INTERVIEWINVESTIGATION EPI A5 (05).PDF

INTERGOVERNMENTAL AGREEMENT (IGA) 
AMENDMENT
ARIZONA DEPARTMENT 
OF HEALTH SERVICES 
150 N 18
th Ave Suite 530 
Phoenix, Arizona 85007 
Contract No.: ADHS16-130023 
Amendment No.: 5 
 Procurement Officer 
Christopher Balderrama 
Page 1 of 2 
INTERVIEW AND INVESTIGATIONS OF INFECTIOUS DISEASES 
Effective upon signature of both parties, it is mutually agreed that the Intergovernmental Agreement referenced 
is amended as follows: 
1.
Pursuant to the Terms and Conditions, Provision Six (6) Contract Changes, Section 6.1 Amendments, Purchase
Orders and Change Orders:
1.1 
Scope of Services, Provision Five (5) Deliverables, Section 5.1 Deliverable One (1) Disease
Investigations and Surveillance, Sub-Section 5.1.4. Conduct surveillance of valley fever, including 
monitoring and assessing trends and performing analyses, as identified in Amendment Three (3), is 
hereby removed. 
1.2   The Agreement Price Sheet is revised and replaced with the Price Sheet of this Amendment Five (5). 
-- All other provisions of this Agreement remain unchanged. -- 
Maricopa County by and through its’ 
Maricopa County Department of Public Health 
CONTRACTOR SIGNATURE 
Contractor Name 
4041 North Central 
Contractor Authorized Signature 
Address 
Phoenix      
 Arizona   
 85012 
Printed Name 
    City    
    State 
  Zip 
Title 
CONTRACTOR ATTORNEY SIGNATURE 
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 the State 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 
Signed this _________ day of _________________________ 2020 
Signature   
 Date 
Printed Name 
Procurement Officer 
Contract No. ADHS16-130023, which is an Agreement between public 
agencies, has been reviewed pursuant to A.R.S. § 11-952 by the 
undersigned Assistant Attorney General, 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 
Printed Name:  
C-86-16-115-3-05
Clint Hickman
Chairman, Board of Supervisors
Anne Longo, Attorney for County
ATTEST:

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
AMENDMENT 
 
ARIZONA DEPARTMENT 
OF HEALTH SERVICES 
 
150 N 18
th Ave Suite 530 
Phoenix, Arizona 85007 
 
Contract No.: ADHS16-130023 
Amendment No.: 5 
 Procurement Officer 
Christopher Balderrama 
 
Page 2 of 2 
 
Revised Price Sheet 
 
Maricopa County Department of Public Health 
 
For Budget Period May 1, 2020 through April 30, 2021 
 
 
DESCRIPTION 
QUANTITY 
UNIT 
AMOUNT 
Enteric case investigations, surveillance, education, control, and prevention 
awareness. 
1 
Year 
Use Carryover 
Funds 
Outbreak management. 
1 
Year 
Use Carryover 
Funds 
AFM case investigations, surveillance, coordination, and education. 
1 
Year 
Unfunded 
Valley fever surveillance, and education. 
1 
Year 
Unfunded 
HAI case investigations, surveillance, inspections, education, antimicrobial 
stewardship and prevention awareness. 
1 
Year 
Use Carryover 
Funds 
HAI data analysis, TAP reports, NHSN data quality checks, and summary 
reports. 
1 
Year 
Use Carryover 
Funds 
$39,940.00 to be carried over from this past grant year(s) to apply to enteric 
case investigations, surveillance, education, control, and prevention awareness 
activity. 
1 
Year 
$39,940.00 
$61,029.28 to be carried over from this past grant year(s) to apply to outbreak 
management activities (deliverable six (6)). 
1 
Year 
$61,029.28 
$54,278.19 to be carried over from this past grant year(s) to apply to HAI case 
investigations surveillance, inspections, education, antimicrobial stewardship, 
and prevention awareness activities. 
1 
Year 
$54,278.19 
$40,500.00 to be carried forward from this past grant year(s) to apply to HAI 
data analysis, TAP reports, NHSN data quality checks, and summary reports. 
1 
Year 
$40,500.00 
ANTICIPATED TOTAL BUDGET 
$195,747.47 
 
 
* Unspent funds may be extended into the following budget period to conduct tasks/deliverables into the next year 
as needed if approved by program.