CTR061304 AMENDMENT 1 (004.PDF

Maricopa County — Formal (2025-01-10)

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INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
OFFICE OF PROCUREMENT 
 
150 N. 18th Ave., Suite 530 
Phoenix, Arizona 85007 
Contract No.: CTR061304 
IGA Amendment No: 1 
Procurement Officer: 
Gracie Torrecillas 
 
Page 1 of 4 
Revised 05/29/2024 
 
HIV Care Services 
 
It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows: 
 
1. Pursuant to Terms and Conditions, Provision Six (6) Contract Changes, subsection 6.1 Amendments, the Contract is 
hereby revised with the following: 
 
1.1. The Price Sheet is revised and replaced.  
 
1.2. Exhibit – 2 CFR 200.332 is revised and replaced. 
 
 
 
 
ALL CHANGES ARE REFLECTED IN RED 
 
All other provisions of this agreement remain unchanged. 
Maricopa County Department of Public Health - Ryan White Part A 
Program 
 
 
Contractor Name:  
 
County Authorized Signature 
4041 North Central Avenue 
 
 
Address:  
 
Print Name 
Phoenix 
AZ 
85012 
 
 
City 
State 
Zip 
 
Title and Date 
 
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney has determined 
that this Intergovernmental Agreement is in proper form and is within the powers and 
authority granted under the laws of Arizona 
This Intergovernmental Agreement Amendment shall be 
effective the date indicated.  The Public Agency is hereby 
cautioned not to commence any billable work or provide any 
material, service or construction under this IGA until the IGA has 
been executed by an authorized ADHS signatory.  
 
State of Arizona 
 
Signature 
Date 
 
Signed this                          day  of                                  2024. 
 
 
Print Name 
 
Procurement Officer 
 
 
Contract No.: CTR061304, which is an Agreement between public agencies, has been 
reviewed pursuant to A.R.S. § 11-952 by the undersigned Assistant Attorney, who has 
determined that it is in proper form and is within the powers and authority granted 
under the laws of the State of Arizona.  
 
 
 
Signature 
Date 
 
Assistant Attorney General 
Print Name

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
OFFICE OF PROCUREMENT 
 
150 N. 18th Ave., Suite 530 
Phoenix, Arizona 85007 
Contract No.: CTR061304 
IGA Amendment No: 1 
Procurement Officer: 
Gracie Torrecillas 
 
Page 2 of 4 
Revised 05/29/2024 
 
 
Cost Reimbursement Contract 
HIV Care and Services   
Contract Price Sheet  
Through 6/30/2027 
ACCOUNT CLASSIFICATION 
LINE-ITEM TOTALS 
PERSONNEL SERVICES AND ERE* 
$0 
TRAVEL* 
$0 
PROFESSIONAL & OUTSIDE SERVICES* 
$3,000,000.00 
CAPITAL EXPENSES 
$0.00 
OTHER OPERATING EXPENSES* 
$0 
INDIRECT  
$0 
CONTRACT NOT TO EXCEED (NTE): 
$3,000,000.00 
*Indicates Indirect Cost calculation. 
 
If applicable, the Contractor is authorized to transfer up to a maximum of 25% of the total budget amount between 
line items with the written approval from an ADHS program representative. 
  
Transfers exceeding 25% or to a non-funded line item shall require an Amendment.

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
OFFICE OF PROCUREMENT 
 
150 N. 18th Ave., Suite 530 
Phoenix, Arizona 85007 
Contract No.: CTR061304 
IGA Amendment No: 1 
Procurement Officer: 
Gracie Torrecillas 
 
Page 3 of 4 
Revised 05/29/2024 
 
2 CFR 200.332 
§ 200.332  
Requirements for pass-through entities. 
All pass-through entities must: 
(a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following 
information at the time of the subaward and if any of these data elements change, include the changes in 
subsequent subaward modification. When some of this information is not available, the pass-through entity must 
provide the best information available to describe the Federal award and subaward. 
 
Prime Awardee:  
Arizona Department of Health Services 
UEI # 
QMWUG1AMYF65 
 
 
Federal Award Identification (Grant Number): 
X07HA00080‐34‐01 
 
 
Subrecipient name (which must match the name 
associated with its unique entity identifier): 
Maricopa County Department of Public Health 
 
 
Subrecipient's unique entity identifier (UEI #): 
LM85MG1513K5 
 
 
Federal Award Identification Number (FAIN, 
sometimes it’s the same as the Grant Number): 
X07HA00080 
 
 
Federal Award Date (see the definition of Federal 
award date in § 200.1 of this part) of award to the 
recipient by the Federal agency; 
04/01/2023 
 
 
Subaward Period of Performance Start and End 
Date; 
4/1/24-3/31/25 
 
 
Subaward Budget Period Start and End Date: 
4/1/24-3/31/25 
 
 
Amount of Federal Funds Obligated by this action 
by the pass-through entity to the subrecipient (this 
is normally the contract amount): 
$3,000,000 
 
 
Total Amount of Federal Funds Obligated to the 
subrecipient by the pass-through entity including 
the current financial obligation (how much is 
available for contracts): 
$3,000,000 
 
 
Total Amount of the Federal Award committed to 
the subrecipient by the pass-through entity 
N/A -no pass through 
 
 
Federal award project description, as required to 
be responsive to the Federal Funding 
Accountability and Transparency Act (FFATA) 
RYAN WHITE CARE ACT TITLE II

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
OFFICE OF PROCUREMENT 
 
150 N. 18th Ave., Suite 530 
Phoenix, Arizona 85007 
Contract No.: CTR061304 
IGA Amendment No: 1 
Procurement Officer: 
Gracie Torrecillas 
 
Page 4 of 4 
Revised 05/29/2024 
 
Name of Federal awarding agency, pass-through 
entity, and contact information for awarding official 
of the Pass-through entity 
Health Resources & Services Administration India 
Smith Grants Management Specialist Office of Federal 
Assistance Management (OFAM) Division of Grants 
Management Office (DGMO) ISmith@hrsa.gov (301) 
443-2096 
 
 
Assistance Listings number and Title; the pass-
through entity must identify the dollar amount 
made available under each Federal award and 
the Assistance Listings Number at time of 
disbursement: 
 $17,217,265.00/ CFDA 93.917 
 
 
Identification of whether the award is R&D 
Not R & D 
 
 
Indirect cost rate for the Federal award (including 
if the de minimis rate is charged) per § 200.414 
N/A