CTR046145 A1 DIETETIC INTERNSHIP.PDF
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INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR046145 IGA Amendment No: 1 Procurement Officer Kristine Newton 1 Dietetic Internship 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 Change Orders, the following changes are made under this Amendment One (1): 1.1 The Price Sheet is revised and replaced by the Price Sheet of this Amendment One (1). All other provisions of this agreement remain unchanged. Contractor Name: MARICOPA COUNTY DEPT. OF PUBLIC HEALTH Authorized Signature Address: 4041 N. CENTERAL AVE., SUITE 1400 Print Name PHOENIX ARIZONA 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 20___. Print Name Procurement Officer Contract No.: CTR046145, 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 Clint Hickman Chairman, Board of Supervisors Anne Longo ATTEST: _______________________________ Office of the Clerk of the Board _______________________________ Date INTERGOVERNMENTAL AGREEMENT (IGA) Amendment ARIZONA DEPARTMENT OF HEALTH SERVICES 150 18 th Ave Suite 530 Phoenix, Arizona 85007 Contract No.: CTR046145 IGA Amendment No: 1 Procurement Officer Kristine Newton 2 PRICE SHEET October 1, 2020 to September 30, 2021 Cost Reimbursement Line Item Budget Agency Name: Maricopa County Department of Public Health WIC-Track Dietetic Internship Federal Award Date: October 1, 2020 CFDA number and name: 10.557 Special Supplemental Nutrition Program for Women, Infants, and Children WIC Services Account Classification Amount Personnel $76,063.00 Employee Related Expenses $34,266.00 Professional & Outside Services $1.00 Travel Expense $3,000.00 Occupancy Expenses $6,260.00 Other Operating Expenses $6,247.00 Capital Expenditures $1.00 Indirect Cost $24,162.00 Total $150,000.00 Additional Terms and Conditions: 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. Authorization for purchase of services under this Contract shall be made only upon ADHS issuance of a Purchase Order that is signed by an authorized agent. The Purchase Order will indicate the Contract number and the dollar amount of funds authorized. The Contractor shall only be authorized to perform services up to the amount on the Purchase Order. ADHS shall not have any legal obligation to pay for services in excess of the amount indicated on the Purchase Order. No further obligation for payment shall exist on behalf of ADHS unless a.) The Purchase Order is modified with an official ADHS Procurement Change Order, and/or b.) An additional Purchase Order is issued for purchase of services under this Contract. ADHS reserves the right to adjust awards given to local agencies depending on federal dollars received. Adjustments will be at the discretion of ADHS.