CTR062177 - IMMUNIZATION SERVICES (MARICOPA COUNTY) A3 (002).PDF

Maricopa County — Formal (2024-09-25)

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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%