 44th Street, #200 150 N. 18th Avenue, Suite 320 Phoenix, AZ 85008 Phoenix, AZ 85007 US Email: procure@azdhs.gov Contract No.: ADHS11-006208 (602) 364-1400 Title: HRPP Community Nursing MAIL INVOICE IN DUPLICATE TO: Arizona Department of Health Services AP Services - Trang Huynh 1740 West Adams #301 Phoenix, AZ 85007 US INVOICES@azdhs.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. 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 952-13 HRPP/NICP Community Nursing *** PO EFFECTIVE 7/1/13 -6130/14 1 CONTRACT EFFECTIVE 6/30/09 - 6/30/14 *** CONTRACTOR TO 1.00 QTR $ 75,000.00 $ 75,000.00 INVOICE ACCORDING TO CONTRACT PRICE SHEET """ THIS CONTRACT CONTAINS BOTH STATE (QUARTERLY) AND FEDERAL (ANNUAL) ENCUMBRANCES ""*" ANNUAL CONTRACT AMOUNT = $468,001.00""'"*"*"*"""""""*" THIS LINE TO PAY FROM 43010/ 43440 Class-Item 952-13 2 1.00 YR $ '145,000.00 $ 145,000.00 THIS LINE TO PAY FROM 99301/ 43440 *** HRPP/NICP Community Nursing Class-Item 952-13 3 1.00 YR $ 23,000.00 $ 23,000.00 THIS LINE TO PAY FROM 99309/ 43440 "*" HRPP/NICP Community ro,Frcinrr CONTRACT RELEASE Class-Item 952-13 4 too YR $ 1.00 $ 1.00 THIS LINE TO PAY FROM 45001/ 67400 *** HRPP/NICP Community Nursing TOTAL: $ 243,001.00 Approved By: Dee Viahos Phone No.: (602) 364-1425