CONTRACT AMD 1 RE TB SCREENING WITH CITY OF PHX.PDF

City of Phoenix HUMAN SERVICES DEPARTMENT
CONTRACT AMENDMENT Contract #136014-001
CONTRACTOR NAME (name & address) AMENDMENT: #001
Maricopa County Dept. of Public Health EFFECTIVE DATE OF AMENDMENT: 07/01114
ATTN: Corinne Velasquez SERVICE: TB Screening & Diagnostic Services
1645 E. Roosevelt THIS AMENDMENT: Rate Agreement
Phoenix, AZ 85006
THE ORIGINAL CONTRACT IS AMENDED AS FOLLOWS:
1. Extend the contract term.
2. Increase funding.
3. Revise Terms and Conditions.
The explanations of the revisions are as follows:
1. In accordance with the Contract Terms, this contract is being renewed for the period beginning
July 1,2014 and ending June 30, 2015, which is the first of two renewal periods.
2. For the renewed period, the funding being added is $4,000. The total cumulative amount for the
period of July 'I, 2013 to June 30, 2015 is $8,000.
3, Remove in its entirety item 1.7, Iran and Sudan, under Terms and Conditions.
Revise Items C and E under "Insurance Requirements" to read as follows:
C. NOTICE OF CANCELLATION: For each insurance policy required by the insurance
provisions of this Contract, the Consultant must provide to the City, within 2 business days of
receipt, a notice if a policy is suspended, voided or canceled for any reason. Such notice shall
be sent directly to: Michael Smiley, Contracts Specialist I, Human Services Department,
200 W. Washington Street, 18 th Floor, Phoenix, Arizona 85003-1611.
E. VERIFICATION OF COVERAGE: Contractor shall furnish the City with certificates of
insurance (ACORD form or equivalent approved by the City) as required by this Contract. The
certificates for each insurance policy are to be signed by a person authorized by that insurer to
bind coverage on its behalf.
All certificates and any required endorsements are to be received and approved by the City
before work commences. Each insurance policy required by this Contract must be in effect at or
prior to commencement of work under this Contract and remain in effect for the duration of the
project. Failure to maintain the insurance policies as required by this Contract or to provide
evidence of renewal is a material breach of contract.
All certificates required by this Contract shall be sent directly to: Michael Smiley, Contracts
Specialist I, Human Services Department, 200 W. Washington Street, 18 th Floor, Phoenix,
Arizona 85003-1611,
The City project/contract number and project description shall be noted on the certificate of
The City reserves the right to require complete, certified copies of all insurance policies required
by this Contract at any time. DO NOT SEND CERTIFICATES OF INSURANCE TO THE CITY'S
RISK MANAGEMENT DIVISION.
03/17/14 Page 1 of 2

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 ENGLAND. MD . MPH MOISES GALLEGOS
TYPED NAME TYPED NAME
DIRECTOR ACTING HUMAN SERVLCESDIRFCTOR
TITLE TITLE
DATE DATE
ATTEST:
CITY CLERK DATE
APPROVED AS TO FORM:
ACTING CITY ATTORNEY DATE
03/17/14 Page 2 of 2

C-86-14-109-3-02 ATTACHED TO AND A PART OF
Contract #136014-001, Amendment #001
TB Screening & Diagnostic Services
IN WITNESS WHEREOF, the parties agree to enter into this Contract and its
Amendments:
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