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HomeMy WebLinkAboutA-95-356 DPH Misc. Docs.pdf ow 4EW CONTRACT STATUS FORM co�,� RECEj o � s6 0 DATE: December 01, 2023 A[p -IQN 172024 (LeadD IDivision viON(S d first) Children's Medical Services pN A OF /cH rs CONTRACTOR: Fresno Unified School District sfpry SERVICES: Telephone Service for Ginsburg and Storey MTU's CONTRACT TERM: 7/25/95 to 6/30/24 E ADDITIONAL INFO: Evergreen Agreement-Please Review ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 Contract#: A-95-356 StateNendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1. 2024 Extend contract through: , 20 ❑ With no changes in terms or conditions. With the following change(s): ® Evergreen: Continue contract through: JUI?f ,�� , 20 Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by. Program Supervisor/Staff AnalvXfDate: Division Manag Date: 2'w Z� Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 _ _ CO U� CONTRACT STATUS FORM R� , t 9103 0 s 0 DATE: December 01, 2022 �N1 EA�j �rzE DIVISION(S): Children's Medical Services p `.dRpC (Lead Division listed first) CONTRACTOR: Fresno Unified School District SERVICES: Telephone Service for Ginsburg and Storey MTU's CONTRACT TERM: 7/25/95 to 6/30/23 E ADDITIONAL INFO: Evergreen Agreement-Please Review ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1, 2023 Extend contract through: , 20 ❑ With no changes in terms or conditions. With the following change(s): dEvergreen: Continue contract through: June Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by. Program Supervisor/Sta Analy �'u6an 1 S r mr Date: 01 17 SO 23 Division Manager: Date: --(2-23 Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 i CO U� CONTRACT STATUS FORM 't o so DATE: December 01, 2021 RECENEDES� DIVISION(S): Children's Medical Services MAR p g2U22 (Lead Division listed first) tow CONTRACTOR: Fresno Unified School DistrictOISSEC SERVICES: Telephone Service for Ginsburg and Storey Schools CONTRACT TERM: 7/25/95 to 6/30/22 E ADDITIONAL INFO: Evergreen Agreement-Please Review ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1, 2022 Extend contract through: , 20 With no changes in terms or conditions. With the following change(s): ® Evergreen: Continue contract through: Ju" 90 20 Cancel contract effective: , 20 ❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by. �- Program Supervisor/St t: Date: �ZZ Division Manager: Date: -4d Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 # 4- co CONTRACT STATUS FORM O� 56 O DATE: December 01, 2020 DIVISION(S): Children's Medical Services RECEIVE (Lead Division listed first) {AN 2 v ZU CONTRACTOR: Fresno Unified School District DEPARTMENT OF PUBL HEALTH C NTRACTS SECTION SERVICES: Telephone Service for Ginsburg and Storey Schools CONTRACT TERM: 7/25/95 to 6/30/21 E ADDITIONAL INFO: Evergreen Agreement-Please Review ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1. 2021 Extend contract through: , 20 11 With no changes in terms or conditions. With the following change(s): DEvergreen: Continue contract through: Jun e L _ , 20 Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by. P400ffiffi-s�i br a lyst ./A fi7� Date: / // apt/ Division Man er: Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 CO C' "NTRACT STATUS F02(M DATE: December 02, 2019 RECEIVED o =. iiEs�o DIVISION(S): Children's Medical Services JAN 14 0 (Lead Division listed first) DEPARTMENT OF PU I HEALTH CONTRACTOR: Fresno Unified School District CONTRACTS SECTION SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/25/95 to 6/30/20 E Auto-renewal: El through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Evergreen Agreement-Please Review Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1, 2020 Renew contract through: , 20 ❑ With no changes in terms or conditions. ❑ With the following change(s): Evergreen: Continue contract through: \jWlL �O 9 20 02/ ❑ Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by. 47 P /Staff Analyst; I Date: Division Manager: Date: 77 Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 co CONTRACT STATUS FOIM O, s6 O DATE: November 29, 2018 WEIVED ESQ DIVISION(S): Children's Medical Services DEC 112018 (Lead Division listed first) DEPARTMENT CONTRACTOR: Fresno Unified School District CONTRA�SSECT 1PUBLI0H AL SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/25/95 to 6/30/2019 E Auto-renewal: ❑ through: (if not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1, 2019 ElRenew contract through: h,\�r -2c , 20 _. 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.): Approved by: Program Supervisor/Staff Analyst: Date: (� Division Manage - Date: 1 I Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 COUP CONTRACT STATUS FORM DATE: December 01, 2017 RECEIVES DIVISION(S): Children's Medical Services QEC 12 (Lead Division listed first) 2�I CONTRACTOR: Fresno Unified School District MPARTMENTOFPUBLICN CONTRACTS SECTION TH SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/17 to 6/30/2018 E Auto-renewal: © through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1, 2018 Renew contract through: _, 20, With no changes in terms or conditions. ❑ With the following change(s): Evergreen: Continue contract through: u..�2. 2,0 , 20 Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by. Program Su ervisor/Staff Anal t: Date: 9 P Division Manager: Date: l L(I�T Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090 CO U� CONTRACT STATUS FORM ti O� s6 0 DATE: November 28, 2016 FictEs� DIVISION(S): Children's Medical Services RECEIVED (Lead Division listed first) A?, 0 7 2016 CONTRACTOR: Fresno Unified School District DEPWWNTOF LiC CQNTWTS SECTO TH SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/16 to 6/30/17 E Auto-renewal: 17 through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1. 2017 Renew contract through: 30 , 20 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.): Approved by. Program Supervisor/Sta I Date: Division Manager Date: i Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 w CO U� C"NTRACT STATUS FOWM tip. O� 56 0 DATE: November 20, 2015 RECEIVEDEs�' DIVISION(S): Children's Medical Services NOV 2 4 2015 (Lead Division listed first) DEPARTMENT OF PUBLIC HEALTH ADMINISTRATION CONTRACTOR: Fresno Unified School District SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/15 to 6/30/16 E Auto-renewal: W through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by:March 1, 2016 ❑ Renew contract through: , 20 ❑ With no changes in terms or conditions. ❑ With the following change(s): IVI Evergreen: Continue contract through: NNE. 30 20YN J . ❑ Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Program Supervisor/Staff Analyst: V Date: (l Zy 1 Division Manager: ' Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 co CONTRACT STATUS FORM ti a s O s56 O DATE: December 09, 2014 FUES� DIVISION(S): Children's Medical Services RECEIVED (Lead Division listed first) CONTRACTOR: Fresno Unified School District DEC 2 9 2014 p g y DEPACONTRACTS SECTI HEALTH SERVICES: Telephone Service for Ginsburg and Store Schools CURRENT PERIOD: 7/1/14 to 6/30/15 E Auto-renewal: O through: (if not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by: March 1, 2015 Renew contract through: (O Z 30 , 20�412 0 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.): Approved by: Program Supervisor/Staff Analyst: Date: eivision Manager: Date Z3 / Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 co CONTRACT STATUS FORM /7 O� 8560 DATE: December g, 2013 DIVISION(S): Children's Medical Services RECEIVED (Lead Division listed first) CONTRACTOR: Fresno Unified School District JAN 13 2014 DEPARTMENT OF PUBLIC HEWN SERVICES: Telephone Service for Ginsburg and Storey Schools CONTRACTS SECTION CURRENT PERIOD: 7/1/13 to 6/30/14 E Auto-renewal: ❑ through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by: March `K, 2014" Renew contract through: 30 , 20-, 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.): � 1 4pproved by. � - rram Supervisor/ ffAnalyst.P �vi ion Manager: Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090 co CUNTRACT STATUS FORM 1 0�.. 56 O DATE: December 03, 2012 �5�' DIVISION(S): Children's Medical Services (Lead Division listed first) CONTRACTOR: Fresno Unified School District SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/12 to 6/30/13 E Auto-renewal: ❑ through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by: March 1, 2013 ❑ Renew contract through: , 20 ❑ 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: p �( Program Superviso Staff Analyst: — Date: .� z Division Manager: Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090 IFW w CO CONTRACT STATUS FOMI 'o DATE: December 05, 2011 DIVISION(S): Children's Medical Services (Lead Division listed first) CONTRACTOR: Fresno Unified School District SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/11 to 6/30/12 E Auto-renewal: ❑ through: (if not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH.Contracts by: March 1, 2012 Renew contract through: , 20 With no changes in terms or conditions. With the following change(s): 19/Evergreen: Continue contract through: , 20 /-3 Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by: _ Program Supervis Date: Division Manager: Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 445-7090 "r COUP CONTRACT STATUS FORM '0 O asG O DATE: December 01, 2010 FREc�� DIVISION(S): Children's Medical Services (Lead Division listed first) CONTRACTOR: Fresno Unified School District SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/10 to 6/30/11 E Auto-renewal: through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete:the,information belownand:ret€iri to-.DPW� ootraeft by.- March-1 °:204, Renew contract through: , 20 ❑ With no changes in terms or conditions. ❑ With the following change(s): Evergreen: Continue contract through: 0 , 20 Z-12 , Cancel contract effective: , 20 Additional Information (e.g., anticipated effective date/term, contract extension, etc.): Approved by: Program Superviso tall Analysts — Date: c� Division Manager: Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 445-7090 E W COUP C15NTRACT STATUS FORM Ir O is6 O DATE: November 24, 2009 DIVISION(S): Children's Medical Services (Lead Division listed first) CONTRACTOR: Fresno Unified School District SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/09 to 6/30/10 E Auto-renewal: ❑ through: (if not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment II Contract#: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by: March 1, 2010 Renew contract through: , 20 ❑ 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.): Approved by: _ / Program Supervisor/Staff Analyst: C Date: 1�o Division Manager: Date: Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 445-7090 co Contract Renewal/Termination Form O 1856 O DATE: December 01, 2008 FRV`o RECEIVED DIVISION(S): Children's Medical Services (Lead Division listed first) APR 15 2009 CONTRACTOR: Fresno Unified School District DEPARTMENT OF PUBLIC HEALTH CONTRACTS SECTION SERVICES: Telephone Service for Ginsburg and Storey Schools CURRENT PERIOD: 7/1/08 to 6/30/09 E Auto-renewal: ❑ through: (If not checkmarked above,contract will terminate ENTIRE TERM: 7/25/1995 to Evergreen at the end of the current period.) ORGANIZATION #(s): 56201601 CONTRACT AMOUNT: $4,000.00 ADDITIONAL INFO: Amendment I Contract #: A-95-356 State/Vendor#: N/A Lead Dept: DPH Other Dept(s): Complete the information below and return to DPH Contracts by: March 1. 2009 ❑ Renew contract through: , 20 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.): Approved by: Program Supervisor/Staff Analyst: Date: —4 '� .v�ivision Manager: Date: - Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 445-7090