# St. Louise Regional Hospital SL1710152HM

FORM AUTH USE/DISCLOSURE PHI, 9090 08/2020; FORM AUTH USE/DISCLOSURE PHI, SP 9090S 8/2020

**Recipient:** 5003980 RR DONNELLEY

**Award Amount:** $143.12
**Ceiling:** $143.12

**Awarded:** September 01, 2026

**Identifier:** SL1710152HM

St. Louise Regional Hospital (canonical buyer; listed in the PO as SAINT LOUISE REGIONAL HOSPITAL-DEPAUL) awarded PO SL1710152HM to **5003980 RR DONNELLEY**. The purchase includes 2 copies of “FORM AUTH USE/DISCLOSURE PHI, 9090 08/2020” at $35.56 each ($71.12 extended) and 2 copies of “FORM AUTH USE/DISCLOSURE PHI, SP 9090S 8/2020” at $36.00 each ($72.00 extended), for a total of $143.12. No additional contract requirements or multi-year terms are stated.

### Description

FORM AUTH USE/DISCLOSURE PHI, 9090 08/2020; FORM AUTH USE/DISCLOSURE PHI, SP 9090S 8/2020