HomeMy WebLinkAboutA-24-131 DPH Misc. Docs.pdf ' w co
CONTRACT STATUS FORM
IVE
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DATE: June 03, 2024 OCT 0 9 202 � ES�
DIVISION(S): Health Policy and Wellness DEPARTMENT OF PUBLIC HE TH
(Lead Division listed first) CONTRACTS SECTION
CONTRACTOR: Cultiva La Salud
SERVICES: Health Disparities Intervention Activities
CONTRACT TERM: 3/28/23 to 12/31/24
ADDITIONAL INFO: Term expires, 12/3112024, requires a letter to extend.
ORGANIZATION #(s): 56201558 56201019 56201022
CONTRACT AMOUNT: $1,155,000.00
Contract#: A-24-131 State/Vendor#:
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:September 1, 2024
Extend contract through: s�/ 20
❑X With no changes in terms or conditions.
With the following change(s):
Evergreen: Continue contract through: 20
Cancel contract effective: , 20
�C Additional Information (e.g., anticipated effective date/term, contract extension, etc.):'�
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Approved by:
Program Supervisor/Staff Analyst, Date:
Division Manager: Date: 101gi
Submit to: DPH Contracts - Stop#147 - Brix Building, 6th Floor- Phone #: 600-7090