Procurement Request PRS-8103cb42.pdf
PDF 122 KB Posted
- Attached to
- Master Agreement AZ|CTR068280
- Contract number
- CTR068280
- Issued by
- Arizona
About this file
This document is a Procurement Request Form from the Arizona Department of Health Services (ADHS) for a new two-year contract with the Mohave County Department of Public Health. The procurement request is associated with the Public Health Emergency Preparedness (PHEP) bureau and is classified as a grant-funded sub-recipient agreement under PMS ID# PRS-8103cb42.
The contract involves a federal funding allocation of $126,500.00 annually, with an annual renewal term. The procurement is marked as a new status, created on 8/18/2023, and involves the Mohave County Department of Public Health located in Kingman, Arizona. The contract appears to be part of the Medical Reserve Corps (MRC) STRONG program, with attachments including an email to proceed, a Code of Federal Regulations (CFR) document, a Scope of Work (SOW), and a grant guide. The requestor is sylvia.puente-araiza@azdhs.gov, and the assigned procurement officer is hana.hehman@azdhs.gov.
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Other files
| File | Type | Posted |
|---|---|---|
| CTR068280 Pricing.pdf | ||
| CTR068280 A1.pdf | ||
| CTR068280 A2 Pricing.pdf | ||
| CTR068280 A2.pdf | ||
| CTR068280_Mohave_County_MRC_STTRONG_fully_executed.pdf |
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Text version
150 N. 18th Avenue, Phoenix, AZ 85007
Procurement Request Form PMS ID# PRS-8103cb42
Basic Information:
Title: RUSH - New 2-Year Contract Request Mohave
County Department of Public Health_$126,500
Bureau: PHEP
Procurement Request Type: Grant
Description: RUSH - NEED ASAP New 2-Year Contract Request Mohave County Department of Public Health_$126,500
Existing Contract Number:
Supplier Name: Mohave County Department of Public Health - PO Box 7000, Kingman, AZ 86402, palmem@mohave.gov 928 753-0794 Ext.4298
Supplier ID#
Requestor Information:
Requestor: sylvia.puente-araiza@azdhs.gov
Phone: 480 521-9961
Estimated date needed: 10/17/2023
Program Information:
Program contact: ruth.penn@azdhs.gov
Program contact phone:
602 768-1624
Other Participants:
Financial Information:
Estimated Annual Amount: $126,500.00
Funding Available?: N
Funding Type: Federal tel:480 521-9961 tel:602 768-1624
Are funds for a sub-recipient or contractor?
Sub-Recipient
2 CFR 200.332 Form: Y
Contract Term: Annual renewal
PMS ID# PRS-8103cb42
Supplemental Information:
Created Date: 8/18/2023
Procurement Status: NEW
Assigned Officer: hana.hehman@azdhs.gov
Date Assigned:
Amendment#:
Date Completed:
Chosen Supplier: Mohave County Department of Public Health - PO Box 7000, Kingman, AZ 86402, palmem@mohave.gov 928 753-0794 Ext.4298
Effective Date:
Max End Date:
Attachments:
File Description/Lab el Comments Added By Date Added
0f31c3fc.File.195
MRC STTRONG
Email to Proceed - Mohave sylvia.puente-araiza@azdhs.g ov
8/18/2023 a9b94638.File.1 95302
MRC STTRONG
CFR - Mohave sylvia.puente-araiza@azdhs.g ov
8/18/2023 e0ef019a.File.19
MRC STTRONG
SOW - Mohave sylvia.puente-araiza@azdhs.g ov
8/18/2023
9b1e6575.File.1 95312.v1
MRC STTRONG
Grant Guide - Mohave sylvia.puente-araiza@azdhs.g ov
8/18/2023
Procurement Comments:
PMSID# Comment Added By Date Entered
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