IGA AMENDMENT 4 RE DIETETIC INTERNSHIP PROGRAM WITH ADHS.PDF
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3-0 ARIZONA DEPARTMENT OF HEALTH SERVICES 41411" . INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 1740 W Adams, Room 303 84 Phoenix, Arizona 85007 (602) 542-1040 . .. (602) 542-1741 Fax Procurement Specialist Contract No: ADHS11-005228 Amendment No 4 Tracey Thomas Dietetic Internship Program Effective March 1,2014, It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: 1. Pursuant to Special Terms and Conditions, Section 4, Contract Administration and Operation, Item 42, Contract Renewal is hereby extended through September 30, 2015 All other provisions Of this agreement remain unchanged. CONTRACTOR SIGNATURE Maricopa County Public Health Contractor Name Contractor Authorized Signature 4041 North Central Avenue, Suite 1400 Address Printed Name Phoenix Arizona 85012 City State Zip Title CONTRACTOR ATTORNEY SIGNATURE This intergovernmental Agreement Amendment shall be effective the Pirrsuant to A. R S § 11 -952, the undersigned public agency attorney date indicated. The Public Agency is hereby cautioned not to commence has determined that this intergovernmental Agreement is in proper any billable work or provide any material, service or construction under form and Is within the powers and authority granted under the laws of this IGA until the iGA has been executed by an authorized ADHS the State of Arizona. signatory State of Arizona Signed this day of 2014 Signature Date Printed Name Procurement Officer RESERVED FOR USE aY THE SecaaTARY OF STATE Attorney General Contract No. P0012012000033, which is an Agreement between public agencies, has been reviewed pursuant to Under House Bill 2011, A.R.S. § 11-952 A RS. § 11 -952 by the undersigned Assistant Attorney General, who has determined that it Is in proper form and is Within the powers and was amended to remove the requirement authority 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: