HomeMy WebLinkAboutAmendment 1 P-24-529.pdf P-24-529
Amendment 1
Customer Authorization for Contract Modification S T E R S
Customer(Bill To): FRESNO COUNTY COMMUNITY HEALTH DEPT PO#: P-24-529
Customer(End User): FRESNO COUNTY COMMUNITY HEALTH DEPT Agreement#: 1-8157080952/1
Invoice Schedule: Annual Agreement End Date: 8/31/2025
EQUIPMENT
Add/Remove Equip Level of Service Serial# Description Equip Start Date Equip End Date Annual Value Monthly Cost PO
#### Add Total Care Connect 33052005 AMSCO 110LS VAC MAN SD CAB 208V AF 5/1/2025 8/31/2025 $15,084.00 $1,257.00 $5,028.00
#### Add Total Care Connect 33052004 AMSCO 110LS VAC MAN SD CAB 208V AF 5/1/2025 8/31/2025 $15,084.00 $1,257.00 $5,028.00
#### $0.00 $0.00
#### $0.00 $0.00
####I I $0.00 $0.00
#### $0.00 $0.00
#### $0.00 $0.00
Increase to PO $10,056.00
COMMENTS
Your signature below authorizes the add/removal of the equipment from agreement noted above.
Email:westsvcsupport@steris.com
Fax:440-392-8932 attn.
Phone:440-392-8303
APPROVAL
Customer Approval: STERIS-Submitted By:
Print Name: Riley Blackburn Print Name: Brandon Sartain
Digitally signed by Riley Blackburn
Signature: Riley Blackburn Da,e:2025.04.2808:52:21-0r00' Signature: 5T„,.,/,,,Q�ayran
Date: Date: 4/21/2025