RFGA2022-003-007 (MARICOPA)_REV. 1.PDF

GRANT AMENDMENT 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
OFFICE OF PROCUREMENT 
150 N 18th Ave., Ste. #530 
Phoenix, Arizona 85007 
GRANT NO.: RFGA2022-003-007 
AMENDMENT NO.: Three (3) 
Procurement Officer 
Darrnell Welch 
 
Page 1 of 2 
Revised 03.25.2024 
Home Visiting Services for The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) 
 
Effective upon signature by both parties, it is mutually agreed that the Grant referenced in this Amendment Three (3) is 
amended as follows: 
 
1. Pursuant to the Terms and Conditions, Provision Five (5), Sub-Section 5.1, Amendments, Purchase Orders, And 
Change Orders, the Grant is hereby revised with the following: 
 
1.1 The Price Sheet is revised and replaced.  
 
 
 
 
 
ALL CHANGES ARE REFLECTED IN RED 
 
 
ALL OTHER PROVISIONS SHALL REMAIN IN THEIR ENTIRETY 
 
Contractor hereby acknowledges receipt and acceptance of 
above amendment and that a signed copy must be filed with 
the Procurement Office before the effective date 
 
 
 
 
 
The above referenced Grant Amendment is hereby executed 
this _____ day of __________ 20______ at Phoenix, 
Arizona 
 
 
 
(To be filled out by ADHS Procurement Office) 
Contractor Signature 
 
 
 
Contractor Signature Date 
 
 
Authorized Signatory’s Name and Title 
 
Maricopa County Department of Public Health 
Contractor’s Name 
Procurement Officer Signature

GRANT AMENDMENT 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
OFFICE OF PROCUREMENT 
150 N 18th Ave., Ste. #530 
Phoenix, Arizona 85007 
GRANT NO.: RFGA2022-003-007 
AMENDMENT NO.: Three (3) 
Procurement Officer 
Darrnell Welch 
 
Page 2 of 2 
Revised 03.25.2024 
Maricopa Co DPH FY25 
Cost Reimbursement Line-Item Budget 
 
ACCOUNT CLASSIFICATION 
AMOUNT 
Personnel * 
$951,409.53 
ERE * 
$338,981.46 
Professional & Outside Services * 
$38,237.00 
Travel Expense (In-State) * 
$11,519.00 
Out-of-State Travel 
$1,407.00 
Occupancy 
$20,983.83 
Operating Expenses/ Other Operating * 
$17,586.00 
Capital Outlay Expense 
$0.00 
Indirect (if authorized) (15.79%)  
$217,921.55 
TOTAL ANNUAL 
$1,598,045.37 
(*) Indicates line items used to calculate the Indirect Cost. 
With prior written approval from the Program Manager, the Contractor is authorized to transfer up 
to a maximum of ten percent (10%) of the total budget amount between funded line items. Transfers 
of funds are only allowed between funded line items. Transfers exceeding ten percent (10%) or to 
a non-funded line item shall require an amendment.