ADHS MULTI-HSG A4 (06).PDF

Maricopa County — Formal (2018-11-07)

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ARIZONA DEPARTMENT OF
HEALTH SERVICES
150 N. 18th Avenue, Suite 260
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT Phoenix, Arizona 85007
Contract No: ADHS15-084012
Procurement Specialist
Amendment No. 4
Carlos Carranza
MCDPH No: C-86-15-053-3-06
ARIZONA MULTI-HOUSING PROJECT
Effective upon signature. It is mutually agreed that the Intergovernmental Agreement referenced is amended as
follows:
1. Pursuant to Terms and Conditions, Provision Four (4), Contract Administration and Operation, subsection 4.2,
Contract Renewal, this agreement is hereby extended through October 31, 2019, the fifth and final year.
Funding to remain the same at $819,640.00.
ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED
CONTRACTOR SIGNATURE
Maricopa County Department of Public Health
Contractor Name Contractor Authorized Signature
4041 North Central Avenue, Suite 1400 Steve Chucri
Address Printed Name
Phoenix Arizona 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 form any billable work or provide any material, service or construction under
and is within the powers and authority granted under the laws of the this IGA until the IGA has been executed by an authorized ADHS
State of Arizona. signatory.
State of Arizona
Signed this ______ day of _______________________ 2018
Signature Date
Printed Name Procurement Officer
RESERVED FOR USE BY THE SECRETARY OF STATE
Contract No. ADHS15-084012, 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:
APPROVED AS TO FORM:______________________________, Attorney for County
ATTEST:_____________________________________________, Office of the Clerk of the Board
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