ADHS RX OVERDOSE PREVENTION AMD 1 (04).PDF

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
150 18th Ave Suite 260
Amendment
Phoenix, Arizona 85007
Contract No.: ADHS16- Senior Procurement Specialist
Amendment No: 1
109742 Ted Cooper
MARICOPA COUNTY - ARIZONA PRESCRIPTION DRUG OVERDOSE PREVENTION PROGRAM
C-86-16-039-3-04
Effective September 1st, 2018, 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 replace the Price Sheet with the Revised Price Sheet in this
amendment.
All other provisions of this agreement remain unchanged.
MARICOPA COUNTY BY AND THROUGH ITS DEPARTMENT OF
PUBLIC HEALTH
Contractor Name: Authorized Signature
4041 NORTH CENTRAL, SUITE 1400 Steve Chucri
Address: 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 This Intergovernmental Agreement Amendment shall be
determined that this Intergovernmental Agreement is in proper form and is within the effective the date indicated. The Public Agency is hereby
powers and 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 County Procurement Officer
Contract No.: ADHS16-109742, which is an Agreement between public agencies, RESERVED FOR USE BY THE SECRETARY OF STATE
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 Under House Bill 2011, A.R.S. § 11-952
authority granted under the laws of the State of Arizona.
was amended to remove the
requirement that Intergovernmental
Signature Date Agreements be filed with the
Secretary of State.
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.: ADHS16- Senior Procurement Specialist
Amendment No: 1
109742 Ted Cooper
Maricopa County Department of Public Health
PRICE SHEET (Fixed Price contract)
Type of Unit Rate per Unit Unit of Measure # of Units Total
Implementation of the Rx Toolkit $50,000.00 Quarterly 4 $200,000.00
TOTAL $200,000.00
AUTHORIZATION FOR PROVISION OF SERVICES: 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 changed or modified with an official ADHS Procurement Change Order, and/or b) an additional Purchase Order is
issued for purchase of services under this contract.
ATTEST: ____________________________________, Office of the Clerk of the Board
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