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Master Blanket Purchase Order AAGO16-146620

Header Information
Purchase Order Number: AAGO16-146620 Release Number: 0 Short Description: Mental Health Illness & Disorders, Developmental Learning Disorders & Neurocognitive Disease Program
Status: 3PS - Sent Purchaser: Cindy Palmer Receipt Method: Quantity
Fiscal Year: 2016 PO Type: Blanket Minor Status:
Organization: Office of the Arizona Attorney General
Department: PAD - Civil Litigation Location: CPA - Consumer Protection & Advocacy Type Code:
Alternate ID: Entered Date: 08/24/2016 04:42:56 PM Control Code:
Days ARO: 0 Retainage %: 0.00% Discount %: 0.00%
Print Dest Detail: If Different
Catalog ID: Release Type: Direct Release Pcard Enabled: No
Contact Instructions: Contact Cindy Palmer 602-542-7986 Tax Rate: Actual Cost: $715,076.00
Master Blanket/Contract End Date (Maximum):
Project No.: AG16-0023
Special Purchase Types:
PIJ NUMBER:
Commodity Reference Id:
PO External Doc Type: None
Agency Attachments: Uniform Terms and Conditions V9_(Rev 7-1-2013)~19.pdf Uniform Instructions to Offerors (rev 9-2014)~7.pdf 1 AAGO16-00006015 RFGA 03092016.pdf 2 AAGO16-00006015 Attachment I 03092016.docx 3 AAGO16-00006015 Attachment II 03092016.docx 4 AAGO16-00006015 Attachment III Designation of Confidential Trade Secret Proprietary Information Form 03092016.pdf 5 AAGO16-00006015 Exhibit A Logic Model (Template) 03092016.docx 6 AAGO16-00006015 Exhibit B Gantt Chart (Template) 03092016.xls 7 AAGO16-00006015 Exhibit C AGO Janssen Consent Judgment (Reference).pdf 8 Logic Model and Gantt Chart Tutorial (Reference).pdf 9 Logic Model and Gantt Chart Tutorial (Reference).mp4 10 Logic Model and Gantt Chart Tutorial (Reference).pptx AAGO16-00006015 RFGA Amendment I 04222016.pdf AAGO16-00006015 Janssen Settlement Distribution Evaluation 08242016.pdf AAGO16-00006015- Determination for Award 08242016~1.pdf Intermountain Offer and Acceptance.pdf
Vendor Attachments: Attachment III Designation of Confidential Trade Secret Proprietary Information Arizona Substitute W9 BAFO Confirmation Letter Intermountain Offer and Acceptance.pdf BAFO Attachment II Scope of Work Narrative Certificate of Insurance Attachment I Program Details Attachment I Signed Offer and Acceptance Transmittal Letter
Agency Attachment Forms:
Vendor Attachment Forms:
Primary Vendor Information & PO Terms
Vendor: 9000011535 - INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT, INC.
David K. Giles
P.O. Box 17749
Tucson, AZ 85731-7749
US
Email: RLopez@ichd.net
Phone: (520)721-1887
FAX: (520)721-0069
Alt. Reference: Z0001
Payment Terms: Shipping Method:
Shipping Terms: Freight Terms:
PO Acknowledgements:
Document Notifications Acknowledged Date/Time
Purchase Order Emailed to RLopez@ichd.net at 08/25/2016 08:37:16 AM 08/31/2016 10:22:33 AM
Master Blanket/Contract Vendor Distributor List
Vendor ID Alternative ID Vendor Name Preferred Delivery Method Vendor Distributor Status
9000011535
PZ9000011535 INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT, INC. Email Active
Master Blanket/Contract Controls
Master Blanket/Contract Begin Date: 08/24/2016 Master Blanket/Contract End Date: 08/31/2017
Cooperative Purchasing Allowed: No
Organization Department Dollar Limit Dollars Spent to Date Minimum Order Amount
AAGO - Office of the Arizona Attorney General PAD - Civil Litigation $0.00 $312,834.00 $0.00
Item Information   
Print Sequence # 1.0, Item # 1:   Totals from AAGO16-00006015 Request for Grant Application Attachment II, Section 2.8 Cost Sheet Form, should be matched to the corresponding line items below. 3PS - Sent
Bid # / Bid Item #:  AAGO16-00006015 / 1
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
This item is narrative
 
Print Sequence # 10.0, Item # 2:   Program 1.4.3 (Year One) - Administrative Expenses Total (Includes Personnel, Operating, and Other Expenses) 3PS - Sent
NIGP Code: 952-13
   Community Services : H013-00
Bid # / Bid Item #:  AAGO16-00006015 / 10 Quote # / Quote Item #:  000039490-R1 / 10
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $250,059.00 EA - Each 0.00 $0.00 $0.00 $250,059.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 11.0, Item # 3:   Program 1.4.3 (Year One) - Program Expenses Total (Expenses Not Included in Administrative Expenses) 3PS - Sent
NIGP Code: 952-13
   Community Services : H013-00
Bid # / Bid Item #:  AAGO16-00006015 / 11 Quote # / Quote Item #:  000039490-R1 / 11
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $62,775.00 EA - Each 0.00 $0.00 $0.00 $62,775.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 12.0, Item # 4:   Program 1.4.3 (Year Two) - Administrative Expenses Total (Includes Personnel, Operating, and Other Expenses) 3PS - Sent
NIGP Code: 952-13
   Community Services : H013-00
Bid # / Bid Item #:  AAGO16-00006015 / 12 Quote # / Quote Item #:  000039490-R1 / 12
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $308,967.00 EA - Each 0.00 $0.00 $0.00 $308,967.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 13.0, Item # 5:   Program 1.4.3 (Year Two) - Program Expenses Total (Expenses Not Included in Administrative Expenses) 3PS - Sent
NIGP Code: 952-13
   Community Services : H013-00
Bid # / Bid Item #:  AAGO16-00006015 / 13 Quote # / Quote Item #:  000039490-R1 / 13
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $93,275.00 EA - Each 0.00 $0.00 $0.00 $93,275.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
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