PE WEST VALLEY OBGYN AMENDMENT.PDF

CONTRACT NO: C-86-24-004-X-02 / PH RFP 220294

AMENDMENT NO: 3

AMENDMENT TO

CONTRACT

Between

MARICOPA COUNTY
by and through
DEPARTMENT OF PUBLIC HEALTH

and

West Valley OB-GYN

I. The above-named contract is hereby amended as specified below:

A. Section 1.0 CONTRACT TERM shall be updated to reflect a new expiration date of June 30,

2026.

B. Exhibit A, PRICING - TOTAL REQUESTED shall be updated to $645,929. The increase of
$210,956 are for services beginning in the new budget period starting July 1, 2025, and is

shown on page 2 of this amendment.

i. All other terms and conditions of the original contract shall remain in full force and effect.

IN WITNESS WHEREOF, the parties agree to the changes indicated herein:

FOR AND ON BEHALF OF FOR AND ON BEI
MARICOPA COUNTY WEST VALLEY 0}
f
By: By: i
Chairman, Board of Supervisors West Valley'GB-GYN Gh
Date Date oe
ATTEST
Clerk of the Board
Date
APPROVED AS TO FORM

Attorney for Maricopa County

Date

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CONTRACT NO: C-86-24-004-X-02 / PH RFP 220294 AMENDMENT NO:
Exhibit A: Pricing
RFP # and Title: PH RFP 220294, Expanded Testing Services for Sexually Transmitted Diseases
July 1, 2025 - June 30, 2026 '

Section | -- Organization Information

Date Prepared: 6/6/2024
Organization Name: West Valley OB-GYN

Section II -- Budget at a Glance

*** Formulas in this section will auto-calculate with information entered into the Budget Detail Tab ***

3

Total Budget Requested

Personnel Salaries $ 159,300.00
Personnel Fringe Benefits $ 19,116.00
Total Personnel and Staff Expenses: | $ 178,416.00

Total Equipment and Supplies Cost: | $ :

Total Contractual Costs: | $ .
Total Operating / Infrastructure Costs: | $ 13,363.00
Total Amount Requested Before Indirect Applied: | $ 191,779.00
Indirect Costs:| $ 19,177.00

Section Ill -- Compensation Schedule
Date Deliverable as eee ___ Payment Amount

1-Jul-22 Completion of Signed Contract - 25% $ 52,739.00
1-Oct-22 October and Invoice - 25% $ 52,739.00
1-Jan-23 January Report and Invoice - 25% $ 52,739.00
1-Apr-23 April Report and Invoice - 25% $ 52,739.00

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