CTR062177 - IMMUNIZATION SERVICES (MARICOPA COUNTY) A3 (002).PDF
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INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR062177 IGA Amendment No.: Three (3) Procurement Officer Kailee Gray 1 IMMUNIZATION 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, Section 6.1., Amendments, Purchase Orders and Changes Orders, the following revision is made under this Amendment Three (3): 1.1. The Price Sheet is hereby revised and replaced; and 1.2. Exhibit F is hereby revised and replaced. ALL CHANGES ARE REFLECTED IN RED All other provisions of this agreement remain unchanged. Maricopa County Public Health Department Contractor Name: Authorized Signature 4041 North Central Avenue, Suite 1400 Address: Print Name Phoenix AZ 85012 City State Zip Title 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.: CTR062177, 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 150 18th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR062177 IGA Amendment No.: Three (3) Procurement Officer Kailee Gray 2 Price Sheet Activity Frequency Unit Rate Unit of Measure Total Total Personnel/ERE; Salary/Fringe – May claim only salary and fringe benefits for immunization program staff/other staff who work to meet contract requirements Yearly N/A Total UP TO $31,111,264.00 Supplemental flu vaccination activities. (SAIF Funds) As needed by June 30, 2025 N/A Total Not to exceed allocation= $1,005,000.00 (minus any payout from previous contract) Improve vaccine cold storage capacity; increase capacity for data entry and reminder recall activities (IDEAS Funds) As needed by June 30, 2025 N/A Total Not to exceed allocation= $125,000 (minus any payout from previous contract) Enhance VFC/COVID-19 activities (VIP Funds) As needed by June 30, 2025 N/A Total Not to exceed allocation= $1,216,200.00 (minus any payout from previous contract) IZCOVIDSUP (SUP Funds) Enhance COVID-19 activities and throughput As needed by June 30, 2025 N/A Total Not to exceed allocation= $10,000,000.00 (minus any payout from previous contract) IZCOVID4 COVID-19 Vaccination Equity Funding (Equity Funds) As needed by June 30, 2025 N/A Total Not to exceed allocation= $16,000,000.00 (minus any payout from previous contract) Bridge Access Program Administration Fee and operating costs for COVID-19 Vaccine to uninsured adults As needed by June 30, 2025 N/A Total Not to exceed allocation= $2,765,064.00 (specific to county) *Prices may be reviewed and adjusted annually over the term of the Agreement INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR062177 IGA Amendment No.: Three (3) Procurement Officer Kailee Gray 3 Exhibit F Bridge Access Program Exhibit - 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): 6 NH23IP922599-05-01 Subrecipient name (which must match the name associated with its unique entity identifier): Maricopa County Subrecipient's unique entity identifier (UEI #): LM85MG1513K5 Federal Award Identification Number (FAIN, sometimes it’s the same as the Grant Number): NH23IP922599 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; 08/01/2023 Subaward Period of Performance Start and End Date; 07/01/2019 – 06/30/2025 Subaward Budget Period Start and End Date: 08/29/2023 – 06/30/2025 Amount of Federal Funds Obligated by this action by the pass-through entity to the subrecipient (this is normally the contract amount): $2,765,064.00 INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR062177 IGA Amendment No.: Three (3) Procurement Officer Kailee Gray 4 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): $8,426,507.00 Total Amount of the Federal Award committed to the subrecipient by the pass-through entity $8,426,507.00 Federal award project description, as required to be responsive to the Federal Funding Accountability and Transparency Act (FFATA) CDC-RFA-IP19-1901 Immunizations Vaccines for Children Name of Federal awarding agency, pass-through entity, and contact information for awarding official of the Pass- through entity Centers for Disease Control and Prevention 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: 93.268 Immunization Cooperative Agreement Identification of whether the award is R&D NO Indirect cost rate for the Federal award (including if the de minimis rate is charged) per § 200.414 10%