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PURCHASE ORDER Page 1 of 2 C-86-18-001-3-04 Phoenix, on 7/13/2021 PROP 201 - SMOKE FREE ARIZONA FY22 - MARICOPA COUNTY-MARICOPA COUNTY ITEM CONTRACT ID CODE/SKU REFERENCE AND DESCRIPTION QTY UNIT UNIT PRICE (USD) TOTAL (USD) 1 CTR038067 405598-1 TOTAL COST, Not to Exceed Annual Total of $816,413.00 Commentaire : Class-Item 948-33 Bureau of Epidemiology and Disease Control Office of Environmental Health PROP 201 - SMOKE FREE ARIZONA FY22 - MARICOPA COUNTY Contract # ADHS18-175355 through 6/30/2022 Estimated Quarterly @ $204,103.25 PO Annual Total $816,413.00 TOTAL COST, Not to Exceed Annual Total of $816,413.00 1.0000 Each 816,413.000 0 816,413.000 0 Total before Tax 816,413.0000 USD Non-Taxable - 0 % 0.0000 USD Total after Tax 816,413.0000 USD SUPPLIER MARICOPA COUNTY Attn: MICHELLE RUSSO Address: Legal Address 1001 N CENTRAL AVE STE 500 UNITED STATES PHOENIX, Arizona 85004 Phone: E-mail: MICHELLERUSSO@MAIL.MARICOPA.GOV DELIVER TO (unless specified differently per item) Address: 150 N 18th Ave #140 UNITED STATES Phoenix, Arizona 85007 Deliver To: ATTN: SMOKE-FREE ARIZONA PROGRAM MANAGER - MYRNA MOTTA Requested Delivery Date: (Unless specified differently per item in section delivery details) BILL TO Address: 150 N 18th Ave #260 invoices@azdhs.gov UNITED STATES Phoenix, Arizona 85007 Payment Terms: Net 30 ORDER No. PO0000335562 (please refer to this number on all documents) Amendment: Requestor: Thom Wilson Agency: Arizona Department of Health Services Division: Public Health Preparedness Department: ADHS PREP BUR Epidemiology Disease Control Site: ADHS PREP EDC S Environmental Health Phone: 602-364-3118 Email: thom.wilson@azdhs.gov PURCHASE ORDER Page 2 of 2 ______________________________ Jack Sellers, Chairman Date Board of Supervisors APPROVED AS TO FORM: ______________________________ Attorney to County Date ATTEST: ____________________________________ Office of the Clerk of the Board Date FOR COUNTY: