PO RE WEST NILE VIRUS WITH ADHS.PDF

Page 1 of 1
ARIZONA STATE CONTRACT
CONTRACT RELEASE
ProcureAZ Purchase Order No.: ADHS12-012315:2
Organizational Reference No.: E0118278
Issued: 07/22/2013
V Vendor Number: 000010983 Arizona Department of Health Services
E Maricopa County Public Health S Epidemiology and Disease Control
N 501 N. 44th Street, #200 H Office of Infectious Disease Services
Phoenix, AZ 85008 I 150 N. 18th Avenue, Suite 140
D Phoenix, AZ 85007
O P US
R Email: christine.wampler@azdhs.gov
T
O
Contract No.: ADHS12-012315 (602) 364-3854
Title: MARICOPA COUNTY WNV ENHANCED SURVEILLANCE
AUG-SEPT 2013 MAIL INVOICE IN DUPLICATE TO:
B Arizona Department of Health Services
I Epidemiology and Disease Control
Office of Infectious Disease Services
L 150 N. 18th Avenue, Suite 140
L Phoenix, AZ 85007
US
T Email: christine.wampler@azdhs.gov
O
(602) 364-3854
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 Requisition Quantity Unit Unit Price Total
Class-Item 948-34
1 2.00 EA $ 8,500.00 $ 17,000.00
MARICOPA COUNTY WNV ENHANCED SURVEILLANCE AUG-SEPT
2013, MONTHLY REPORTS FOR AUGUST & SEPTEMBER 2013-----
Monthly Enhanced Surveillance Project Tasks CFDA# 93.521
TOTAL: $ 17,000.00
Approved By: Christine Wampler
Phone No.: (602) 364-3854

C-86-12-033-3-02 ATTACHED TO AND A PART OF
Purchase Order ADHS12-012315:2 for
Maricopa County West Nile Virus (WNV)
Enhanced Surveillance Aug-Sep 2013
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