AHCCCS -HOSPITALIZATION AMENDMENT NO.5.PDF

DocuSign Envelope ID: 05C60956-27F8-494D-80EC-BE58465BE9B5 
Atizono Health Core Cost Containment System 
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 
1. AMENDMENT#: 
2. AGREEMENT#: 
3. EFFECTIVE DATE OF AMENDMENT: 
4. PROGRAM: 
5 
YH16-0018-07 
October 1, 2023 
C-26-19-002-3-05
5. CONTRACTOR/PROVIDER NAME AND ADDRESS: 
Maricopa County 
c/o Correctional Health Services 
234 N. Central, Fifth Floor, Suite 5000 
Phoenix, AZ 85004 
6. PURPOSE: To extend the agreement for an additional five years. 
7.
THE ABOVE REFERENCED AGREEMENT IS HEREBY AMENDED AS FOLLOWS:
DFSM/DMPS 
A. Pursuant to Section 3, Term, this agreement is hereby extended through September 30, 2028.
EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL AGREEMENT NOT 
HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL EFFECT. 
Electronic Submission: An electronic or portable document file (PDF) copy of this amendment shall serve as the original. 
IN WITNESS THEREOF, the parties have executed this Agreement: 
COUNTY: Maricopa County 
Signature:
Printed Name:  
Title: Chairman, Maricopa County Board of 
Supervisors 
Date: ______________ _ 
Arizona Health Care Cost Containment 
System (AHCCCS): 
DocuSigned by: 
Signature: 
bcsFdettS
Printed Name: Tracey Thomas 
Title: Procurement Manager 
Date: __ 6_/_1_s_;2_0_2 _3 _______ _ 
DocuSign Envelope ID: F4D9A2B3-6C58-4DDB-AB32-A4688A687245
C-26-19-002-3-05

DocuSign Envelope ID: F4D9A2B3-6C58-4DDB-AB32-A4688A687245
6/20/2023