AMENDMENT NO 2 RE STATEWIDE NEEDS ASSESSMENT WITH ADHS.PDF

ARIZONA DEPARTMENT
OF HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 1740 West Adams, Room 303
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 FAX
Procurement Officer:
Contract No.: ADHS14-059037 Amendment No.: 2
Delilah Gonzalez
STATEWIDE COMPREHENSIVE NEEDS ASSESSMENT
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 Budget is made part of the Contract. All items will be added to the ProcureAZ “Items” tab.
(CONTINUED ON NEXT PAGE)
ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED.
Contractor Name: Authorized Signature
MARICOPA COUNTY RYAN WHITE PART A PROGRAM
.
301 WEST JEFFERSON, #3200
Address: Print Name
PHOENIX ARIZONA 85003
City State Zip Title
This Intergovernmental Agreement Amendment shall be effective
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has the date indicated. The Public Agency is hereby cautioned not to
determined that this Intergovernmental Agreement is in proper form and is within commence any billable work or provide any material, service or
the powers and authority granted under the laws of Arizona construction under this IGA until the IGA has been executed by
an authorized ADHS signatory.
State of Arizona
Signature Date
Signed this day of 2014.
Print Name Title
Procurement Officer
Attorney General Contract No.: P00120143000033 , which is an Agreement RESERVED FOR USE BY THE SECRETARY OF STATE
between public agencies, has been reviewed pursuant to A.R.S. § 11-952 by the
undersigned Assistant Attorney, who has determined that it is in proper form and is Under House Bill 2011, A.R.S. § 11-952
within the powers and authority granted under the laws of the State of Arizona.
was amended to remove the
requirement that Intergovernmental
Agreements be filed with the Secretary
Signature Date of State.
Assistant Attorney General
Print Name Title
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ARIZONA DEPARTMENT
OF HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 1740 West Adams, Room 303
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 FAX
Contract No.: ADHS14-059037 Amendment No.: 2 Procurement Officer:
Delilah Gonzalez
Budget
Phase Hours Hourly Office of HIV Phoenix Total*
Rate Prevention EMA Part A
Office
Phase I: Meet with HIV Prevention Program 50 $80 $2,000 $2,000 $4,000
staff, Ryan White Part A staff, and Ryan White
Part A Planning Council and HIV Statewide
Advisory Group members, to develop
assessment methodologies, tools, sample
size requirements, and a timeline for the
completion of activities.
Phase II: Conduct consumer assessments 450 $80 $21,000 $15,000 $36,000
based on agreed-upon parameters
Phase III: Analyze assessment data and 162.5 $80 $8,000 $5,000 $13,000
present draft findings for review/Focus Groups
Phase IV: Provide a completed report and 212.5 $80 $9,000 $8,000 $17,000
presentations to the HIV Statewide Advisory
Group and Ryan White Part A Planning
Council.
Total 875 $80 $40,000 $30,000 $70,000
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