C-86-13-050-3-01 AMD 1 HIV PREVENTION SERVICES.PDF

CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS13-034910:1
Organizational Reference No.: E0117968
Issued: 07/19/2013
Vendor Number: 000010983 Arizona Department of Health Services
Maricopa County Public Health Bureau of Tobacco and Chronic Disease
501 N. 44th Street, #200 150 N. 18th Avenue, Suite 310
Phoenix, AZ 85008 Phoenix, AZ 85007
US
Email: procure@azdhs.gov
Contract No.: ADHS13-034910 (602) 364-0824
Title: BTCD Maricopa HIV Prevention (PO 07/01)13 - 06/30/14)
MAIL INVOICE IN DUPLICATE TO:
Arizona Department of Health Services
Bureau of Tobacco and Chronic Disease
150 N. 18th Avenue, Suite 310
Phoenix, AZ 85007
US
Email: procure@azdhs.gov
(602) 364-0824
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 952-43
1 1.00 YR $ 147,394.00 $ 147,394.00
HIV Prevention - Partner Services Part A
Class-Item 952-43
2 1.00 YR $ 117,256.00 $ 117,256.00
HIV Prevention - Testing Part A
Class-Item 952-43
3 HIV Prevention -Supplemental Part B 1.00 YR $ 134,500.00 $ 134,500.00
CFDA# 93.940 (100% Federal Funding)
Purchase Order for the Period 07101/2013 -06/30/2014
Total Purchase Order - $ 798,299
First PO represents 50% Funding.

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Approved By: Byron Homer
Phone No.: (602) 364-1223

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IN WITNESS WHEREOF, the parties agree to enter into this Agreement:
FOR AN 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