EXAMPLE RFP 200234 AMENDMENT.PDF

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CONTRACT NO: 200234 
AMENDMENT NO: 2 
AMENDMENT TO CONTRACT 
Between 
MARICOPA COUNTY 
By and Through 
DEPARTMENT OF PUBLIC HEALTH 
and 
PARTNER NAME
for 
Mass Immunization Services and Administration 
I. 
The above-named contract is hereby amended as specified below: 
A. Exhibit A, COMPENSATIONS/FEES on the PRICING SHEET is revised in its entirety and 
replaced in its entirety as specified in the COMPENSATIONS/FEES – AMENDMENT on 
Page 2 of this Amendment. 
B. Exhibit B, SCOPE OF WORK is revised in its entirety and replaced in its entirety as specified 
in the SCOPE OF WORK – AMENDMENT beginning on Page 3 of this Amendment. 
C. Section 3.3, INVOICES is revised in its entirety and replaced in its entirety as specified in 
INVOICES – AMENDMENT as shown on Page 6 of this Amendment. 
II.
All other terms and conditions of the original contract shall remain in full force and effect.
III.
This Amendment supersedes any and all other amendments to these sections completed on this contract.
IN WITNESS WHEREOF, the parties agree to the changes indicated herein: 
FOR AND ON BEHALF OF 
MARICOPA COUNTY 
FOR AND ON BEHALF OF 
CONTRACTOR 
By: 
By: MCDPH Procurement Officer  
Date 
Date

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COMPENSATION/FEES – AMENDMENT 
For Contract 200234, Mass Immunization Services and Administration 
COMPENSATION/FEES: 
RATE 
1) 
Flu Vaccine unit cost for each flu vaccination administered in accordance with FDA and ACIP vaccine dosing schedule. 
Reimbursement will be based on the type of vaccine product administered to:   
- 
an uninsured/underinsured individual 
Fluzone High Dose 
$44.52 
Flucelvax Quad 
$27.64 
Fluarix, Flulaval and Fluzone 
$20.19 
2) 
Flu Administration unit cost for each vaccination administered in accordance with FDA and ACIP vaccine dosing 
schedule to:  
- 
an uninsured/underinsured individual 
$25.60 
- 
an uninsured/underinsured child 
$16.90 
3) 
COVID-19 Administration unit cost for each COVID-19 vaccination administered in accordance with FDA and ACIP 
vaccine dosing schedule to: 
- 
an uninsured/underinsured individual 
 
$40.00 
4) 
Vaccine Event Fee 
 
 
 
 
 
Not to exceed 
$1,120 per event 
For each MCDPH approved event conducted by Contractor, the Contractor may bill the following fees: 
- 
Planning – up to 4 hours of planning at $40/hour to accommodate coordination, site surveys, and other event planning 
activities. This fee can be charged for up to four staff personnel. Total planning billable costs shall not exceed $640 
per event. 
- 
Event set up/tear down – up to two hours of time to complete event set up and event tear town at $40/hour. This fee 
can be charged for up to four staff personnel. Total set up/tear down billable costs shall not exceed $320 per event. 
- 
Reporting – up to 2 hours of time to complete required event reporting at $40/hour. This fee can be charged for up to 
two staff personnel. Total reporting billable costs shall not exceed $160 per event. 
- 
Contractor must provide supporting documentation of any planning, setup/tear down, and/or reporting activities when 
requesting reimbursement for an item under this provision.

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SCOPE OF WORK – AMENDMENT 
For Contract 200234, Mass Immunization Services and Administration 
2.0 SCOPE OF WORK: 
Contractor shall: 
2.1 Have and maintain throughout the period of performance, sufficient qualified staff to perform all functions related 
to administering immunizations, including, but not limited to, patient registration, screening, and vaccination. 
2.1.1 
Contractor shall ensure at least one bilingual staff person is available at each site. Language 
provided shall be appropriate for the population(s) being served. 
2.1.2 
Contractor shall verify and ensure all clinic staff members are licensed and/or certified to 
administer immunizations. 
2.1.2.1 In addition, all staff must be trained in the following: 
2.1.2.1.1 hands-on injection techniques. 
2.1.2.1.2 clinical evaluation of indications and contraindications of vaccines based on the 
Advisory Committee of Immunization Practices (ACIP). 
2.1.2.1.3 the recognition and treatment of emergency reactions to immunizations. 
2.1.2.1.4 Basic Life Support including possession of a current certification. 
2.1.2.1.5 Proper use of personal protective equipment (PPE), especially as it relates to 
proper protection from COVID-19 
2.1.2.1.6 Cultural competency 
2.2 Perform services at community-based clinic locations as directed by MCDPH ensuring the vaccine is 
administered to clients based on the current ACIP recommendations. 
2.3 Work with representatives of the chosen locations to discuss and plan event operation including location cost 
(if applicable), insurance, set-up and tear down requirements, and any other information that may be required 
for each location.  
2.3.1 
Contractor to provide all materiel, supplies, and equipment needed to conduct event. 
2.3.2 
Contractor shall enforce current social distancing guidelines as set forth by Centers for Disease 
Control (CDC) and/or Arizona Department of Health Services (ADHS). 
2.3.3 
Contractor shall provide all clients with a safe, temperature-controlled environment in which to 
wait for services. 
2.3.4 
All locations shall be American Disabilities Act (ADA) compliant and clients with Disabilities or 
Access and Functional Needs (DAFN) shall be able to access the clinic without the need for 
accommodation. 
2.4 If contracted to provide vaccine:

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2.4.1 
Contractors shall either already be currently on-boarded as a COVID vaccine provider by the 
Arizona Department of Health Services (ADHS) or be willing to do so and shall complete the 
process within 60 days of contract start date.  
2.4.2 
Contractor to obtain sufficient vaccines for scheduled events using contractor’s established supply 
chain. Vaccines that are available through the Arizona Stata Immunization Information System 
(ASIIS) shall be directly ordered. Vaccines that are not available through ASIIS shall be ordered 
through MCDPH. 
2.5 Transport vaccines in a manner consistent with manufacturer’s recommendations to community clinics in a 
qualified container designed for vaccine transport ensuring the vaccines always remain within the temperature 
range recommended by the CDC and its manufacturer. 
2.5.1 
Contractor shall always ensure proper storage of vaccine based on manufacturer’s requirements. 
If at any time, or for any reason, Contractor believes that a malfunction might have occurred and 
the vaccine’s temperature has failed to remain in compliance with the proper storage 
requirements, Contractor shall immediately notify MCDPH.  
2.5.1.1 Temperatures must be monitored on-site using a continuous temperature recording 
device as recommended by the CDC. MCDPH requires the use of a digital data logger. 
2.6 Provide all supplies needed to administer the vaccine in accordance with ACIP and MCDPH recommendations. 
Ensure staff utilize appropriate PPE while conducting work under the terms of this contract. All PPE shall be 
used as indicated and in accordance with current MCDPH and/or CDC guidelines or best practices. 
2.6.1 
Confirm that all supplies and materials used conform to governmental industry standards and 
either meet or exceed the minimum performance requirements in use at their time of service. 
2.6.2 
Supplies that have yet to receive approval but have been granted an Emergency Use Authorization 
(EUA) must maintain a copy of the EUA on file. Current EUAs in use may be found at 
https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-
authorizations#covid19ivd 
2.6.3 
MCDPH may have a limited supply of personal protective equipment (PPE) to provide to 
Contractors, however Contractors should not assume these items will be available.  
2.6.3.1 Any supplies provided to the Contractor may be charged against the final invoice 
decreasing the total amount paid for each unit of service. These amounts shall be 
discussed and agreed upon in advance of MCDPH providing Contractor supplies. 
2.7 Perform all requested vaccinations on the population(s) identified by MCDPH in accordance with ACIP 
guidelines and recommendations. 
2.7.1 
Contractor shall screen all patients for medical contraindications and allergies for the vaccines(s) 
being offered at the clinic. 
2.7.2 
Contractor shall follow manufacturers’ instructions for correct age, injection dose, site, and route. 
2.7.3 
Contractor shall document each immunization with the name of person being vaccinated; date of 
birth; vaccination date; vaccination type; lot number; manufacturer; patient receipt of most up to 
date Vaccine Information Statement (VIS), including edition date and date VIS was provided;

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injection site; vaccination route; dosage; and name, title, and office/company address of person 
who administered the vaccine. 
2.7.4 
Contractor shall provide patients with documentation of immunization for their personal records 
and to share with their medical providers. 
2.7.5 
Contractor shall report any adverse events to the Vaccine Adverse Event Reporting System 
(VAERS): https://vaers.hhs.gov/index  
1.1.1 
Contractor shall provide the necessary immunizations to anyone requesting a vaccine regardless 
of their ability to pay or the applicability of any insurance. All immunizations provided shall be 
documented and provided to MCDPH monthly for potential compensation.  
2.8 Contractor shall submit for reimbursement to all major health plans, AHCCCS, and Medicare plans. 
Contractor shall include a list of all health care plans they currently work with in their proposal however, the 
inability to bill all health plans does not automatically prevent a Respondent from being awarded a contract. 
2.9 Report vaccines administered to the Arizona State Immunization Information System (ASIIS) within 24 hours 
of administration. 
2.10 To be eligible for compensation, Contractor must provide a community clinic report form to MCDPH within 24 
hours of each vaccination clinic by email or fax. Report to include number of individuals immunized with 
COVID-19 vaccine and number of individuals immunized with Flu vaccine. Contractor must also complete 
demographic report (template to be provided by MCDPH). 
2.11 Contractor shall indicate in their response the populations they are willing to serve. Please identify if you are 
willing to provide flu and/or COVID for infants*, toddlers*, adolescents and/or adults. 
*when available
2.12 Other Services: 
MCDPH is aware that there may be other related services not included above that may be useful to the County. 
In your proposal, you are invited to explain such services and your firm’s qualifications for such.  Include these 
additional services and their corresponding hourly rates in your proposal. 
2.13 Compensation: 
Compensation shall be made on a per unit Administration cost for uninsured/underinsured persons receiving a 
flu or COVID-19 vaccine, as well as a per unit cost of the specific flu vaccine received by an individual. Payment 
of vaccine event fees are based on the specific activities performed in the planning, setup, tear down, and 
reporting associated with each event. See Attachment A, Pricing Sheet – Compensation/Fees for details. 
Please note, uninsured is defined as a person that has been verified by the Contractor as not having any medical 
insurance (commercial or AHCCCS). The fact that a Contractor does not contract with an individual’s particular 
health plan does not make the person uninsured. Contractors must perform due diligence to collect and verify 
insurance information on all patients before submitting invoices for payment. The Contractor must submit a 
report from the Arizona Immunization Information System detailing patient information.  
Contractors failing to accurately verify insurance information of patients may incur penalties such as 
chargebacks, temporary suspension of services, or even termination.

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INVOICES – AMENDMENT 
For Contract 200234, Mass Immunization Services and Administration 
3.3 INVOICES: 
3.3.1 
The Contractor shall submit one (1) legible copy of their detailed invoice before payment(s) will be 
made. Incomplete invoices will not be processed.  At a minimum, the invoice must provide the 
following information: 
•
Company name, address and contact
•
County bill-to name and contact information
•
Contract Serial Number
•
County purchase order number
•
Invoice number and date
•
Payment terms
•
Date of service or delivery
•
Quantity
•
Contract Item number(s)
•
Description of Purchase (services)/Project title
•
Hours by project team member
•
Pricing per unit of purchase
•
Extended price
•
Arrival and completion time
•
Total Amount Due
•
Line list by event
•
Patient ID and date of birth
•
Type of vaccine administered
•
Dose number for COVID-19 vaccine administered
•
Manufacturer name for each Flu vaccine administered
•
Date of vaccine administered
Problems regarding billing or invoicing shall be directed to the Department as listed on the 
Purchase Order. 
3.3.2 
Payment shall only be made to the Contractor by Accounts Payable through the Maricopa County 
Vendor Express Payment Program.  This is an Electronic Funds Transfer (EFT) process.  After 
Contract Award the Contractor shall complete the Vendor Registration Form located on the County 
Department 
of 
Finance 
Vendor 
Registration 
Web 
Site 
(https://azdom-vss-
ext.hostams.com/PRDVSS2X1/Advantage4)  
3.3.3 
Discounts offered in the contract shall be calculated based on the date a properly completed invoice 
is received by the County.  
3.3.4 
EFT payments to the routing and account numbers designated by the Contractor will include the 
details on the specific invoices that the payment covers.  The Contractor is required to discuss 
remittance delivery capabilities with their designated financial institution for access to those details.