HomeMy WebLinkAboutCalViva Health A-11-058 (2).pdf w CO U�
CONTRACT STATUS FORM
RECEIVED
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DATE: August 01, 2023 MAY 0 2 2024Es�
DIVISION(S): Administration DEPARTMENT Of PUBLIC HE4AD
(Lead Division listed first) CONTRACTS SECTION
CONTRACTOR: CalViva Health (Fresno, Kings, Madera Regional Health Authority)
SERVICES: Public Health Services
CONTRACT TERM: 3/1/11 to 2/28/24 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): 56201620 56201650 56201654
CONTRACT AMOUNT: $150,000.00
Contract#: A-11-058 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:November 1, 2023
Extend contract through: 2-%7� 20 7 5
—With no changes in terms or conditions.
With the following change(s):
❑ Evergreen: Continue contract through: 20 .
❑ Cancel contract effective: 120
❑ Additional Information (e.g., anticipated effective date/term, co tract extension, etc.):
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Approved by. titer
Program Supervisor/Staff Analyst:v Date:
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090