CTR046145 A1 DIETETIC INTERNSHIP.PDF

Maricopa County — Formal (2020-08-19)

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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.