CTR053477 A 2 Rural Metro Ambulance executed with Debarment.pdf

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Master Agreement AZ|CTR053477
Contract number
CTR053477
Issued by
Arizona

About this file

This document is a Contract Amendment for the High Risk Perinatal Program (HRPP) Hospital Services issued by the Arizona Department of Health Services, Office of Procurement. The amendment involves Rural Metro Ambulance as the contractor and is specifically Amendment No. 2 to Contract No. CTR053477. The contract is being extended through June 30, 2024, which represents the third year of the contract period, in accordance with the Special Terms and Conditions regarding Contract Extensions.

The amendment pertains to hospital services for high-risk perinatal care, with the primary action being a contract extension. No specific pricing details or service modifications are explicitly outlined in the provided document. The amendment follows standard governmental contract extension protocols, maintaining the existing terms and conditions while prolonging the contract duration. The document is signed by Glenn Kasprzyk, President of the Southwest Region for Rural Metro Ambulance, and includes a procurement officer signature from the Arizona Department of Health Services.

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CONTRACT AMENDMENT

ARIZONA DEPARTMENT OF

HEALTH SERVICES

OFFICE OF PROCUREMENT

150 N 18th Ave., Ste. #530 Phoenix, Arizona 85007

CONTRACT NO.: CTR053477 AMENDMENT NO.: 2 Procurement Officer Lucas Terry

High Risk Perinatal Program (HRPP) Hospital Services

Effective upon signature by both parties it is mutually agreed that the Contract referenced in this Amendment Two (2) is amended as follows:

1. Pursuant to the Special Terms and Conditions, Provision Three (3), Contract Extensions (5 Year Maximum), the

Contract is hereby extended through June 30, 2024, the third year of the Contract.

ALL CHANGES ARE REFLECTED IN RED

ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY

Contractor hereby acknowledges receipt and acceptance of above amendment and that a signed copy must be filed with the Procurement Office before the effective date

The above referenced Contract Amendment is hereby executed this _____ day of __________ 20______ at Phoenix, Arizona

(To be filled out by Procurement Office)

Contractor Signature

Contractor Signature Date

Authorized Signatory’s Name and Title

Rural Metro Ambulance

Contractor’s Name Procurement Officer Signature

Gina Corwin

Digitally signed by Gina Corwin Date: 2023.05.23 15:50:26 -07'00'

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