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CONTRACT NO: C-86-18-051-3-05
FUNDING FOR INTERGOVERNMENTAL AGREEMENT (IGA)
Between MARICOPA COUNTY
By and Through its DEPARTMENT OF PUBLIC HEALTH and
ARIZONA DEPARTMENT OF HEALTH SERVICES
I.
The Price Sheet to IGA ADHS18-188819 with the Arizona Department of Health
Services provides funding as follows:
1. The HIV portion of the IGA is in the not to exceed amount of $240,000 for the budget
period ending December 31, 2020.
2. The RWPB portion is in the not-to-exceed amount of $914,098 for the budget period
ending March 31, 2021.
All other terms and conditions of the original IGA shall remain in full force and effect.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein:
FOR AND ON BEHALF OF
MARICOPA COUNTY
By:
Clint Hickman
Chairman, Board of Supervisors
Date
ATTEST
Clerk of the Board
Date
APPROVED AS TO FORM
Attorney for Maricopa County
Date
2
INTERGOVERNMENTAL AGREEMENT (IGA)
AMENDMENT
PRICE SHEET
ARIZONA DEPARTMENT OF
HEALTH SERVICES
150 North 18th Avenue, Suite 280
Phoenix, Arizona 85007
(602) 542-1040
Contract No: ADHS18-188819
Clinical Services
Procurement Specialist
Carlos Carranza
FOR BUDGET PERIOD ENDING MARCH 31, 2021
HIV Prevention Price Sheet CY20
Cost Reimbursement Line Items
Budget Amount
1. Personnel Services
$0
2. Employee Related Expenses
$0
2. Professional & Outside Services
$0
3. Travel Expenses
$0
4. Other Operating Expense
$240,000
5. Capital Outlay Expense
$0
6. Other (Indirect Costs)
$0
Total HIV Prevention Amount
$240,000
FOR BUDGET PERIOD ENDING DECEMBER 31, 2020
Ryan White Part B Price Sheet
Cost Reimbursement Line Items
Budget Amount
1. Personnel Services – Core
$336,166
2. Employee Related Expenses – Core
$190,133
3. Personnel Services – Admin
$184,043
4. Employee Related Expenses –
Admin
$ 97,945
5. Professional & Outside Services
$0
6. Travel Expenses
5,500
7. Other Operating Expense
$15,054
8. Capital Outlay Expense
$0
9. Other (Indirect Costs)
$85,257
Total Ryan White Part B Amount
$914,098