ORAL HEALTH WITH PHX ELEM SD AMD 5 (05).PDF

CONTRACT NO: C-86-13-022-3-05 AMENDMENT NO: 5
AMENDMENT NO.5 TO MEMORANDUM OF UNDERSTANDING
Between MARICOPA COUNTY
By and through its
DEPARTMENT OF PUBLIC HEALTH
And PHOENIX ELEMENTARY SCHOOL DISTRICT
I. The above named Memorandum of Understanding (MOU) is hereby
amended as specified below:
Background, Paragraph 4, Sentence 2 is amended to read:
A Licensed dental hygienist will provide written take-home findings
and a list of dental clinics to all (insured and uninsured) second and sixth
grade students who return “positive” parental consent forms.
C., fourth bullet point is amended to read:
Provide licensed dental hygienists and trained dental assistants to conduct the dental
screening and dental sealant activities at each school.
Term Addendum, page 5: Agreement valid from July 1, 2017 thru June 30, 2018.
II. All other terms and conditions of the original MOU 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 PHOENIX ELEMENTARY SCHOOL DISTRICT
By By
Denny Barney
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 Signature
Date Date