CONTRACT AMD RE TB SCREENING WITH CITY OF PHOENIX.PDF

C16- 14-109 -3-O3
City of Phoenix HUMAN SERVICES DEPARTMENT
CONTRACT AMENDMENT Contract # 136014
CONTRACTOR NAME (name & address) AMENDMENT: #002
Mar:co PA (cort4 cvld -11$10m9h its EFFECTIVE DATE OF SERVICE: 7/01/2015
Maricopa County Department of Public Health SERVICES: TB Screening and Diagnostics
ATTN: Corinne Velasquez, Division Administrator PREVIOUS CEILING: $ 8,000
1645 E. Roosevelt Street THIS AMENDMENT: $ 4,000
Phoenix, AZ 85006 NEW CONTRACT CEILING: $12,000
THE ORIGINAL CONTRACT IS AMENDED AS FOLLOWS:
1. Extend the contract term.
2. Increase the funding.
3. Revise Award Notification.
The explanation of the revisions is due to the following:
1. In accordance with the contract terms, this contract is being renewed for the period July 1, 2015 to
June 30, 2016. This is the second and final renewal.
2. For the renewal period, the funding being added is $4,000. The total cumulative amount for the period
of July 1, 2013 to June 30, 2016 is $12,000.
3. Revise CITY contact information under "Notices" to read as follows:
The Contractor shall address all notices relative to this Contract to the attention of:
City of Phoenix Human Services Department
ATTN: Margi M. Watts, Human Services Program Coordinator
200 W. Washington Street, 19th Floor
Phoenix, AZ 86003-1611
Phone: (602) 262-4043
Fax: (602) 495-5690
Email: margi.wattshoenix.gov

All the terms and conditions of the original contract not specifically modified herein or in conflict with this
amendment shall remain unchanged and in full force and effect. This amendment shall become effective on the
date of the last signature unless otherwise specified herein.
CONTRACTOR CITY OF PHOENIX
SIGNATURE OF AUTHORIZED SIGNATOR SIGNATURE OF AUTHORIZED SIGNATOR
BOB FNGLAND. MD. MPH MOISES GALLEGOS
TYPED NAME TYPED NAME
DIRECTOR HUMAN SERVICF_S_ DIRECTOR
TITLE TITLE
DATE DATE
ATTEST:
CITY CLERK DATE

C-86-14-109-3-03 ATTACHED TO AND A PART OF
Contract 136014 Amendment 002
City of Phoenix, Human Services Department
TB Screening and Diagnostic
IN WITNESS WHEREOF, the parties agree to enter into this Contract:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Attorney for Maricopa County
Date