CTR061131_Offer_and_Acceptance.pdf

Request for Proposal

Solicitation No. BPM004543

Pharmaceutical Services for the Arizona State Veterans’ Homes

ARIZONA DEPARTMENT OF

VETERANS’ SERVICES

3839 N. 3rd Street Phoenix, Arizona

85012

Solicitation Offer Form Page 1 of 1

Offer and Acceptance Form

SUBMISSION OF OFFER: Undersigned hereby offers and agrees to provide PHARMACEUTICAL SERVICES in compliance with the Solicitation indicated above and our Offer indicated by the latest dated version below:

Initial Offer:

5/18/22

Date Signature

Revised Offers:

Date Signature Date Signature

Date Signature Date Signature

Best and Final Offer:

Date Signature

Guardian Pharmacy of Arizona dba Saliba’s Extended Care Pharmacy

Offeror company name Signature of person authorized to sign Offer

925 E Covey Lane John Saliba, President

Address Printed name and title

Phoenix, AZ 85024 John Saliba, President

City | State | ZIP Contact name and title

20-0076525 JSaliba@salibaspharmacy.com (602) 818-3085

Federal tax identifier (EIN or SSN) Contact Email Address Contact phone number

CERTIFICATION: By signature in the above, Offeror certifies that it:

1. will not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, [Arizona] State Executive

Order 2009-9 or A.R.S. § 41−1461 through 1465;

2. has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause will result in rejection of the Offer. Signing the Offer with a false statement will void the Offer, any resulting contract, and may be subject to legal penalties under law;

3. complies with A.R.S. § 41-3532 when offering electronics or information technology products, services, or maintenance; ad

4. is not debarred from, or otherwise prohibited from participating in any contract awarded by federal, state, or local government.

ACCEPTANCE OF OFFER: State hereby accepts the initial Offer, Revised Offer, or Best and Final Offer identified by the latest date and number at the top of this form (the Accepted Offer). Offeror is now bound (as Contractor) to carry out the Work under the attached Contract, of which the Accepted Offer forms a part. Contractor is cautioned not to commence any billable work or to provide any material or perform any service under the Contract until Contractor receives the applicable Order or written notice to proceed from the Procurement Officer.

State’s Contract Number is: Contract Effective Date:

Procurement Officer Signature Award Date Procurement Officer Name Title

7/7/2022 Christina Jimenez Senior Procurement Officer

August 1, 2022CTR061131 mailto:JSaliba@salibaspharmacy.com