MCHSD AMEND 12 12 22 14.DOC

Maricopa County — Formal (2015-01-21)

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Intergovernmental Agreement
CONTRACT AMENDMENT
1. CONTRACTOR (Name and address) 2. CONTRACT ID NUMBER
Maricopa County Administered by its Human Services Department DE111071001
234 N. Central Ave., Suite 3000
Phoenix, Arizona 85004 3. AMENDMENT NUMBER
Twelve (12)
4. THE PARTIES AGREE TO THE FOLLOWING AMENDMENT
Pursuant to the Terms and Conditions, Amendments or Modifications section, the purpose of this amendment is to:
Funding for the contract period July 1, 2014 through June 30, 2015:
The reimbursement ceiling for the service Case Management has not changed. Funding has been moved between
budget categories.
The reimbursement ceiling for the service Community Services is increased from $803,198 to $1,067,603. This is an
increase of $264,405, which includes $209,405 “Carry Forward” funding. The carry forward funding is not added to the
cumulative reimbursement ceiling.
The cumulative reimbursement ceiling for the contract period July 1, 2010 through June 30, 2015 is $25,243,058.
Therefore, the Itemized Service Budget for the services of Case Management (Attachment A) and Community Services
(Attachment B) are revised and attached.
5. EXCEPT AS PROVIDED HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT AS HERETOFORE CHANGED AND/OR
AMENDED REMAIN UNCHANGED AND IN FULL FORCE AND EFFECT. THE AMENDMENT SHALL BECOME EFFECTIVE ON THE DATE
OF LAST SIGNATURE UNLESS OTHERWISE SPECIFIED HEREIN. BY SIGNING THIS FORM ON BEHALF OF THE CONTRACTOR, THE
SIGNATORY CERTIFIES HE/SHE HAS THE AUTHORITY TO BIND THE CONTRACTOR TO THIS CONTRACT.
6. 7. NAME OF CONTRACTOR
ARIZONA DEPARTMENT OF ECONOMIC SECURITY Maricopa County Administered by its Human Services
Department
SIGNATURE OF AUTHORIZED INDIVIDUAL SIGNATURE OF AUTHORIZED INDIVIDUAL
TYPED NAME TYPED NAME
NAJWA STUCK
TITLE TITLE
Procurement Manager
DATE DATE
IN ACCORDANCE WITH ARS §11-952 THIS CONTRACT AMENDMENT HAS BEEN REVIEWED BY THE UNDERSIGNED WHO HAVE DETERMINED THAT THIS
CONTRACT AMENDMENT IS IN APPROPRIATE FORM AND WITHIN THE POWERS AND AUTHORITY GRANTED TO EACH RESPECTIVE PUBLIC BODY.
ARIZONA ATTORNEY GENERAL’S OFFICE
BY: BY:
ASSISTANT ATTORNEY GENERAL PUBLIC AGENCY LEGAL COUNSEL
DATE: DATE:
Revised: 8/22/13