HomeMy WebLinkAboutA-21-195 DPH Misc. Docs.pdf w CO U�
CONTRACT STATUS FORM
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DATE: December 02, 2024Es'�
DIVISION(S): Administration
(Lead Division listed first)
CONTRACTOR: Fresno Pacific University
SERVICES: Clinical and Field Experience for Students
CONTRACT TERM: 7/1/21 to 6/30/25
OF P SECS\0�
ADDITIONAL INFO: Term expres 6/30/2025, requires a letter to extend.pEQ$�O�OON�EtFO�S
ORGANIZATION #(s): 56201500 56107001 56302003 3430999
CONTRACT AMOUNT: $0.00
Contract#: A-21-195 State/Vendor #:
Lead Dept: DPH Other Dept(s): DSS, DBH, PROBATION
Complete the information below and return to DPH Contracts by:March 1, 2025
Extend contract through: 120
1-1 With no changes in terms or conditions.
With the following change(s):
Evergreen: Continue contract through: 20 .
Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
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Approved by:
Program Supervisor/Staff Analyst: Date:
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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COUP
County of Fresno
o� 56 o DEPARTMENT OF PUBLIC HEALTH
�uES� David Luchini, Director
Dr. Rais Vohra, Interim Health Officer
April 21, 2022
Business Manager
Fresno Pacific University
1717 S. Chestnut Ave.
Fresno, CA 93702
Agreement: 21-195
Dear Contractor,
The County of Fresno, Department of Public Health has not received current verification
of your insurance requirements in accordance with the "Insurance" Section of the
Agreement between the County of Fresno and your agency.
Please send us an original insurance certificate(s) verifying that your insurance is in
compliance for the current period of the Agreement at your earliest possible
convenience but no later than thirty (30) days from the date of this letter. Please
forward a copy of the certificate to dphcontractsCab-fresnocountyca.gov or mail the
original to:
County of Fresno, Department of Public Health
P.O. Box 11867
Fresno, CA 93775
ATTN: Contracts Section — 6t" Floor
If you have any questions, please contact me at (559) 600-7090.
Sincerely,
`J
Roberta Bynum
Senior Staff Analyst
RB: Iw
Promotion,preservation and protection of the community's health
1221 Fulton Street/P. O. Box 11867, Fresno,CA 93775
(559)600-3200 0 FAX(559)600-7687
The County of Fresno is an Equal Employment Opportunity Employer
www.co.fresno.ca.us 0 www.fcdph.org
COUP
County of Fresno
o� s6 o DEPARTMENT OF PUBLIC HEALTH
September 3, 2021
Business Manager
Fresno Pacific University
1717 S. Chestnut Ave.
Fresno, CA 93702
Agreement: A-21-195
SECOND REQUEST
Dear Contractor,
The County of Fresno, Department of Public Health has not received current verification
of your insurance requirements in accordance with the "Insurance" Section of the
Agreement between the County of Fresno and your agency.
Please send us an original insurance certificate(s) verifying that your insurance is in
compliance for the current period of the Agreement at your earliest possible
convenience but no later than thirty (30) days from the date of this letter. Please
forward a copy of the certificate to dphcontracts(cb-fresnocountyca.gov or mail the
original to:
County of Fresno, Department of Public Health
P.O. Box 11867
Fresno, CA 93775
ATTN: Contracts Section — 6t" Floor
If you have any questions, please contact me at (559) 600-7090.
Sincerely,
Roberta Bynum
Senior Staff Analyst
RB: Iw
Promotion,preservation and protection of the community's health
1221 Fulton Street/P. O. Box 11867, Fresno, CA 93775
(559)600-3200 0 FAX(559)600-7687
The County of Fresno is an Equal Employment Opportunity Employer
www.co.fresno.ca.us 0 www.fcdoh.orq
coU�
County of Fresno
DEPARTMENT OF PUBLIC HEALTH
June 14, 2021
Business Manager
Fresno Pacific University
1717 S. Chestnut Ave.
Fresno, CA 93702
Agreement: A-21-195
Dear Contractor,
The County of Fresno, Department of Public Health has not received current verification
of your insurance requirements in accordance with the "Insurance" Section of the
Agreement between the County of Fresno and your agency.
Please send us an original insurance certificate(s) verifying that your insurance is in
compliance for the current period of the Agreement at your earliest possible
convenience but no later than thirty (30) days from the date of this letter. Please
forward a copy of the certificate to d_phcontractsCa�-fresnocountyca.gov or mail the
original to:
County of Fresno, Department of Public Health
P.O. Box 11867
Fresno, CA 93775
ATTN: Contracts Section — 6th Floor
If you have any questions, please contact me at (559) 600-7090.
Sincerely,
Roberta B num
Y
Senior Staff Analyst
RB: Iw
Promotion,preservation and protection of the community's health
1221 Fulton Street/P. O. Box 11867, Fresno, CA 93775
(559) 600-3200 0 FAX(559) 600-7687
The County of Fresno is an Equal Employment Opportunity Employer
www.co.fresno.ca.us 0 www.fcdph.org