TOBACCO USE-PREVENTION ADHS14-072483 A2 (03).PDF

ARIZONA DEPARTMENT OF
INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES
AMENDMENT 150 N. 18th Avenue, Ste. No. 260
Phoenix, Arizona 85007
PROCUREMENT OFFICER
CONTRACT No.: ADHS14-072483 AMENDMENT No.: 2 Merrilyn Forbin
C-86-15-002-3-03 TOBACCO EDUCATION AND PREVENTION SERVICES
Effective July 1, 2018, it is mutually agreed that the Intergovernmental Agreement (IGA) referenced is amended as
follows:
Pursuant to the Terms and Conditions, Provision Four (4) Contract Administration and Operation, Item 4.2, Contract
Renewal, the Contract is hereby extended through June 30, 2019 (Its Fifth Year).
ALL OTHER PROVISIONS OF THIS AGREEMENT SHALL REMAIN IN THEIR ENTIRETY.
CONTRACTOR SIGNATURE
Maricopa County by and through its
Maricopa County Public Health
Contractor Name Contractor Authorized Signature
4041 N. Central Avenue, #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.
Maricopa County, MCAO State of Arizona
Signed this ________ day of _______________________ 20_____
Signature Date
Printed Name Procurement Officer
Attorney General Contract, No. P0012014000078, which is an RESERVED FOR USE BY THE SECRETARY OF STATE
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 the proper form and is within the powers
granted under the laws of the State of Arizona to those parties to the Under House Bill 2011, A.R.S. § 11-952 was amended
Agreement represented by the Attorney General. to remove the requirement that Intergovernmental
The Attorney General, BY:
Agreements be filed with the Secretary of State.
Signature Date
Assistant Attorney General
Printed Name:
ATTEST:___________________________________________, Clerk of the Board