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HomeMy WebLinkAboutA-23-169 DPH Misc. Docs.pdf co County of Fresno ply. p DEPARTMENT OF PUBLIC HEALTH 5 David Luchini, Director Dr. Rais Vohra, Interim Health Officer April 13, 2023 Department of Health Care Services Inmates Medi-Cal Claiming Unit Local Governmental Financing Division 1501 Capitol Ave., MS2628 Sacramento, CA 95814 Re: Fresno County Executed Participation Agreement and Administrative Services Agreement (FY 2023-2026) To Whom it May Concern; I have enclosed two copies each of Fresno County's signed MCIP Agreements along with a copy of the Fresno County Board of Supervisors corresponding Minute Order dated April 11, 2023. Once the Agreements have been executed by the State, please return one copy of each signed and fully executed Agreements to my attention: Shelly Awes, Staff Analyst Department of Public Health PO Box 11867 Fresno, CA 93775 Please feel free to contact me at the phone number or email below if you have any questions or concerns. Respectfully, Shelly Awes;fSt ff Analyst County of Fresno, Department of Public Health Email: sawesna,fresnocountyca.gov Phone#(559) 600-6439 Promotion,preservation and protection of the community's health 1221 Fulton Street JP.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.fcdi)h.ora c; ady y fadEa 81,53 00711 3193 '"Ty Tracking Inc. Express �.� �,. .-,., Number O N rom Plea ep nand sshaM. 4 Express Package Service •Tomoallooad.m. Packages up to150lhs. �22 Sender's FedEx ,, _ forpeakapesova Wtbs-me era ate t.� Account Number •:1Lw'�+�t"•'r";-'-�',��Ca-2 P.de.epaer.pmusum;x. soda,': �t / }�,(' r � ;a ,r; Y-t 1 f FedEx FrstOvernight FedEx2DayA.M. ame G_ �%S Phone( �:.� T I �' 4 L,1! ❑ EadioA nag busnesamommp derrverym soled ❑Second business reammg.• locations.fridayshipmema vag haddivered on Sanadey Delivery NOTavegaGe. MorMayunless Saturday oagveryis selected. r'`-'= z 1.t"T PUBLIC } s ed,x PriorityOvernight FedEx 2Da DmPany V'ti r.:rtl: i.r g..71u E'+ 1 T i' L),t3 „S�,«• Y'�'i?„::"^. _•i "+ Naxtbusiness kp.'Frida9shipmems 11 be ❑Sacontl bu.in ys sham.on.•Tlxesday sNpmems darwered on Mondayudass Saturday Delivery xdpbadW r•dou Mcodayua6:Saturday :selected. Oelrveryiaselacted. �.2'c ,i. "�. l..., i�3.,1 G;"f' FeclEx Standard Overnight FeclEx Express Saver ddfeSS ❑ Saturde Delrvary NO evaNable. ❑TE.`deY oe da NOTavapable, v Oept/noogsuhelRaom Y b+eiY ty f'REI State CA ZIP 5 Packaging •oauarada.luefkeasspD. p ❑ FedEx Envelope* FedEx Pak* ❑FedEx ❑FedEx Other our Internal Billing Reference t 3 Box Tube characterss124 checters wdl appear on imdce. D 6 Special Handling and Delivery Signature OptiOns Fe.xmeyappty.SaemefedEa Service Guido. ecipient's ame Phone l i ❑ Saturday Delivery �,� NoTaauilablato;rod&Standard Overnight,fedEx2oayA.M,orFadExEapresaSever. I ' i � � '� K��G�� No-lSi nature Required s-,ren Signature ❑IndirectSi�nature v a t g Q 9 Indirect avicturei ems Dmpany .� Package map be leh vdmout Someone al recipZr address dmesx someone atsna bodnp (�� ,,�j' obteiningas+gnaturehudeli—y.. ay sign for address address me sign(.,dak-y.Far ��© ( -/"► 1 1-7-6�. i t vt� Hold Weekday asda""I�°uyade'°"h. Holdl Weekday Does this shipment contain dangerous goods? flEOUIREO.NOT-iibbl�for ddress a --------- Una hex enact bu,.backed. ------ FadEx First Ovamighk e cannel deliver to P.O.bolos or P.O.ZIP codas. Dept/Floor/Suite/Hoom y �(• ❑Yeses ❑ D lce HoldSaturda o naparatia=had eoadamdon ory o,9,UN1895 . k Jr`,� FadEr locaoneddmss ShippaYs Oeclaredon. rwtrequired. g ddress �"'V flEQUiRluork, i.ebfo Ut.LYfor ❑fee&Pruaey0vami®hl and Restdcdans apptyfadanparous goods—seems curtonlFad&Se+vice Guide. ❑ Cargo Aircraft Only :e this line far the HOLD Iocationaddress or for continuation of your shipping address. Fed&2)aym ctlkoc=etloru. g/� --/yt� � ` 7 Payment Bill to, i 1 "L O State ZIP Ernes FedEx AecC No.or Credit cadNo.below. --, y_�.Sender P1 vxcctNo.T "s0C001 ❑ Recipient El Third Party ❑Credit Card ❑ Cash/Check , btloged. �0 131 r.6Y,.a<.�,..f F :�. 3.6 Gad Ck&d�N�O. X v Total Packages Total Weight Total Declared Valuer u a4 r jn s _ t r bs. $ oil tOurliabgirylsdmdedm USSIOOudessynudec mahipharvalue.Seobackfordatags.B uski disairbR L�•�1- '" ; Fr, to s' 4,ysl}yF(st}It I!4^v'x-.+; •r ,P a, agreetomeseM scondroonsonthia 1, Mdas a'uhid aM'nthe euneauFedEx ServrteG Wend pt� 6 1.L metrxwtaurliabgby. Rev Date 5/15•Part at63134.01994-2015 RJU•PRVTEO IN U.SA SRM cc rn c c LLJ C-) N Ln U C3 rV .. .,"-. L -�+ Q CV tJ cc -11- CS'T LL. co LO U L0 In 4 Q i*F-1T iU _ L:_! - c` 1— W m w: LLJ CD LLI !Zl CI Qg LL1 O aJ � ,4- C/3 as L 1 _ y C: C73 T' LL fl 4-1 OCZ) _ Q C ? r L.Lr rT i �iT v O Q ai {ti CC O LJJ Cl') • C.e f CD W CV LL- =.. Co n � �I. = %� Om .J ;,rLn :n RO aJ �4 as W _ V. _J � :V .'f,., .O •C3 as .J :C t1