IGA AMD RE TUBERCULOSIS CONTROL WITH ADHS.PDF
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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. 2 Jacqueline Ortega-Avila/CR TUBERCULOSIS CONTROL Effective July 21, 2014, it is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: 1. Pursuant to Terms and Conditions of the Agreement, Provision Six (6), Contract Changes, Item (6.1), Amendments, Purchase Orders and Change Orders; the Agreement Price Sheet Effective January 1, 2014 is replaced with the Revised Price Sheet January 1, 2014 of this Amendment to add additional funding received by the ADHS funding source for this Program. Pricing will be updated in the ProcureAZ “Items Tab” to reflect the pricing upon execution of this Amendment. (CONTINUED ON NEXT PAGE) ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED. CONTRACTOR SIGNATURE Maricopa County Department of Public Health Contractor Name Contractor Authorized Signature Denny Barney 4041 North Central Avenue, Suite #1400 Address Printed Name Chairman Board of Supervisors Phoenix Arizona 85012 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 has date indicated. The Public Agency is hereby cautioned not to commence determined that this Intergovernmental Agreement is in proper form and is any billable work or provide any material, service or construction under within the powers and authority granted under the laws of the State of this IGA until the IGA has been executed by an authorized ADHS Arizona. signatory. State of Arizona Signed this ______ day of _______________________ 2014 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 Under House Bill 2011, A.R.S. § 11-952 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 was amended to remove the requirement granted under the laws of the State of Arizona. that Intergovernmental Agreements be filed with the Secretary of State. Signature Date Assistant Attorney General Printed Name: Patricia LaMagna 1 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. 1 Jacqueline Ortega-Avila 1.1 Travel Expenses shall increase by $5,783.00 to reflect the new total amount of $40,871.00. 1.2. Other Operating Expenses shall increase by $18,000.00 to reflect the new total amount of $26,500.00. 1.3 Other shall increase by $3,567.00 to reflect the new total amount of $50,001.00. 1.4 The new Agreement total is $383,341.00 All other funding lines remain the same as Amendment 1. 2 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. 2 Jacqueline Ortega-Avila/CR TUBERCULOSIS CONTROL REVISED PRICE SHEET EFFECTIVE JANUARY 1, 2014 THROUGH DECEMBER 31, 2014 ACCOUNT CLASSIFICATION AMOUNT 1. Personnel Services and ERE $265,969.00 2. Professional and Outside Services $0.00 3. Travel Expenses $40,871.00 4. Other Operating Expenses $26,500.00 5. Capital Outlay Expenses $0.00 6. Other $50,001.00 TOTAL $383,341.00 LINE ITEM BUDGET TRANSFERS With prior approval from the ADHS TB Program Manager, the contractor is authorized to transfer up to a maximum of thirty-five percent (35%) of the total budget amount between line items. Transfers of funds are only allowed between funded line items. Transfers exceeding thirty-five percent (35%) or to a non- funded item shall require an Agreement Amendment. 3