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C-86-19-027-3-01 ARIZONA DEPARTMENT OF INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT HEALTH SERVICES 150 N. 18th Ave., Ste 260, Phoenix, Arizona 85007 (602) 542-2942 Contract No: CTR040486 Amendment No. 1 Procurement Specialist Bariah Steiner STD Control Services Effective upon signature, it is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: Pursuant to the Uniform Terms and Conditions, Section Six (6), Contract Changes, Item 6.1, Amendments, Purchase Orders and Change Orders, the Contract is amended as follows: 1. The Tasks and State Provided Item sections in the Scope of Work are hereby revised and replaced to include data entry services in this Amendment One (1); and 2. The Price Sheet is hereby revised and replaced with the Price Sheet in this Amendment One (1) to include the costs for an additional data entry clerk. (CONTINUED ON THE NEXT PAGE) All other provisions of this agreement remain unchanged. CONTRACTOR SIGNATURE Maricopa County by and through its Department of Public Health Contractor Name Contractor Authorized Signature 4041 N Central Avenue, Suite 1400 Bill Gates Address Printed Name Phoenix, AZ 85012 Chairman, Board of Supervisors City State Zip Title CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be effective the Pursuant to A.R.S. § 11-952, the undersigned public agency attorney date indicated. The Public Agency is hereby cautioned not to commence has determined that this Intergovernmental Agreement is in proper any billable work or provide any material, service or construction under form and is within the powers and authority granted under the laws of this IGA until the IGA has been executed by an authorized ADHS the State of Arizona. signatory. State of Arizona Signed this ______ day of _______________________ 201_ Signature Date Printed Name Attorney for County Procurement Officer RESERVED FOR USE BY THE SECRETARY OF STATE Attorney General Contract No. CTR040486 , which is an Agreement between public agencies, has been reviewed pursuant to Under House Bill 2011, A.R.S. § 11-952 A.R.S. § 11-952 by the undersigned Assistant Attorney General, who has determined that it is in proper form and is within the powers and was amended to remove the requirement authority granted under the laws of the State of Arizona. that Intergovernmental Agreements be filed with the Secretary of State. Signature Date Assistant Attorney General Printed Name: 1 ATTEST:_______________________________________ Office of the Clerk of the Board Date INTERGOVERNMENTAL AGREEMENT (IGA) ARIZONA DEPARTMENT OF HEALTH SERVICES AMENDMENT 1740 W. Adams, Room 303 Phoenix, Arizona 85007 (602) 542-1040 Contract No: CTR040486 Amendment No. 1 Procurement Bariah Steiner Specialist 4. Tasks 4.6.3. Enter all Maricopa County Communicable Disease Reports (CDRs) and Laboratory Reports into PRISM in a timely and accurate manger. This includes reports for cases that occur on tribal lands if the Tribe does not have access to PRISM. Tribes with PRISM access are expected to enter their own CDRs. 8. State Provided Items 8.6. ADHS will provide funding to support an additional data entry clerk. If funding is reduced to only support one data entry clerk, ADHS will resume responsibility of entering Laboratory Reports. 2 INTERGOVERNMENTAL AGREEMENT (IGA) ARIZONA DEPARTMENT OF HEALTH SERVICES AMENDMENT 1740 W. Adams, Room 303 PRICE SHEET Phoenix, Arizona 85007 (602) 542-1040 Contract No: CTR040486 Amendment No. 1 Procurement Bariah Steiner Specialist Price Sheet Maricopa County Public Health Department January 1, 2019, to December 31, 2019 COST REIMBURSEMENT LINE ITEMS BUDGETED AMOUNT PERSONNEL SERVICES $295,669.00 ERE $138,150.00 PROFESSIONAL & OUTSIDE SERVICES $0.00 TRAVEL $ 0.00 SUPPLIES $0.00 OTHER OPERATING $ 1.00 CAPITAL OUTLAY EXPENSES $0.00 OTHER $63,368.00 TOTAL $497,188.00 NOTE: With prior approval from the Program Manager, MCDPH is authorized to transfer up to a maximum of ten percent (10%) of the total budget amount between line items. Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent (10%) or to a non-funded item shall require a written Amendment. 3