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ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Ave. Suite 260 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 Fax Procurement Officer: Agreement No: ADHS16-102232 Amendment No. 6 Russell Coplen C-86-15-112-3-07 Healthy People Healthy Communities Effective upon signature, it is mutually agreed that the Agreement referenced above is amended as follows: 1. The Intergovernmental Agreement Price Sheet is revised and replaced with the Price Sheet of this Amendment number Six (6). ProcureAZ Items Tab will be updated upon execution of this Amendment. All other provisions shall remain in its entirety. CONTRACTOR SIGNATURE Maricopa County , By and through its Department of Public Health Contractor Name Contractor Authorized Signature Denny Barney 4041 N. Central Ave. Suite 1400 Address Printed Name Phoenix AZ 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 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 an State of Arizona. authorized ADHS signatory. State of Arizona Signed this _________ day of _________________________ 2016 Signature Date MCAO Printed Name Procurement Officer Attorney General Contract No. P0012014000078, 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: Page 1 of 3 ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Ave. Suite 260 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 Fax Agreement No: ADHS16-102232 Amendment No. 6 Procurement Officer: Russell Coplen PRICE SHEET HEALTHY PEOPLE HEALTHY COMMUNITIES MARICOPA - ADHS16-102232 JULY 1, 2017 - JUNE 30, 2018 ACTION PLAN UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS Action Plan – All Programs EA 1 $250,366.00 $250,366.00 TOTAL 1 $250,366.00 $250,366.00 TOBACCO UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS See SOW for Specific Service Strategies (i.e. Prevention, QTR 4 $488,404.38 $1,953,617.52 Cessation, Secondhand Smoke, Enforcement) TOTAL 4 $488,404.38 $1,953,617.52 HEALTH IN ARIZONA POLICY INITIATIVE UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS See SOW for Specific Service Strategies (i.e. Alzheimer’s, Chronic Pulmonary Disease, Hypertension, Self-Management, Procurement, QTR 4 $134,183.62 $536,746.48 Healthy Community Design, School Health, Worksite Wellness, Clinical Care, and Special Health Care Needs) TOTAL 4 $134,183.62 $536,746.48 Page 2 of 3 ARIZONA DEPARTMENT OF HEALTH SERVICES INTERGOVERNMENTAL AGREEMENT(IGA) 150 N. 18th Ave. Suite 260 AMENDMENT Phoenix, Arizona 85007 (602) 542-1040 (602) 542-1741 Fax Agreement No: ADHS16-102232 Amendment No. 6 Procurement Officer: Russell Coplen HEALTHY ARIZONA WORKSITE PROGRAM UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS See SOW for Specific Service QTR 4 $70,509.50 $282,038.00 Strategies TOTAL 4 $70,509.50 $282,038.00 PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS See SOW for Specific Service Strategies (i.e. Fees for Accreditation, Quality Improvement Projects, Workforce Development Implementation, QTR 1 $81,750.00 $81,750.00 Performance Management Documentation, Progress Toward County Health Improvement Plan) 3 $81,750.00 $245,250.00 TOTAL $327,000.00 FAMILY PLANNING / MATERNAL and CHILD HEALTH (Title V Block Grant) UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS See SOW for Specific Service QTR 4 $67,676.00 $270,704.00 Strategies TOTAL 4 $67,676.00 $270,704.00 TEEN PREGNANCY PREVENTION UNIT OF NUMBER ITEM/SERVICE DESCRIPTION UNIT RATE TOTAL MEASURE OF UNITS See SOW for Specific Service Strategies QTR 4 $45,967.00 $183,868.00 TOTAL 4 $45,967.00 $183,868.00 TOTAL ITEM/SERVICE DESCRIPTION TOTAL GRAND TOTAL $3,804,340.00 Page 3 of 3