HomeMy WebLinkAboutP-24-175 DPH Misc. Docs.pdf COUP
CONTRACT STATUS FORM tip ,
DATE: June 03, 2024 RECEIVEDES�
DIVISION(S): Administration SEP 2 7 2024
(Lead Division listed first) DEPARTMENT OF PUBLIC HEALTH
CONTRACTOR: Poverello House CONTRACTS SECTION
SERVICES: Data Sharing, Data User Census Work and Consultation Services
CONTRACT TERM: 4/15/24 to 12/31/24
ADDITIONAL INFO:
ORGANIZATION #(s): 56201508
CONTRACT AMOUNT: $26,000.00
Contract#: P-24-175 State/Vendor#:
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:September 1, 2024
71 Extend contract through: 114 A A., 36 120
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, contract extension, etc.):
Approved by.
Program Supervisor/Staff AnalystG- -a - C�'=- Date: 1y y�
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
coU���
+ County of Fresno
o� so DEPARTMENT OF PUBLIC HEALTH
FRE`' David Luchini, Director
Dr. Rais Vohra, Interim Health Officer
April 18, 2024
Zachary Darrah
Poverello House
412 F Street
Fresno, CA 93706
Agreement: P-24-175
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. For your reference the
insurance requirements are listed on pages 2 and 3 of the enclosed Agreement.
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(s) to dphcontracts(aD-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.fcdph.org