HomeMy WebLinkAboutA-23-430 DPH Misc. Docs.pdf CONTRACT STATUS FORM co
DATE: June 03, 2024 RECEIVED FRE56 0
DIVISION(S): Health Policy and Wellness OCT 0 9 2024
(Lead Division listed first) DEPARTMENT OF PUBLIC LTH
CONTRACTOR: BLACK Wellness & Prosperity Center CONTRACTS SECT►
SERVICES: Health Disparities Intervention Activities
CONTRACT TERM: 8/22/23 to 12/31/24
ADDITIONAL INFO: Term expires, 12/31/2024, requires a letter to extend.
ORGANIZATION #(s): 56201019 56201022 56201558
CONTRACT AMOUNT: $1,156,109.00
Contract#: A-23-430 State/Vendor#:
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:September 1. 2024
Extend contract through: , 20
With no changes in terms or conditions.
❑ With the following change(s):
Evergreen: Continue contract through: 20
Cancel contract effective: /Z/3/ , 20 ?-4
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
412 6A^S�a^-
Approved by: !'
Program Supervisor/Staff Analyst: Date: �� 7 �Y
Division Manager: Date: I�
Submit to: DPH Contracts - Stop#147 - Brix Building, 6th Floor- Phone #: 600-7090
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County of Fresno
DEPARTMENT OF PUBLIC HEALTH
FRESH David Luchini, Director
Dr. Rais Vohra, Interim Health Officer
August 28, 2024
Shantay R. Davies-Balch, President & CEO
BLACK Wellness & Prosperity Center
2201 Calaveras Street
Fresno, CA 93721
Agreement: 23-430
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. For your reference the
insurance requirements are listed in Exhibit G 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 dphcontractsCD-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.
cerely,
lttaBynum
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.oro
COtj�
f County o Fresno
DEPARTMENT OF PUBLIC HEALTH
FRESH David Luchini, Director
Dr. Rais Vohra, Interim Health Officer
August 29, 2023
Shantay R. Davies-Balch, President & CEO
BLACK Wellness & Prosperity Center
2201 Calaveras Street
Fresno, CA 93721
Agreement: 23-430
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 in Exhibit G 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 ddphcontracts(a-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,
Qblea Byn�}rn
Senior Staff Analy #
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
y The County of Fresno is an Equal Employment Opportunity Employer
www.co.fresno.ca.us 0 www.fcdph.oro