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Master Blanket Purchase Order ADCS16-111622

Header Information
Purchase Order Number: ADCS16-111622 Release Number: 0 Short Description: Transportation Services
Status: 3PS - Sent Purchaser: Jim Kennedy Receipt Method: Quantity
Fiscal Year: 2016 PO Type: Blanket Minor Status:
Organization: Arizona Department of Child Safety
Department: OP - Office of Procurement Location: OP - Contracts Type Code:
Alternate ID: Entered Date: 10/11/2015 02:56:35 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: Jim Kennedy - JKennedy@azdes.gov Tax Rate: Actual Cost: $153.87
Master Blanket/Contract End Date (Maximum):
Project No.:
Special Purchase Types:
PIJ NUMBER:
Commodity Reference Id:
PO External Doc Type: None
Agency Attachments: ADCS15-00005296 Transportation Services RFP rev 8-18-15 Attachment 1_Offerers Experience Attachment 2 -Transportation Services Info Form Attachment 3 - List of References Attachment 4 - Service Implementation Questionnaire Attachment 5 - Written Assurance Attachment 6 - Designation of Confidentiality Payment Schedule Sole Prioprietor Waiver Independent Contractor Waiver HITECH Business Associate Agreement Exhibit A Transportation Services Request ADCS~2.xls Exhibit A Transportation Services Request ADES~2.xls Exhibit B DCS-1125A Unusual Incident Report Exhibit C Monthly Activity Report Exhibit D DCS Region Boundaries rev 8-14-15 Exhibit E ADCS Transportation Invoice rev 8-14-15 AZ Substitute W-9 Pre-Solicitation Documents~5.zip Award Letter_Tymon LLC Signed Offer and Acceptance Change Order 1 - Amendment 1 Evaluation Documents Independent Contractor Agreement - Manal Elbasheir dbaTymon LLC~1.pdf Tymon - Amendment 2.docx Tymon - COI_exp 3-05-17.pdf Tymon_Contract Amendment 3.zip Tymon_Contract Amendment 4.zip
Vendor Attachments:
Agency Attachment Forms:
Vendor Attachment Forms:
Primary Vendor Information & PO Terms
Vendor: 000031017 - Tymon llc
Manal Elbasheir
8016 S. 32 Way, Phoenix, AZ 85042
Phoenix, AZ 85042
US
Email: tymonllc@yahoo.com
Phone: (480)232-8025
FAX: (480)517-4828
Alt. Reference: Z0001
Payment Terms: Shipping Method:
Shipping Terms: Freight Terms:
PO Acknowledgements:
Document Notifications Acknowledged Date/Time
Purchase Order Emailed to tymonmedtrans@gmail.com at 10/11/2015 05:05:12 PM 10/11/2015 03:39:19 PM
Change Order 1 Emailed to tymonmedtrans@gmail.com at 10/13/2015 04:38:41 PM 10/13/2015 05:40:51 PM
Change Order 2 Emailed to tymonllc@yahoo.com at 02/06/2016 05:21:00 PM 02/06/2016 05:25:48 PM
Change Order 3 Emailed to tymonllc@yahoo.com at 10/28/2016 11:22:18 AM 09/12/2017 07:07:59 PM
Change Order 4 Emailed to tymonllc@yahoo.com at 09/14/2017 07:05:40 AM 09/28/2017 02:35:22 PM
Change Order 5 Emailed to tymonllc@yahoo.com at 08/24/2018 10:30:36 AM
Master Blanket/Contract Vendor Distributor List
Vendor ID Alternative ID Vendor Name Preferred Delivery Method Vendor Distributor Status
000031017
PZ000031017 Tymon llc Email Active
Master Blanket/Contract Controls
Master Blanket/Contract Begin Date: 10/10/2015 Master Blanket/Contract End Date: 10/31/2019
Cooperative Purchasing Allowed: Yes
Organization Department Dollar Limit Dollars Spent to Date Minimum Order Amount
ADCS - Arizona Department of Child Safety AGY - Agency Umbrella Master Control $0.00 $0.00 $0.00
ADES - Arizona Department of Economic Security AGY - Agency Umbrella Master Control $0.00 $0.00 $0.00
Item Information   
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Print Sequence # 1.0, Item # 1:   No Show/Cancellation: (1) Paid when notice of cancellation is done less than 1 (one) hour prior to pick up time, or with on-scene cancellation, or with no-show clients after wait time as specified in Scope of Work, Section 4.15.5. Payment will only be made if the Contractor notified the referring Department staff in writing of a no-show within twenty-four (24) hours of the scheduled pick-up time (see Scope of Work Section 4.15.5). (2) Additionally, if there were multiple people scheduled for the transport, cancellation fee will only by paid if all clients cancel/no-show. 3PS - Sent
NIGP Code: 952-54
   Transportation : H054-00
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $20.00 TRIP - Trip 0.00 $0.00 8.050% $1.61 $21.61
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 2.0, Item # 2:   Wait Time: (1) Rate per hour for Pre-approved wait time (2) Payment will only be made with the submittal of the signed case manager approval of wait time with the monthly invoice. (3) Hourly rate with hours, paid by the nearest quarter hour (i.e. if the driver waits for thirty (30) minutes, then the invoice shall say 0.50 hours) 3PS - Sent
NIGP Code: 952-54
   Transportation : H054-00
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $15.00 HR - Hour 0.00 $0.00 8.050% $1.21 $16.21
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 3.0, Item # 3:   Attendant Rate: (1) Rate per Hour for Pre-approved addition of Contractor staff member to be on board during the transport. Rate includes monitoring, assistance, and services for client. Payment will only be made with the signed submittal of the case manager approval of attendant requirement with the monthly invoice. (2) Hourly rate with hours, paid by the nearest quarter hour (i.e. if an attendant works for 1 (one) hour and seven (7) minutes, then the invoice shall reflect one (1) hour and fifteen (15) minutes). 3PS - Sent
NIGP Code: 952-54
   Transportation : H054-00
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $15.00 HR - Hour 0.00 $0.00 8.050% $1.21 $16.21
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 4.0, Item # 4:   Central Region - Ambulatory Services - per mile rate: Actual miles from pick up to drop off, regardless of number of passengers. 3PS - Sent
NIGP Code: 952-54
   Transportation : H054-00
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $1.80 MILE - Mile 0.00 $0.00 8.050% $0.14 $1.94
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
Print Sequence # 5.0, Item # 5:   Central Region - Ambulatory Services - flag drop: Paid upon initial pick up of referral and paid upon any additional pick-ups en route to final destination. Additional pick-ups are one flag drop at each location and not per person. 3PS - Sent
NIGP Code: 952-54
   Transportation : H054-00
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 1.0 $7.30 EACH - Each 0.00 $0.00 8.050% $0.59 $7.89
Manufacturer: Brand: Model:
Make: Packaging:
Property Number:
 
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