AMENDMENT 1 MESA SHI(01).PDF

Maricopa County — Formal (2018-01-17)

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CONTRACT NO: C-86-18-016-3-01 AMENDMENT NO: 1
AMENDMENT TO INTERGOVERNMENTAL AGREEMENT (IGA)
Between
MARICOPA COUNTY
By and Through
DEPARTMENT OF PUBLIC HEALTH
and MESA SCHOOL DISTRICT
I. The above named IGA is hereby amended as specified below:
A. Additional funding in the amount of $2,000.00 for a total, not-to-exceed amount of
$8,000.00 for the budget period beginning September 1, 2017 through August
31, 2018.
B. Replace Attachment A with the Revised Attachment A (increases the number of
District Schools to 4).
3. All other terms and conditions of the original contract and its amendments shall
remain in full force and effect.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY MESA SCHOOL DISTRICT
By: By:
Chairman, Board of Supervisors
Date Date
ATTEST ATTEST
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVED AS TO FORM
Attorney for Maricopa County
Date Date
1

Revised Attachment A
SHI AND SHIP Complete all grey highlighted areas
OSHWI
School District: Mesa School District Representative: Elizabeth Holmes
School District contact: Nadine Miller
Title: Director of Health Services
Email: namiller@mpsaz.org
Phone No.: 480-472-0562
Mail Contract to:
Name: Nadine Miller
Title: Director of Health Services
Email: namiller@mpsaz.org
Address City State ZIP
Mailing Address: 63 E Main St #101 Mesa AZ 85201
Name of School: Address City State Zip Amount SHI or SHIP
1. Crismon Elementary 825 W. Medina St Mesa AZ 85201 $2000.00 SHI
2. Rhodes Junior High 63 E. Main St Mesa AZ 85201 $2000.00 SHI
3. Westwood High 945 W 8th St Mesa AZ 85201 $2000.00 SHI
4. Wilson Elementary 5619 E. Glade Ave Mesa AZ 85206 $2000.00 SHI
5.
6.
7.
8.
9.
10.
Total Amount: $8,000