CONTRACT AMD RE DENTAL INS WITH DELTA DENTAL PA.PDF

CONTRACT NO: C-86-13-061-3-02 AMENDMENT NO: 2
AMENDMENT TO
CONTRACT
Between
MARICOPA COUNTY
By and Through
DEPARTMENT OF PUBLIC HEALTH
and
DELTA DENTAL PLAN OF ARIZONA
I. The above named contract is hereby amended as specified below:
A. Page 19, Add the following in section 1.3 Implementation and Ongoing
Requirements as:
1.3.5 Dental services outside of the country are not covered under the Delta
Dental plan offered by Ryan White Part A. If an Ryan White eligible client
receives services out of the country they are responsible for any costs
incurred.
II. All other terms and conditions of the original contract and its amendments shall
remain in full force and effect.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF FOR AND ON BEHALF OF
MARICOPA COUNTY DELTA DENTAL OF ARIZONA
By: By:
Chairman, Board of Supervisors
Date Date
ATTEST ATTEST
Clerk of the Board
Date Date
APPROVED AS TO FORM APPROVED AS TO FORM
Attorney for Maricopa County
Date Date
1