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Master Blanket Purchase Order AAGO16-146613

Header Information
Purchase Order Number: AAGO16-146613 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: $518,095.00
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 MIKID Offer and Acceptance.pdf AAGO16-146613 Contract Extension Mikid 08312017 Executed.pdf
Vendor Attachments: Mentally Ill Kids In Distress__AAGO16-00006015__Peer and Family Support.pdf Mentally Ill Kids In Distress__AAG16-00006015__Youth Suicide Prevention.pdf MIKID AAGO16-00006015 BAFO Program 1~2.pdf MIKID AAGO16-00006015 BAFO Program 2~2.pdf MIKID Offer and Acceptance.pdf
Agency Attachment Forms:
Vendor Attachment Forms:
Primary Vendor Information & PO Terms
Vendor: 000005853 - MIKID MENTALLY ILL KIDS IN DISTRESS
Dick Geasland
7816 N 19th Ave
Phoenix, AZ 85021
US
Email: dickg@MIKID.org
Phone: (602)253-1240
FAX: (602)944-2141
Alt. Reference: Z0001
Payment Terms: Net 30 Shipping Method: Best Way
Shipping Terms: F.O.B., Destination Freight Terms: Freight Allowed
PO Acknowledgements:
Document Notifications Acknowledged Date/Time
Purchase Order Emailed to dickg@MIKID.org at 08/25/2016 08:54:39 AM 09/12/2016 11:14:40 AM
Change Order 1 Emailed to dickg@MIKID.org at 09/01/2017 08:28:27 AM
Master Blanket/Contract Vendor Distributor List
Vendor ID Alternative ID Vendor Name Preferred Delivery Method Vendor Distributor Status
000005853
PZ000005853 MIKID MENTALLY ILL KIDS IN DISTRESS Email Active
Master Blanket/Contract Controls
Master Blanket/Contract Begin Date: 08/24/2016 Master Blanket/Contract End Date: 08/31/2018
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 $259,239.44 $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 # 2.0, Item # 4:   Program 1.4.1 (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 / 4 Quote # / Quote Item #:  000039493-R5 / 4
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $70,873.00 EA - Each 0.00 $0.00 $0.00 $70,873.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 3.0, Item # 5:   Program 1.4.1 (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 / 5 Quote # / Quote Item #:  000039493-R5 / 5
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $71,364.00 EA - Each 0.00 $0.00 $0.00 $71,364.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 4.0, Item # 2:   Program 1.4.2 (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 / 2 Quote # / Quote Item #:  000039493-R5 / 2
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $189,357.00 EA - Each 0.00 $0.00 $0.00 $189,357.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 5.0, Item # 3:   Program 1.4.2 (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 / 3 Quote # / Quote Item #:  000039493-R5 / 3
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $186,501.00 EA - Each 0.00 $0.00 $0.00 $186,501.00
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
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