CTR053477 A 2 Rural Metro Ambulance executed with Debarment.pdf
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- Attached to
- 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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