HomeMy WebLinkAboutA-23-134 DPH Misc. Docs.pdf CONTRACT STATUS FORM hew coU�
RECEIVE
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DATE: June 03, 2024 OCT 0 9 2Es�'
DIVISION(S): Health Policy and Wellness DEPARTMENT OF PUBLIC E TH
(Lead Division listed first) CONTRACTS SECTIO
CONTRACTOR: Exceptional Parents Unlimited
SERVICES: Health Disparities Intervention Activities
CONTRACT TERM: 3/28/23 to 12/31/24
ADDITIONAL INFO: Term expires, 12/31/2024, requires a letter to extend.
ORGANIZATION #(s): 56201558 56201019 56201022
CONTRACT AMOUNT: $750,000.00
Contract#: A-23-134 StateNendor#:
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:September 1, 2024
® Extend contract through: �!' 3� 20
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.):
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Approved by:
Program Supervisor/Staff Anal st: Date: 7 Z�
Division Manager: Date: ((AYb'y
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Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone#: 600-7090