IGA AMD RE STD SVCS 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
Contract No.: ADHS14-071224 Amendment No.: 1 Procurement Officer:
Delilah Gonzalez
(STD) SEXUALLY TRANSMITTED DISEASE SERVICES
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 Agreement expiration date is hereby changed to December 31, 2018.
2. The Price Sheet of the original Agreement is hereby replaced with the revised Price Sheet of this Amendment (1).
The total of the revised Price Sheet is increased from $390,120.00 to $464,430.00 due to the following line item
changes:
2.1 Personnel Services and ERE increased by $165,636.00, from $238,216.00 to $403,852.00, due to increase
in staff.
2.2 Fringe Benefits (ERE) decreased by $101,019.00 to $0.00.
2.3 Other (Indirect) increased by $9,693.00, from $50,885.00 to $60,578.00, due to increased costs.
ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED.
Contractor Name: Authorized Signature
Maricopa County by and through its
MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
4041 NORTH CENTRAL, SUITE 1400 Steve Chucri .
Address: Print Name
PHOENIX ARIZONA 85012 Chairman, Maricopa County Board of Supervisors
City State Zip Title
This Intergovernmental Agreement Amendment shall be
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has determined effective the date indicated. The Public Agency is hereby
that this Intergovernmental Agreement is in proper form and is within the powers and cautioned not to commence any billable work or provide any
authority granted under the laws of Arizona material, service or construction under this IGA until the IGA
has been executed by an authorized ADHS signatory.
State of Arizona
Signature Date
Signed this day of 2015.
Print Name Title
Procurement Officer
Attorney General Contract No.: P0012014000078 _, 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 Under House Bill 2011, A.R.S. § 11-952
form and is within the powers and authority granted under the laws of the was amended to remove the
State of Arizona. requirement that Intergovernmental
Agreements be filed with the
Secretary of State.
Signature Date
Assistant Attorney General
Print Name Title
ATTEST: ________________________________________________
Clerk of the Board Date

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.: ADHS14-071224 Amendment No.: 1 Procurement Officer:
Delilah Gonzalez
REVISED PRICE SHEET
Effective January 1, 2015
ACCOUNT CLASSIFICATION AMOUNT
Personnel Services and ERE $403,852
Professional & Outside Services $ 0.00
Travel Expense $ 0.00
Occupancy Expense $ 0.00
Other Operating Expenses $ 0.00
Capital $ 0.00
Other $ 60,578
TOTAL $464,430