Re RFO Attachment 2 15 2017 Redacted

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Office of Administration
Commissioner's Office
Contract Period July 1, 2915 ~ Juve 30,2016
“Request for Preauthorization for Other Services”

Program: Alteruatives to Abortion.

Contractors Allie fo Life ~ Masoari Ine

Subcontractor: Bethany Christian Services of Missouri
least enter Helow the tnformation for wie itea/secviee we purchased. Fistthe date of purchase,

item to be purchased, eest forthe item, andthe estication fem must he appraved befor
‘purshastd/provided ‘0 be remburst

Client Nome I Date Borolled_ 8/87/2045

[Pros Purchase Dare |

Justification, incade
otter sources 0: f.ling
‘that have heen
ttemigted
‘Gene works full te
utis currentiy an leave
ater having her son in
December via c-section.
She does nothave paid.
aternity leave and
eed asistance paying
MER 22s 2iceainec
Fanjoo ar steak Shake |
for? years and isa very
‘ean wosker. She has
‘een coramitted to hor
isvolvernent ia the
progeant and bas bee
| enrolled since tay 2016.
| she as needed wery
j Ite essistance prior to
| | Naving her baby ard 20
| come coming in te to
being on eave, There are
! ro otter funding suurces
available i Phare
ely wish fas need

ise

E-um provider ot
services)

[Fepriana3, 2017 Fab Gar Payne TOTS

STS
Altech 8

‘uchorized person requssting parca
Alliance Zor Life Program Manager, Mal
Approved forpwrehase: (/)

Purchese denied
Reason for deny:ng purchase:
IMAGIIS3.i8

hupuatinityonglecnrn! fsesfinutTavatie’ Joh gemitmsicven CéquNOoNULOee-e ec,

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