AZBOP AMD 4 (04).PDF

Maricopa County — Formal (2021-08-04)

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AGREEMENT NO: C-86-20-024-3-04 AMENDMENT NO: 4
AMENDMENT TO INTERGOVERNMENTAL AGREEMENT (IGA)
Between MARICOPA COUNTY
By and Through its
DEPARTMENT OF PUBLIC HEALTH
and ARIZONA STATE BOARD OF PHARMACY
I. The above named IGA contract is hereby amended as specified below:
a. The agreement amount is increased by an additional $92,393 for the budget period
September 1, 2021 through August 31, 2022.
b. Attachment A replaced with the revised Attachment A.
All other terms and conditions of the original contract and its amendments shall remain in full force
and effect.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY ARIZONA BOARD OF PHARMACY
By________________________________ By________________________________
Jack Sellers Douglas Skvarla, Director
Chairman, Board of Supervisors
__________________________________ __________________________________
Date Date
ATTEST: ATTEST:
__________________________________ __________________________________
Clerk of the Board
__________________________________ __________________________________
Date Date
APPROVED AS TO FORM: APPROVED AS TO FORM:
__________________________________ __________________________________
Attorney for Maricopa County
_________________________________ __________________________________
Date Date

AGREEMENT NO: C-86-20-024-3-04 AMENDMENT NO: 4
ATTACHMENT A -BUDGET
For Arizona State Board of Pharmacy
For the Period September 1, 2021 to August 31, 2022
AZ Board of Pharmacy Year 2 Itemized Budget
A. Salaries and Wages $ 56,100
B. Fringe Benefits $ 23,348
C. Consultant Costs
D. Equipment
E. Supplies $ 900
F. Travel $ 2,600
G. Other Categories
H. Contractual $ 1,500
I. Total Direct Charges (sum of a-h) $ 84,448
J. Total Indirect Charges $ 7,945
K. TOTALS (sum of I and J) $ 92,393