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CONTRACT STATUS FORktFILCEIVED
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DATE: December 02, 2024 DEC 1, 8 2024 FRESH
DEPARTMENT OF PUBLIC HEALTH
DIVISION(S): Emergency Services CONTRACTS SECTION
(Lead Division listed first)
CONTRACTOR: STATE: Emergency Medical Services Authority
SERVICES: Multi-County Emergency Medical Services Coordination
CONTRACT TERM: 7/1/24 to 6/30/25
ADDITIONAL INFO:
ORGANIZATION #(s): 56201692
CONTRACT AMOUNT: $960,447.00
Contract#: A-24-555 State/Vendor#: C24-007
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2025
❑ Extend 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. '�j
Program Supervisor/Staff Analyst: Date: Z/ /�/
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090