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Master Blanket Purchase Order ADVS14-060131

Header Information
Purchase Order Number: ADVS14-060131 Release Number: 0 Short Description: Physician Services Dr.Saka and Dr. Nguyen ASVH-P
Status: 3PS - Sent Purchaser: Margie Silva Receipt Method: Quantity
Fiscal Year: 2014 PO Type: Blanket Minor Status:
Organization: Arizona Department of Veterans' Services
Department: VETHOME - State Veteran Home Location: ADMP - Administration-ASVH-P Type Code:
Alternate ID: Entered Date: 11/08/2013 02:46:52 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: Tax Rate: Actual Cost: $0.00
Master Blanket/Contract End Date (Maximum): 06/04/2019 11:59:59 PM
Project No.:
Special Purchase Types: Competition Impracticable
PIJ NUMBER:
Commodity Reference Id:
PO External Doc Type:
Agency Attachments: PO Ts & Cs.pdf CI Physician Services ASVH-P.pdf Procurement Disclosure Form.pdf Physician Services Dr. Saka and Dr. Nguyen.pdf thanh MICA 6-2013 COI_Report.pdf ADVS14-060131 A1.pdf Certificate of Insurance ADVS14-060131 A2.pdf ADVS14-060131 Competition Impracticable COI exp 6-25-16.pdf AMENDMENT 3.pdf Amendment 4 6 04 2018 CI for Physicians 2018 Dr. Sake and Nguyen.pdf Signed Amendment 5.pdf
Vendor Attachments:
Agency Attachment Forms:
Vendor Attachment Forms:
Primary Vendor Information & PO Terms
Vendor: 000035108 - INTERNAL MEDICINE CONSULTANTS
Raymond Maza
152 S Quarty Cir
Chandler, AZ 85225
US
Email: diepthanh@gmail.com
Phone: (480)821-9339
FAX: (480)821-9555
Alt. Reference: Z0001
Payment Terms: Net 30 Shipping Method:
Shipping Terms: Freight Terms:
Master Blanket/Contract Vendor Distributor List
Vendor ID Alternative ID Vendor Name Preferred Delivery Method Vendor Distributor Status
000035108
PZ000035108 INTERNAL MEDICINE CONSULTANTS Email Active
Master Blanket/Contract Controls
Master Blanket/Contract Begin Date: 06/05/2014 Master Blanket/Contract End Date: 06/04/2019
Cooperative Purchasing Allowed: No
Organization Department Dollar Limit Dollars Spent to Date Minimum Order Amount
ADVS - Arizona Department of Veterans' Services ASVHP - AZ State Veteran Home - Phoenix $0.00 $0.00 $0.00
ADVS - Arizona Department of Veterans' Services VETHOME - State Veteran Home $0.00 $610,650.00 $0.00
Item Information   
Print Sequence # 1.0, Item # 1:   VASC Veterans and/or Patients that are covered by Medicare part A only, without Medicare part B, is $90 per visit by the Physician. 3PS - Sent
NIGP Code: 948-74
   Professional Medical Services (Including Physicians, Pharmacists, and All Specialties)
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 0.0 $90.00 EA - Each 0.00 $0.00 $0.00 $0.00
Manufacturer: Brand: Model:
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