Master Blanket Purchase Order P544378

Header Information
Purchase Order Number: P544378 Release Number: 0 Short Description: Medical Transportation for Medicaid Clients
Status: 3PS - Sent Purchaser: Shayla Wilson Receipt Method: Quantity
Fiscal Year: 2018 PO Type: Blanket Minor Status:
Organization: Baltimore City
Department: HLTH - HEALTH Location: HLTHQ - HEALTH - MAIN OFFICE Type Code:
Alternate ID: MBE/WBE Goals Apply Entered Date: 07/06/2018 10:58:53 AM Control Code:
Days ARO: 0 Retainage %: 0.00% Discount %: 0.00%
Print Dest Detail: If Different
Catalog ID: Release Type: Standard Release Pcard Enabled: No
Contact Instructions: Michael Howard 410-545-0716 Tax Rate: Actual Cost: $0.00
PO Header Work Order Number:
Agency Attachments: P544378 Hart to Heart Change Order to add line item 1-31-19.pdf
Vendor Attachments:
Agency Attachment Forms:
Vendor Attachment Forms:
Primary Vendor Information & PO Terms
Vendor: 00011804 - Hart to Heart Ambulance Service, Inc
Jason Skidmore
355 Granary Rd
Forest Hill, MD 21050
US
Email: jason@H2Htransportation.com
Phone: (443)573-2037
FAX: (443)640-1341
Payment Terms: Net 30 Shipping Method: Best Way
Shipping Terms: F.O.B., Destination Freight Terms: Freight Prepaid
PO Acknowledgements:
Document Notifications Acknowledged Date/Time
Purchase Order Emailed to jason@H2Htransportation.com at 07/06/2018 02:38:52 PM
Change Order 1 Emailed to jason@H2Htransportation.com at 07/23/2018 04:23:57 PM 07/23/2018 05:31:48 PM
Change Order 2 Emailed to jason@H2Htransportation.com at 09/27/2018 11:25:41 AM 09/27/2018 11:44:57 AM
Change Order 3 Emailed to jason@H2Htransportation.com at 12/31/2018 01:32:17 PM 03/29/2019 10:33:26 AM
Change Order 4 Emailed to jason@H2Htransportation.com at 04/08/2019 02:20:32 PM
Change Order 5 Emailed to jason@H2Htransportation.com at 04/17/2019 02:11:56 PM
Change Order 6 Emailed to jason@H2Htransportation.com at 04/30/2019 04:09:27 PM 06/25/2019 02:57:46 PM
Change Order 7 Emailed to jason@H2Htransportation.com at 04/20/2020 11:34:42 AM 04/20/2020 12:02:34 PM
Master Blanket/Contract Vendor Distributor List
Vendor ID Vendor Name Preferred Delivery Method Vendor Distributor Status
00011804
Hart to Heart Ambulance Service, Inc Email Active
Master Blanket/Contract Controls
Master Blanket/Contract Begin Date: 06/27/2018 Master Blanket/Contract End Date: 06/30/2023
Cooperative Purchasing Allowed: No
Organization Department Dollar Limit Dollars Spent to Date Minimum Order Amount
BALT - Baltimore City HLTH - HEALTH $33,424,490.00 $19,713,101.00 $0.00
PO Vendor Subcontractor List
Vendor ID Alternative ID Vendor Name Effective Date Expiration Date Estimated Percent Deactivated
(Date Deactivated)
00002382
Fleming Transportation Corporation 06/27/2018 06/30/2023 300.00% No
00056205
Med-Care Transportation, LLC 06/27/2018 06/30/2023 300.00% No
Item Information   
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Print Sequence # 1.0, Item # 1:   Provide Non-Emergency Medical Transportation Services for Medicaid Eligible Clients as per the prices, specifications, terms and conditions in Contract B50004898 as awarded by the Board of Estimates on June 27, 2018 for the period 6/27/18 thru 6/30/23. - Releases for specified time periods and products shall be issued - Contractor invoice must show the City's full current Purchase Order number (and release number if applicable) as issued to the Contractor and be sent to the bill-to-address as shown above or Email: City-Payables@BaltimoreCity.gov to be promptly considered for payment. - The City of Baltimore requires all vendors to have an approved authorized procurement instrument, i.e. purchase order, contract, purchase order release, etc. in hand prior to providing and delivering any goods or services. Entering into contracts and agreements verbally is prohibited. Any vendor who delivers goods and/or performs services to the City without an approved authorized procurement instrument does so entirely at its own risk and faces having payments delayed and/or the possibility of being denied. 3PS - Sent
Req # / Item #:  R741381  / 1 Bid # / Bid Item #:  Q00018258 / 1
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
This item is narrative
 
Print Sequence # 2.0, Item # 2:   Ambulatory Service for period xx/xx/xx thru xx/xx/xx - Contractor invoice must show the City's full current Purchase Order number (and release number if applicable) as issued to the Contractor and be sent to the bill-to-address as shown above or Email: City-Payables@BaltimoreCity.gov to be promptly considered for payment. 3PS - Sent
NIGP Code: 948-12
   Ambulance Services, Non-emergency (See 990-37 for Emergency Ambulance Services)
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 0.0 $49.00 EA - Each 0.00 $0.00 $0.00 $0.00
Manufacturer: Brand: Model:
Make: Packaging:
PO Item Work Order Number:
 
Print Sequence # 3.0, Item # 3:   Wheelchair Van Service for period xx/xx/xx thru xx/xx/xx - Contractor invoice must show the City's full current Purchase Order number (and release number if applicable) as issued to the Contractor and be sent to the bill-to-address as shown above or Email: City-Payables@BaltimoreCity.gov to be promptly considered for payment. 3PS - Sent
NIGP Code: 948-12
   Ambulance Services, Non-emergency (See 990-37 for Emergency Ambulance Services)
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 0.0 $61.00 EA - Each 0.00 $0.00 $0.00 $0.00
Manufacturer: Brand: Model:
Make: Packaging:
PO Item Work Order Number:
 
Print Sequence # 4.0, Item # 4:   Ambulance Advanced Life Support for period xx/xx/xx thru xx/xx/xx - Contractor invoice must show the City's full current Purchase Order number (and release number if applicable) as issued to the Contractor and be sent to the bill-to-address as shown above or Email: City-Payables@BaltimoreCity.gov to be promptly considered for payment. 3PS - Sent
NIGP Code: 948-12
   Ambulance Services, Non-emergency (See 990-37 for Emergency Ambulance Services)
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 0.0 $420.00 EA - Each 0.00 $0.00 $0.00 $0.00
Manufacturer: Brand: Model:
Make: Packaging:
PO Item Work Order Number:
 
Print Sequence # 5.0, Item # 5:   Ambulance Basic Life Support for period xx/xx/xx thru xx/xx/xx - Contractor invoice must show the City's full current Purchase Order number (and release number if applicable) as issued to the Contractor and be sent to the bill-to-address as shown above or Email: City-Payables@BaltimoreCity.gov to be promptly considered for payment. 3PS - Sent
NIGP Code: 948-12
   Ambulance Services, Non-emergency (See 990-37 for Emergency Ambulance Services)
Receipt Method Qty Unit Cost UOM Discount % Total Discount Amt. Tax Rate Tax Amount Total Cost
Quantity 0.0 $306.00 EA - Each 0.00 $0.00 $0.00 $0.00
Manufacturer: Brand: Model:
Make: Packaging:
PO Item Work Order Number:
 
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