CTR040876.A1.PDF

C-86-19-013-3-01
ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
Amendment 150 18th Ave Suite 260
Phoenix, Arizona 85007
Contract No.: CTR040876 IGA Amendment No: 1 Senior Procurement Specialist
Arizona Procurement Portal Amendment No.: 1 Diana Martinez
WIC, BFPC, FMNP AND ONED SERVICES
It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows:
1. Pursuant to Terms and Conditions, Page Seven (7), Provision Six (6), Contract Changes; the Intergovernmental Agreement is
amended to revise the following:
1.1 Contract No. from ADHS19-207429 to CTR040876.
1.2 The Price Sheet is revised and replaced by the Price Sheet of this Amendment One (1).
1.3 The following sections of the Scope of Work are revised as follows:
4.1.1.16 Prepare and submit WIC Local Agency Quarterly Cost Summary Reports that matches the amount of each quarter’s
expenditures respectively in accordance with the requirements in the WIC PPM.
5.3 WIC Local Agency Quarterly Cost Summary matching the WIC Contractor's CER expenses not later than thirty (30) days
following the end of each quarter report of the program year.
.
All other provisions of this agreement remain unchanged.
Contractor Name: MARICOPA COUNTY, By and Through Authorized Signature
its DEPARTMENT of PUBLIC HEALTH
Address: 4041 N. CENTRAL AVENUE, SUITE 1400 Print Name
PHOENIX ARIZONA 85012 Chairman, Board of Supervisors
City State Zip Title
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has determined This Intergovernmental Agreement Amendment shall be
that this Intergovernmental Agreement is in proper form and is within the powers and effective the date indicated. The Public Agency is hereby
authority 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
Attorney for Maricopa County Procurement Officer
ATTEST:___________________________, Office of Clerk of the Board
Contract No.: CTR040876, 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
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
Amendment 150 18th Ave Suite 260
Phoenix, Arizona 85007
Contract No.: CTR040876 IGA Amendment No: 1 Senior Procurement Specialist
Arizona Procurement Portal Amendment No.: 1 Diana Martinez
PRICE SHEET
WIC, BFPC, FMNP AND ONED SERVICES
October 1, 2018 to September 30, 2019
WIC Services
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $3,769,805.00
Employee Related Expenses $1,920,013.00
Professional & Outside Services $155,500.00
Travel Expense $18,300.00
Occupancy Expenses $341,599.00
Other Operating Expenses $62,035.00
Capital Expenditures $1.00
Indirect Cost $1,184,511.00
RD Supplement $1,038,016.00
Total $8,489,780.00
Breastfeeding Peer Counseling Services
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $240,882.00
Employee Related Expenses $128,658.00
Professional & Outside Services $1.00
Travel Expense $7,365.00
Occupancy Expenses $24,000.00
Other Operating Expenses $7,000.00
Capital Expenditures $0.00
Indirect Costs $77,094.00
Total $485,000.00
Farmer’s Market Nutrition Program Services
March 1, 2019 to September 30, 2019
Type of Service Unit Rate Unit of Measure Estimated Number
of Participants
WIC FMNP Check $1.75 WIC Participant AS NEEDED
Issuance
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
Amendment 150 18th Ave Suite 260
Phoenix, Arizona 85007
Contract No.: CTR040876 IGA Amendment No: 1 Senior Procurement Specialist
Arizona Procurement Portal Amendment No.: 1 Diana Martinez
WIC SPECIAL PROJECTS
Cost Reimbursement Line Item Budget
Account Classification Amount
Personnel $48,495.00
Employee Related Expenses $39,941.00
Professional & Outside Services $0.00
Travel Expense $0.00
Occupancy Expenses $109,980.00
Other Operating Expenses $996.00
Capital Expenditures $0.00
Registered Dietitian $61,824.00
Indirect Costs $49,374.00
Total $310,610.00
Additional Terms and Conditions:
With prior written approval from the Program Manager, the Contractor is authorized to transfer up to a maximum
of ten percent (10%) of the total budget amount between funded line items except for Registered Dietitian
Expenses. Transfers of funds are only allowed between funded line items. Transfers exceeding ten percent
(10%) or to a non-funded line item shall require an amendment. The Registered Dietitian line item is meant to
fund additional Registered Dietitian position(s) to meet high risk counseling requirements.
Authorization for purchase of services under this Contract shall be made only upon ADHS issuance of a Purchase
Order that is signed by an authorized agent. The Purchase Order will indicate the Contract number and the dollar
amount of funds authorized. The Contractor shall only be authorized to perform services up to the amount on the
Purchase Order. ADHS shall not have any legal obligation to pay for services in excess of the amount indicated
on the Purchase Order. No further obligation for payment shall exist on behalf of ADHS unless a.) the Purchase
Order is modified with an official ADHS Procurement Change Order, and/or b.) an additional Purchase Order is
issued for purchase of services under this Contract.
ADHS reserves the right to adjust awards given to local agencies depending on federal dollars received.
Adjustments will be at the discretion of ADHS.
Additional WIC Program:
Should additional administrative monies become available through state or federal grants, ADHS may increase
the purchase order to increase the number of participants served and increase the total of this contract.
The assigned caseload for FFY 2019 is: 53,200
Additional Breastfeeding Peer Counseling Program:
Allowable costs for the Peer Counseling Program include compensation for peer counselors and designated peer
counselor managers/coordinators, and related costs such as training and training materials; telephone expenses
for participant contacts (including pager, cell phones and answering machines); travel for training and home and
hospital visits; recruitment of peer counseling staff; and the purchase of demonstration materials (e.g., breast
pumps for demonstration purposes, videos). Out of state travel must be pre-approved by ADHS. Items and
materials for distribution to WIC participants (e.g. breast pumps, breastfeeding aids) are not allowable costs.
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ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
Amendment 150 18th Ave Suite 260
Phoenix, Arizona 85007
Contract No.: CTR040876 IGA Amendment No: 1 Senior Procurement Specialist
Arizona Procurement Portal Amendment No.: 1 Diana Martinez
Farmer’s Market Nutrition Program:
If funding for additional FMNP checks becomes available and the contract budget (as shown on the Contract Price
Sheet) has been fully expended, Contractor may choose whether or not to distribute the additional checks with no
increase in the contract budget.
WIC Special Projects
Monies are provided for WIC Special Projects that will include the following:
a. Cover occupancy, security, and cleaning services costs for an ADHS WIC computer lab training
room housing up to 40 computers at 2737 W Southern Ave, Suite 10, Tempe, AZ 85282. The
WIC computer lab training room will be for the priority use of the Arizona State WIC Program and
be made available to other Arizona WIC local agencies. ADHS Information Technology staff will
be responsible for installation and maintenance of computer and networking hardware and
software. The training room computers will not be connected to the Maricopa internal network, but
the training room will share the same internet line as the adjacent WIC clinic. ($15,281.00)
b. Cover the occupancy, security, cleaning, utilities, and copier lease costs for the Thunderbird WIC
clinic to keep it open for one year to allow time for the Maricopa County WIC Program find
alternative affordable places for WIC participants in that area to obtain services. In addition, the
site supervisor salary and ERE will also be covered for a period of one year. ($199,642.00)
c. Additional monies have been added to the Registered Dietitian (RD) line item for Maricopa
County WIC Program to provide RD services to Apache County, Navajo County, Mohave County,
and Mariposa Health Center WIC Programs as agreed upon in the Scope of Work documents
between Maricopa and each WIC program services are provided. ($95,687)
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