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ARIZONA DEPARTMENT OF INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES AMENDMENT 150 N. 18th Avenue, Suite #260 Phoenix, Arizona 85007 C-86-15-020-3-05 PROCUREMENT OFFICER CONTRACT No.: ADHS14-071224 AMENDMENT No.: 5 Gina Crocker SEXUALLY TRANSMITTED DISEASE (STD) CONTROL PROGRAM Effective upon signature, it is mutually agreed that the Intergovernmental Agreement (IGA) referenced is amended as follows: Pursuant to the Terms and Conditions, Provision Six (6), Contract Changes, Item 6.1 Amendments, Purchase Orders and Change Orders, the Contract is amended as follows: 1. Add Provision Nineteen (19), to the Terms and Conditions to read as follows: THE FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT (FFATA OR TRANSPARENCY ACT - P.L.109-282, AS AMENDED BY SECTION 6202(A) OF P.L. 110-252), FOUND AT https://www.fsrs.gov/ is hereby added to read as follows: If applicable, the Contractor/Grantee shall submit to ADHS via email the Grant Reporting Certification Form. This form and the instructions can be downloaded from the ADHS Procurement website at http://www.azdhs.gov/operations/financial- services/procurement/index.php#ffata and must be returned to the ADHS by the 15th of the month following that in which the award was received. The form shall be completed electronically, and submitted using the steps outlined in the Grant Reporting Certification Form Instructions to the following email address: ADHS_Grant@azdhs.gov. All required fields must be filled including Top Employee Compensation, if applicable. Completing the Grant Reporting Certification Form is required for compliance with the Office of Management and Budget (OMB), found at http://www.whitehouse.gov/omb/open. Failure to timely submit the Grant Reporting Certification Form could result in the loss of funds. This requirement applies to all subcontractors/sub-awardees utilized by the Contractor/Grantee for amounts exceeding $30,000.00 during the term of the Award. (Continued on Next Page) Maricopa County by and through its Department of CONTRACTOR SIGNATURE Public Health Contractor Name Contractor Authorized Signature 4041 N Central Avenue, Suite 1400 Steve Chucri Address Printed Name Phoenix AZ 85012 Chairman, Board of Supervisors City State Zip Title CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be effective Pursuant to A.R.S. § 11-952, the undersigned public agency attorney the 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 State of Arizona. an authorized ADHS signatory. State of Arizona Signed this ________ day of _________________ 2018 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 Under House Bill 2011, A.R.S. § 11-952 was amended to remove granted under the laws of the State of Arizona to those parties to the Agreement represented by the Attorney General. the requirement that Intergovernmental Agreements be filed The Attorney General, BY: with the Secretary of State. Signature Date Assistant Attorney General Printed Name: ATTEST:__________________________________, Clerk of the Board 1 ARIZONA DEPARTMENT OF INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES AMENDMENT 150 N. 18th Avenue, Suite #260 Phoenix, Arizona 85007 PROCUREMENT OFFICER CONTRACT No.: ADHS184-071224 AMENDMENT No.: 5 Gina Crocker 2. Provision Twenty (20), is hereby added to read as follows: 20. CONTRACTING; PROCUREMENT; INVESTMENT; PROHIBITIONS: 20.1 A public entity may not enter into a contract with a company to acquire or dispose of services, supplies, information technology or construction unless the contract includes a written certification that the company is not currently engaged in, and agrees for the duration of the contract to not engage in, a boycott of Israel. 20.2 A public entity may not adopt a procurement, investment or other policy that has the effect of inducing or requiring a person or company to boycott Israel. 20.3 Contractor hereby certifies that it is not currently engaged in, and will not for the duration of this Contract engage in, a boycott of Israel as defined by A.R.S. § 35-393.01. Violation of this certification by Contractor may result in action by the State up to and including termination of this Contract. 3. Scope of Services, Provision Four (4), Tasks, Section 4.1, is hereby amended to read as follows: 4. TASKS 4.1.1 is deleted from the contract. 4. Scope of Services, Provision Four (4), Tasks, Section 4.3 is hereby amended to read as follows: 4.3.1 Verbiage “Herpes Genitals” is removed from the contract. 5. Scope of Services, Provision Four (4), Tasks, Section 4.3, Item 4.3.5 is hereby added to read as follows: 4.3.5 The Contractor shall process reports in PRISM as noted below: 4.3.5.1 Disposition and close all paper syphilis laboratory reports entered and assigned to them by the Arizona Department of Health Services Sexually Transmitted Disease Control Program (ADHS STDCP). 4.3.5.2 Attach disposition and close all reports transmitted electronically via eCW. 4.3.5.3 Assign cases that reside in other counties or on Reservation land to the appropriate liaison for follow up. 4.3.5.4 All Field Records will be closed within thirty (30) days of receipt of report. 6. Scope of Services, Provision Seven (7), State Provided Items, Section 7.3, Item 7.3.1 is hereby added to read as follows: 7. STATE PROVIDED ITEMS 7.3.1 Enter, disposition, close and reassign to the Contractor all paper and electronic chlamydia and gonorrhea laboratory reports for the Contractor to disposition and close. 2 ARIZONA DEPARTMENT OF INTERGOVERNMENTAL AGREEMENT (IGA) HEALTH SERVICES AMENDMENT 150 N. 18th Avenue, Suite #260 Phoenix, Arizona 85007 PROCUREMENT OFFICER CONTRACT No.: ADHS184-071224 AMENDMENT No.: 5 Gina Crocker 7. Scope of Service, Provision Eight (8), Reporting Requirements / Deliverables and Schedule, Section 8, Items 8.3 and 8.4 are hereby revised and amended to read as follows: 8. REPORTING REQUIREMENTS / DELIVERABLES AND SCHEDULE 8.3 Contractor’s Expenditure Report shall include a summary of all positions included on this contract, filled or vacant, with the breakdown of associated costs incurred with each position and should be submitted monthly or quarterly and shall not exceed the total budget. Reports may be submitted to the ADHS STDCP on a monthly basis but no less than semi-annually to coincide with the submission of the Progress Reports.” 8.4 Contractor shall submit semi-annual activity reports developed in accordance with their work plans within thirty (30) days after June 30th and within thirty (30) days after December 31st 8. Price Sheet “Note” under the Price Sheet is hereby revised and amended to read as follows: The Contractor is authorized to transfer up to thirty-five percent (35%) or $50,000, whichever comes first, of the total budget amount between line items. Transfers of funds are only allowed between funded line items, must be in accordance with the Center for Disease Control Assessment, Assurance, Policy Development and Prevention Strategies (CDC AAPPS) grant requirements and receive approval from the ADHS STDCP Epidemiology Program Manager. Transfers exceeding the abovementioned amount shall require an amendment.” Funding in the not-to-exceed amount of $464,430 for the budget period January 1, 2018 through December 31, 2018 ALL OTHER PROVISIONS OF THIS AGREEMENT SHALL REMAIN IN THEIR ENTIRETY. 3