CONTRACT AMENDMENT RE TB SCREENING WITH THE CITY OF PHOENIX.PDF

City of Phoenix
May 7, 2014
Maricopa County Department of Public Health
ATTN: Corinne Velasquez
1645 E. Roosevelt
Phoenix, AZ 85006
To: Ms. Velasquez:
The City of Phoenix Head Start Program would like to extend the contract term and
increase funding on contract #136014. The current contract is set to expire on June
30th, 2014. I am enclosing the contract amendment for your review and signature.
Please return the original amendment in the enclosed envelope in an expedited manner
to fully process the amendment, at which time you will be emailed a fully executed copy.
The new contract period will be from July 1 st, 2014 through June 30 th, 2015.
If you have any questions, please feel free to call me or email me at
melanie.fierros@phoenix.gov .
Thank you,
624-t-ip ‘
Melanie Fierros
602-496-6671
City of Phoenix
Head Start/Early Head Start
200 W. Washington 19th floor
Phoenix, AZ 85003

City of Phoenix HUMAN SERVICES DEPARTMENT
CONTRACT AMENDMENT Contract # 136014
CONTRACTOR NAME (name & address) AMENDMENT* 001
EFFECTIVE DATE OF SERVICE: 07/01/2014
Maricopa County Dept of Public Health-
ATTN: Corinne Velasquez THIS AMENDMENT: Rate Agreement
1645 E. Roosevelt
Phoenix, Arizona 86006
THE ORIGINAL CONTRACT IS AMENDED AS FOLLOWS:
The purpose of this amendment is to:
1. Extend the contract term
2. Increase funding
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, 2014-
June 30, 2015. This 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 1, 2013 to June 30, 2015 is $8,000.
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 AUTHORIZE* 1GNA 0 A I SIGNATURE OF AUTHORIZED S1GNATOR
Moises Gallegos
TYPED NAME TYPED NAME
I I 11.1 :& its -
TITLE TITLE
r‘
DATE DATE
ATTEST:
CITY CLERK DATE
APPROVED AS TO FORM:
03/17114 Page 1 of 1

City of Phoenix
C-86-14-109-3-01
IN WITNESS WHEREOF, the parties agree to enter into this Agreement:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By
Chairman, Board of Supervisors
Date
ATTEST:
Clerk of the Board
Date
APPROVED AS TO FORM:
Deputy Attorney for Maricopa County
Date