HPHC 16-102232 A8 (09).PDF

Maricopa County — Formal (2018-12-12)

View PDF Item 44 Meeting page

Extracted text (via pymupdf_layout) 4678 characters
ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 N. 18th Ave. Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS16-102232 Amendment No.8 Procurement Officer:
Russell Coplen
C-86-15-112-3-09 Healthy People Healthy Communities
Effective upon signature, it is mutually agreed that the Agreement referenced above is amended as follows:
1. Pursuant to the Terms and Conditions, Provision Six (6), Contract Changes, Section 6.1 Amendments, Purchase
Orders and Change Orders:
1.1 The Price Sheet is revised and replaced by the Price Sheet of this Amendment Eight (8).
All other terms and conditions will remain in effect.
Maricopa County by and through its CONTRACTOR SIGNATURE
Maricopa County Department of Public Health
Contractor Name Contractor Authorized Signature
4041 N. Central Ave.
Address Printed Name
Phoenix AZ 85012 Chairman, Board of the 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
has determined that this Intergovernmental Agreement is in proper form commence any billable work or provide any material, service or
and is within the powers and authority granted under the laws of the construction under this IGA until the IGA has been executed by an
State of Arizona. authorized ADHS signatory.
State of Arizona
Signed this _________ day of _________________________ 2018
Signature Date
Printed Name MCAO Procurement Officer
Contract No. ADHS16-102232, which is an Agreement between public
agencies, has been reviewed pursuant to 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 authority granted under the
laws of the State of Arizona.
Signature Date
Assistant Attorney General
Printed Name:
Page 1 of 4

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 N. 18th Ave. Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS16-102232 Amendment No.8 Procurement Russell Coplen Officer:
PRICE SHEET
HEALTHY PEOPLE HEALTHY COMMUNITIES
JULY 1, 2018 - JUNE 30, 2019
ACTION PLAN
UNIT OF NUMBER
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE OF UNITS
Action Plan – All Programs EA 1 $250,366.00 $250,366.00
TOTAL 1 $250,366.00 $250,366.00
TOBACCO
UNIT OF NUMBER
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies
(i.e. Prevention, Cessation, Secondhand QTR 4 $488,404.38 $1,953,617.52
Smoke, Enforcement)
TOTAL 4 $488,404.38 $1,953,617.52
HEALTH IN ARIZONA POLICY INITIATIVE
UNIT OF NUMBER OF
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE UNITS
See SOW for Specific Service Strategies
(i.e. Alzheimer’s, Chronic Pulmonary
Disease, Hypertension, Self-
Management, Procurement, Healthy QTR 4 $134,183.62 $536,746.48
Community Design, School Health,
Worksite Wellness, Clinical Care, and
Special Health Care Needs)
TOTAL 4 $134,183.62 $536,746.48
Page 2 of 4

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 N. 18th Ave. Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS16-102232 Amendment No.8 Procurement Russell Coplen Officer:
HEALTHY ARIZONA WORKSITE PROGRAM
UNIT OF NUMBER OF
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE UNITS
See SOW for Specific Service Strategies QTR 4 $70,509.50 $282,038.00
TOTAL 4 $70,509.50 $282,038.00
PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT- ACCREDITATION
UNIT OF NUMBER
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE OF UNITS
See SOW for Specific Service Strategies
(i.e. Fees for Accreditation, Quality
Improvement Projects, Workforce
Development Implementation, QTR 1 $81,750.00 $81,750.00
Performance Management
Documentation, Progress Toward County
Health Improvement Plan)
3 $81,750.00 $245,250.00
TOTAL 1 $81,750.00 $327,000.00
FAMILY PLANNING / MATERNAL and CHILD HEALTH (Title V Block Grant)
UNIT OF NUMBER OF
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE UNITS
See SOW for Specific Service Strategies QTR 4 $67,676.00 $270,704.00
TOTAL 4 $67,676.00 $270,704.00
Page 3 of 4

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT(IGA) HEALTH SERVICES
AMENDMENT 150 N. 18th Ave. Suite 260
Phoenix, Arizona 85007
Agreement No: ADHS16-102232 Amendment No.8 Procurement Russell Coplen Officer:
TEEN PREGNANCY PREVENTION
UNIT OF NUMBER OF
ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL
MEASURE UNITS
See SOW for Specific Service Strategies QTR 4 $45,967.00 $183,868.00
TOTAL 4 $45,967.00 $183,868.00
TOTAL
ITEM/SERVICE DESCRIPTION TOTAL
GRAND TOTAL $3, 804,340.00
Page 4 of 4