200812-05_MCSO_EXTENSION REQUEST #3_APPROVAL.PDF

Project Extension Request Form
Arizona Department of Homeland Security 
Version 7.3.0
All previous versions are obsolete 
Arizona Department of Homeland Security
10.30.2017
Subrecipient Information
Subrecipient Agreement Number:
200812-05
Date of Request:
9/13/2022
Agency:
Maricopa County Sheriff's Office
Point of Contact: 
Pat Roshetko
Email:
PatRoshetko@mcso.maricopa.gov
Phone:
602-908-5189
Original Period of Performance:
October 1, 2020 - September 30, 2021
Funding Source (i.e. SHSGP/UASI/OPSG/NSGP):
UASI
Award Amount:
$120,000 
Amount Reimbursed to Date:
$0 
Extension Justification
1. Provide a detailed justification and explanation 
for extending the period of performance.  
A radiation detection device was identified and the vendor 
was selected. Due to procurement challenges, a new 
vendor was later identified and the device was ordered. 
The original projected delivery date by the vendor was 
September 2022. The vendor is currently building the 
device and now anticipates a completion and delivery date 
of January 2023.   
Objective 1:
Date:
Equipment (Vehicle Mounted Radiation Detection & 
ID System) has been ordered and is currently being 
built. 
October 1 - December 31, 2022
Objective 2:
Date:
Equipment is expected to be delivered and received 
by January 31, 2023.  MCSO makes payment to 
vendor.
January 1 - January 31, 2023
Objective 3:
Date:
Objective 4:
Date:
For AZDOHS Official Use Only
Quarterly Report Received:
Q1: Oct 1 - Dec 31
Q2: Jan 1 - Mar 31
Q3: Apr 1 - Jun 30
2.  What is the new timeline for completion, including all major objectives?  Please include specific date(s) 
and a deliverable for each project objective.
Planning Section:
Yes
No
Yes
No
Yes
No

Project Extension Request Form
Arizona Department of Homeland Security 
Version 7.3.0
All previous versions are obsolete 
Arizona Department of Homeland Security
10.30.2017
Q4: Jul 1 - Sep 30
Planner Signature:
Belinda Torres                          Date: 09/21/22
Assistant Director Signature:
                                                Date: 9/21/2022
AZDOHS Recommendation and/or Comments:
Linked to a Modification:
Extension Request:
Amendment Emailed To:
                                                Date: 
RM Update:
GIMS Update:
Reimbursement Request Form Sent To:
                                                Date:
Finance Signature: 
                                                Date:
Finance Section:
Yes
No
Approved
Denied
Date: _________
Date: _________
Initials:________
Initials:________
Yes
No
Cindy Kenney
09/21/22