SIG BLOCK 68363 UNI FX.PDF

Maricopa County — Formal (2022-01-05)

View PDF Item 29 Meeting page

Extracted text (via pymupdf) 3162 characters
Pass-Through Entity (PTE)
Subrecipient
Awarding Agency
 Project Title 
Amount Funded This Action    
Total Amount of Funds Obligated to Date 
Amendment(s) to Original Terms and Conditions 
This Amendment revises the above-referenced Subaward Agreement as follows: 
All other terms and conditions of this Subaward Agreement remain in full force and effect. 
By an Authorized Official of PTE:
Name 
 Date 
Title 
Subaward No 
For clarity: all amounts stated in this amendment are in United States Dollars.
 Subrecipient Cost Share
Start Date:
 End Date: 
FDP Subaward Amendment 
Amendment No
 
Additional Budget Period 
No Cost Extension 
Additional Funding 
Carryover is
Revised 10/2020
PTE/Prime Award No. 
Entity Name  
Contact Email 
Principal Investigator 
Subject to FFATA
Carryover Authorized
The Subrecipient is not required to countersign this 
amendment. Unilateral acceptance of this modification does not 
bypass internal approval processes of the Subrecipient. If 
Subrecipient would like to terminate this action, a request 
should be directed to PTE's Administrative Contact.
Detailed Budget/Scope of Work Attached
For all other contractual changes, the PTE must use the bilateral modification template
Cumulative Budget Period(s)
(Agreement Start Date)
(End Date of Latest Budget Period)
(If changing carryover restrictions from prior Agreement, PTE must use the bilateral modification template)
3
547365
Arizona Board of Regents, University of Arizona
Maricopa County Public Health Department
Subawards@email.arizona.edu
barbara.lu@maricopa.gov
Scott C Carvajal
Mark Gallegos
Health Promotion and Disease Prevention Research Centers - 2019
6 U48DP006413-01-03
National Institutes of Health (NIH)
09/30/2019
09/29/2022
$ 55,000.00
$ 94,992.87
I
I
I
Additional budget period 09/30/2021
 -
09/29/2022
is hereby added to this Subaward. 
Additional funding in the amount of
$ 55,000.00
is hereby obligated to this Subaward.
Not Automatic
Carryover across budget periods requires prior approval.
If carryover is not automatic, the "Total Amount of Funds Obligated to Date" stated above may not reflect the actual balance available. The Subrecipient is responsible for tracking unobligated 
balances and subsequent carryover approvals from prior budget periods. In the event that funding was not fully expended by the Subrecipient during the prior period, the Subrecipient is not 
authorized to use funds from any prior periods, unless approval is granted by the PTE.
I
(Select any that apply)
I
New Budget
Supplemental Budget
Notice of Award
Revised Budget
Carryover Budget
The selected document(s) are hereby incorporated by attachment to this Amendment. The scope of work remains 
unchanged. 
Contract Manager, Subawards
Melissa Kramer
Melissa Kramer
Digitally signed by Melissa Kramer 
Date: 2021.12.09 13:27:33 -07'00'

FOR AND ON BEHALF OF MARICOPA COUNTY
By: ______________________________________
Jack Sellers, Chairman, Board of Supervisors,     Date
ATTEST: 
__________________________________
Office of the Clerk of the Board       Date
APPROVE AS TO FORM: 
____________________________________
Attorny for County                          Date