FY22 FTF CONTRACT AMENDMENT PE.PDF

AGREEMENT NO: C-86-19-014-3-03 AMENDMENT NO: 3
AMENDMENT TO CONTRACT
Between
MARICOPA COUNTY By and Through
DEPARTMENT OF PUBLIC HEALTH
and
DIGNITY COMMUNITY CARE dba CHANDLER REGIONAL MEDICAL CENTER
I. The above named contract is hereby amended as specified below:
A. Cover Page:
5. Start Date: 07/01/2021
6. Expiration Date: 06/30/2022
B. Other Requirements:
MCOOH FTF shall:
9). Will be responsible for 250 of the CSUs in the East Region.
DH FTF shall:
7). Meet the Contracted Service Units (CSU) for children, expectant
mothers and oral health presentations in the East and Southeast
regions designated in the RFGA.
East Region: Children = 1750 Expectant Mothers = 300
Oral Health Presentations = 15
Southeast Region: Children = 2000 Expectant Mothers = 300
Oral Health Presentations = 15
15). Attend the three MCOOH FTF All Staff Meetings and one
Registered Dental Hygienist (RDH) Calibration Meeting.
All Staff Meetings:
e May 7, 2021
e September 10, 2021
e January 21, 2022
RDH Calibration Meeting:
e March 4, 2022
Il. Contract amount to be $414,700.00. All other terms and conditions of the original
contract and its amendments shall remain in full force and effect, as well.

AGREEMENT NO: C-86-19-014-3-03 AMENDMENT NO: 3
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY DIGNITY COMMUNITY CARE DBA
CHANDLER REGIONAL MEDICAL
CENTER ,+
Ml AE
By: By:
Jack Sellers, Chairman
7.
Board of Supervisors
Date Date
Lb /15[ZaT|
ATTEST ATTEST
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVED AS TO FORM
Attorney for Maricopa County
Date Date