CTR047666 STD PROGRAM- PERINATAL A1.DOC.PDF

ARIZONA DEPARTMENT OF
Intergovernmental Agreement (IGA) HEALTH SERVICES
OFFICE OF PROCUREMENT
Amendment 150 N. 18th Ave., #530
Phoenix, Arizona 85007
PROCUREMENT OFFICER
CONTRACT No.: CTR047666 AMENDMENT No.: 1 Nicole Marquez
Maricopa County STD Program- Perinatal Caseworker
Effective upon signature of both parties, it is mutually agreed that the Intergovernmental Agreement referenced
is amended as follows:
1. Pursuant to the Terms and Conditions, Provision Four (4), Contract Administration and Operation, Section 4.1, Term,
as indicated on the signature page of the Contract, the Contract term has been revised with a termination date of
July 31, 2024; and
2. Exhibit A is added.
**All other provisions of this Agreement shall remain in their entirety.**
Maricopa County Public Health STD Clinic
Contractor Name: Authorized Signature
1645 E. Roosevelt St.
Address: Print Name
Phoenix ARIZONA 85006
City State Zip Title
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has determined that This Intergovernmental Agreement Amendment shall be
this Intergovernmental Agreement is in proper form and is within the powers and authority effective the date indicated. The Public Agency is hereby
granted under the laws of Arizona cautioned not to commence any billable work or provide any
material, service or construction under this IGA until the IGA has
been executed by an authorized ADHS signatory.
State of Arizona
Signature Date
Signed this day of 20___.
Print Name
Procurement Officer
Contract No.: CTR047666, which is an Agreement between public agencies, has been
reviewed pursuant to A.R.S. § 11-952 by the undersigned Assistant Attorney, who has
determined that it is in proper form and is within the powers and authority granted under
the laws of the State of Arizona.
Signature Date
Assistant Attorney General
Print Name
Page 1 of 2

ARIZONA DEPARTMENT OF
Intergovernmental Agreement (IGA) HEALTH SERVICES
OFFICE OF PROCUREMENT
Amendment 150 N. 18th Ave., #530
Phoenix, Arizona 85007
CONTRACT No.: CTR047666 AMENDMENT No.: 1 PROCUREMENT Nicole Marquez OFFICER
EXHIBIT A
2 CFR 200.332
§ 200.332
Requirements for pass-through entities.
All pass-through entities must:
(a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following
information at the time of the subaward and if any of these data elements change, include the changes in
subsequent subaward modification. When some of this information is not available, the pass-through entity must
provide the best information available to describe the Federal award and subaward.
Prime Awardee: Arizona Department of Health Services
DUNS # 804745420
Federal Award Identification (Grant Number): NH25PS005157
Subrecipient name (which must match the name associated with its
unique entity identifier): MARICOPA COUNTY
Subrecipient's unique entity identifier (DUNS #): 86600047
Federal Award Identification Number (FAIN, sometimes it’s the same
as the Grant Number): NH25PS005157
Federal Award Date (see the definition of Federal award date in §
200.1 of this part) of award to the recipient by the Federal agency; 07/15/2020
Subaward Period of Performance Start and End Date; 8/1/20-7/31/24
Subaward Budget Period Start and End Date: 8/1/20-7/31/24
Amount of Federal Funds Obligated by this action by the pass-
through entity to the subrecipient (this is normally the contract
amount): 107000 (annual award)
Total Amount of Federal Funds Obligated to the subrecipient by the
pass-through entity including the current financial obligation (how
much is available for contracts): 107000 (annual award)
Total Amount of the Federal Award committed to the subrecipient by
the pass-through entity 107000 (annual award)
Federal award project description, as required to be responsive to
the Federal Funding Accountability and Transparency Act (FFATA) 93.323
Name of Federal awarding agency, pass-through entity, and contact
information for awarding official of the Pass-through entity Centers for Disease Control and Prevention
Assistance Listings number and Title; the pass-through entity must
identify the dollar amount made available under each Federal award Epidemiology and Laboratory Capacity for
and the Assistance Listings Number at time of disbursement: Infectious Diseases (ELC)
Identification of whether the award is R&D NOT R&D
Indirect cost rate for the Federal award (including if the de minimis
rate is charged) per § 200.414 19.20%
Page 2 of 2