CTR053486 A2 SW Ambulance of Tucson executed with Debarment.pdf
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- Attached to
- Master Agreement AZ|CTR053486
- Contract number
- CTR053486
- Issued by
- Arizona
About this file
The document is a Contract Amendment from the Arizona Department of Health Services, Office of Procurement, specifically Amendment No. 2 for Contract No. CTR053486 involving the High Risk Perinatal Program (HRPP) Hospital Services. The contract is between the Arizona Department of Health Services and Southwest Ambulance, a company incorporated in Arizona with its primary address in Scottsdale and registered in the System for Award Management (SAM).
The amendment extends the existing contract through June 30, 2024, which represents the third year of the contract, in accordance with the Special Terms and Conditions, Provision Three regarding Contract Extensions. The contract is limited to a maximum of five years. Southwest Ambulance is registered for "All Awards" purposes and has an active registration set to expire on March 23, 2024. The company is classified as a for-profit organization specializing in emergency medical transportation, with its entity start date being October 1, 2009. The amendment maintains all other existing provisions of the original contract in their entirety.
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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.: CTR053486 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
Southwest Ambulance
Contractor’s Name Procurement Officer Signature
Gina Corwin
Digitally signed by Gina Corwin Date: 2023.05.23 14:05:32 -07'00'
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