HomeMy WebLinkAboutM-11-758 DPH Misc. Docs.pdf CONTRACT STATUS FORM
RECEIVED o s o
DATE: December 01, 2022
MAR 0 7 2023
DIVISION(S): Public Health Nursing DEPARTMENT OF PUBLIC T
(Lead Division listed first) CONTRACTS SECTI
CONTRACTOR: Community Action Partnership of Madera County
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CONTRACT TERM: 7/1/17 to 6/30/23 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): N/A
CONTRACT AMOUNT: $0.00
Contract#: M-11-758 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 1"_.
With no changes in terms or conditions.
❑ With the following change(s):
REvergreen: Continue contract through: ,�z,�c = 20 2-1-4 _.
❑ Cancel contract effective: , 20
1-1 Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by.
Program Supervisor/Sta Analyst: . — Date: zl ZE 1 z-�
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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CONTRACT STATUS FORM
RECEIVED
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DATE: December 01, 2021 FxES�
AUG 2 6 2 22
DIVISION(S): Public Health Nursing
DEPARTMENT OF PUBL TH
(Lead Division listed first) CONTRACTS SECTI
CONTRACTOR: Community Action Partnership of Madera County
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CONTRACT TERM: 7/1/17 to 6/30/22 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): N/A
CONTRACT AMOUNT: $0.00
Contract#: M-11-758 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: 120
With no changes in terms or conditions.
With the following change(s):
Evergreen: Continue contract through: ;Z�n2 '3G , 20 23—.
❑ Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by.
Program Supervisor/Staff Analyst: Date: $/ZS'/LZ
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090
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CONTRACT STATUS FORM ti
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DATE: December 01, 2020 RECE' ES�
DIVISION(S): Public Health Nursing
SEP 2 4 2021
(Lead Division listed first) pEPNRTMEw OF PUBLIC HE
��N%TS SECTIO
CONTRACTOR: Community Action Partnership of Ma ra County
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CONTRACT TERM: 7/1/17 to 6/30/21 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): N/A
CONTRACT AMOUNT: $0.00
Contract#: M-11-758 State/Vendor M N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1. 2021
ffExtend contract through: 6/30 20 22
With no changes in terms or conditions.
1-1 With the following change(s):
Evergreen: Continue contract through: 20
F1Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Supervisor/Staff Analyst: `�"' Date: 9-2 4-2
g Rose Mary Rahn OIQI-R11 Mby Rohn ryRahn
Division Manager: o �z=hn M."R'hn`=g Date:
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D.b 1f121 09 2�1�39 39-0]YIO'
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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CONTRACT STATUS FO
o es o
DATE: December 02, 2019 RECEIVE
DIVISION(S): Public Health Nursing JUN 2 3 2020
(Lead Division listed first) DEPARTMENT OF PUBLIC HEALTH
CONTRACTOR: Madera County Community Action Agency CONTRACTS SECTION
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CURRENT PERIOD: 7/1/17 to 6/30/20 E Auto-renewal: 0 through:
(if not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to Evergreen at the end of the current period.)
ORGANIZATION #(s): N/A
CONTRACT AMOUNT: $0.00
ADDITIONAL INFO: Evergreen Agreement-Please Review
Contract#: N/A 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: 20
Cancel contract effective: , 20
❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by.
Program Supervisor/St alyst: Date:
Division Manager. Date: IV 43d&Z�
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
CONTRACT STATUS FORM co
O� 56 O
DATE: November 29, 2018 �xES�
DIVISION(S): Public Health Nursing RECEIVED
(Lead Division listed first)
CONTRACTOR: Madera County Community Action Agency MAR 2 8 204
t 'dAS1KWbg am
PUBLIC KEALTH
SERVICES: MOU: Coordination of CHDP & Fresno Mig ran
CURRENT PERIOD: 7/1/17 to 6/30/2018 E Auto-renewal: p through:
(if not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to Evergreen at the end of the current period.)
ORGANIZATION #(s): N/A
CONTRACT AMOUNT: $0.00
ADDITIONAL INFO:
Contract#: N/A State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2019
n
e w con throu h:
9—With no changes in terms or conditions.
❑ With the following change(s):
2�Evergreen: Continue contract through: o 2 ,
❑ Cancel contract effective: , 20
❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Supervisor ff Analyst: ,o��4 4L
Date: ,Z
Division Manager: Date: _�
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
_ _ CO
CONTRACT STATUS FORM ti
DATE: November 28, 2016 RECEIVE FRESH
DIVISION(S): Public Health Nursing
^',�R 0 6 20 T
(Lead Division listed first) DEPARTMENT OFpUBLICCO
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CONTRACTOR: Madera County Community Action AgencyNTRACTSCTl01y
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CURRENT PERIOD: 7/1/16 to 6/30/17 E Auto-renewal: CI through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to Evergreen at the end of the current period.)
ORGANIZATION #(s): N/A
CONTRACT AMOUNT $0.00
ADDITIONAL INFO:
Contract#: N/A 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: , 20
With no changes in terms or conditions.
With the following change(s):
0 f
Evergreen: Continue contract through: 0 , 20
❑ Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by.- Ol Z 71-7
Program Supervisor/S Analyst: Date:
Division Manager: Date:
:J5- (.at
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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CUNTRACT STATUS FOMM
o� 56 0
DATE: November 20, 2015 RECEIVED FRESH
MAR 0 2 2016
DIVISION(S): Public Health Nursing
(Lead Division listed first) DEPARTMENT OF PUBLIC HEALTH
CONTRACTS SECTION
CONTRACTOR: Madera County Community Action Agency
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CURRENT PERIOD: 7/1/15 to 6/30/16 E Auto-renewal: 0 through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to Evergreen at the end of the current period.)
ORGANIZATION #(s): N/A
CONTRACT AMOUNT $0.00
ADDITIONAL INFO:
Contract#: N/A 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 ,
1-1 With no changes in terms or conditions.
❑ With the following change(s):
Evergreen: Continue contract through: Z30 , 20
Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by: r
Program Supervisor/ ff Ana t: Date: A
Division Manager: Date: 21/2_>7
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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C&NTRACT STATUS FOR
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O� 36 O
DATE: December 01, 2014 ESQ
DIVISION(S): �1
(Lead Division listed first)
CONTRACTOR: Madera County Community Action Agency
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CURRENT PERIOD: 7/1/14 to 6/30/15 E Auto-renewal: O through: 6/30/2015
(If not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to Evergreen at the end of the current period.)
ORGANIZATION #(s): N/A RECEIVED
CONTRACT AMOUNT: $0.00 JAN 0 6 2015
ADDITIONAL INFO: DEPARTMENT OF PUBLIC HEALTH
Contract#: N/A State/Vendor#: N/A CONTRACTS SECTION
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by: March 1, 2015
Renew contract through: u v i 'w , 20 U,
❑ 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/St Analyst: r Date: L -Z 11
\�'�.`� Division Manager: Date: 17S7
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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COw'RACT STATUS FORD
17 O� 854 O
DATE: December, 2013 RECE ESQ
DIVISION(S): Children's Medical Services JAN 13 2014
(Lead Division listed first) DEPARTMENT OF PUBLIC HEALTH
CONTRACTOR: Madera County Community Action Agency CONTRACTS SECTION
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
CURRENT PERIOD: 7/1/13 to 6/30/14 E Auto-renewal: ❑ through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to Evergreen at the end of the current period.)
ORGANIZATION #(s): N/A
CONTRACT AMOUNT: $0.00
ADDITIONAL INFO:
Contract#: N/A State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by: March 2014
EjRenew contract through: , 20
With no changes in terms or conditions.
With the following change(s):
Evergreen: Continue contract through: 20
11 Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
grogram Supervisor/St Analyst:- Date: ���
tivision Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
cotj�
CMgTRACT STATUS FOR-61
DATE: December 03, 2012ESz'
DIVISION(S): Children's Medical Services
(Lead Division listed first)
CONTRACTOR: Madera County Community Action Agency
SERVICES: MOU: Coordination of CHDP & Fresno Migrant Head Start Program
� L 14-C-4-
CURRENT PERIOD: 7/1/11 to 6k30tt3- E Auto-renewal: O through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 7/1/2011 to _t=F203- at the end of the current period.)
ORGANIZATION #(s): N/A - '-;�-
CONTRACT AMOUNT: $0.00
ADDITIONAL INFO:
Contract#: N/A 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):
REvergreen: Continue contract through: i,��� , 20 /27- ,
Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Superviso tall Ana�� Date:
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090