ADHS 13-042100 TB CONTROL AMD 5 (06).PDF

Maricopa County — Formal (2017-02-15)

Extracted text (via pymupdf_layout) 7516 characters

ARIZONA DEPARTMENT OF
HEALTH SERVICES
1740 W. Adams, Room 303
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Procurement Specialist
Contract No: ADHS13-042100 Amendment No. 5 Delilah Gonzalez
C-86-13-076-3-06 TUBERCULOSIS CONTROL
It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows:
1. Pursuant to Terms and Conditions, Provision Six (6), Contract Changes, Item 6.1, Amendments, Purchase Orders
and Change Orders; the Contract is amended as follows:
1.1 Add Provision (21) to the Terms and Conditions to read as follows:
21. Contracting; Procurement; Investment; Prohibitions
21.1 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.
21.2 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.
1.2 The Revised Price Sheet included in this Amendment is hereby added and made part of the Contract.
1.3 Attachment C Participation if Boycott of Israel is hereby added and made part of the Contract.
(Continued on Next Page)
ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED
CONTRACTOR SIGNATURE
MARICOPA COUNTY PUBLIC HEALTH
Contractor Name Contractor Authorized Signature
4041 N. CENTRAL AVENUE, #1400 Denny Barney
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.
State of Arizona
Signed this ______ day of _______________________ 201__
Signature Date
Printed Name Procurement Officer
RESERVED FOR USE BY THE SECRETARY OF STATE
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:
ATTEST:______________________________________
Maricopa County, Clerk of the Board
1

Attachment C
Arizona Department of
Participation if Boycott of Israel
Health Services
Contract No.: ADHS13-042100 PAGE Office of Procurement
1
150 N.18th Ave., Suite 280
Description: Tuberculosis Control OF Phoenix, AZ 85007
1
All materials submitted as part of a response to a solicitation/contract are subject to Arizona public records law and will be disclosed if
there is an appropriate public records request at the time of or after the award of the contract. Recently legislation has been enacted to
prohibit the state from contracting with companies currently engaged in a boycott of Israel. To ensure compliance with A.R.S. §35-
393.01 This form must be completed and returned with the response to the solicitation/contract and any supporting information to assist
the State in making its determination of compliance.
As defined by A.R.S. §35-393.01:
1."Boycott" means engaging in a refusal to deal, terminating business activities or performing other actions that are intended to limit
commercial relations with Israel or with persons or entities doing business in Israel or in territories controlled by Israel, if those actions
are taken either:
(a) In compliance with or adherence to calls for a boycott of Israel other than those boycotts to which 50 United States Code section
4607(c) applies.
(b) In a manner that discriminates on the basis of nationality, national origin or religion and that is not based on a valid business
reason.
2. "Company" means a sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited
liability partnership, limited liability company or other entity or business association, and includes a wholly owned subsidiary, majority-
owned subsidiary, parent company or affiliate.
3. "Direct holdings" means all publicly traded securities of a company that are held directly by the state treasurer or a retirement system
in an actively managed account or fund in which the retirement system owns all shares or interests.
4."Indirect holdings" means all securities of a company that are held in an account or fund, including a mutual fund, that is managed by
one or more persons who are not employed by the state treasurer or a retirement system, if the state treasurer or retirement system
owns shares or interests either:
(a) together with other investors that are not subject to this section.
(b) that are held in an index fund.
5.”Public entity" means this State, a political subdivision of this STATE or an agency, board, commission or department of this state or a
political subdivision of this state.
6. ”Public fund" means the state treasurer or a retirement system.
7. "Restricted companies" means companies that boycott Israel.
8. "Retirement system" means a retirement plan or system that is established by or pursuant to title 38.
All offerors must select one of the following:
X My company does not participate in, and agrees not to participate in during the term of the contract a boycott of Israel in
accordance with A.R.S. §35-393.01. I understand that my entire response will become public record in accordance with
A.A.C. R2-7-C317.
My company does participate in a boycott of Israel as defined by A.R.S. §35-393.01. :
By submitting this response, proposer agrees to indemnify and hold the State, its agents and employees, harmless from any claims or
causes of action relating to the State’s action based upon reliance on the above representations, including the payment of all costs and
attorney fees incurred by the State in defending such an action.
Maricopa County, by and through the Department of Public Health
Company Name Signature of Person Authorized to Sign
4041 N Central Avenue, Suite 1400 Denny Barney
Address Printed Name
Phoenix AZ 85012 Chairman, Board of Supervisors
City State Zip Title
3