CTR040486 STD A4 (05).PDF

Maricopa County — Formal (2021-09-01)

View PDF Item 51 Meeting page

Extracted text (via pymupdf) 2809 characters
INTERGOVERNMENTAL AGREEMENT (IGA) 
Amendment 
ARIZONA DEPARTMENT 
OF HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Agreement No.: CTR040486 
IGA Amendment No.: 4 
Procurement Officer 
Karla Varela 
Page 1 of 2 
STD Control Services 
1.
Effective upon signature by all parties and pursuant to the Terms and Conditions, Provision Six (6), Contract Changes,
Section 6.1, Amendments, Purchases Orders and Change Orders it is mutually agreed that the Intergovernmental
Agreement referenced is amended as follows under this Amendment Four (4):
1.1 Price Sheet is revised and replaced.
ALL CHANGES ARE REFLECTED BELOW IN RED. 
All other provisions of this Agreement remain unchanged. 
Maricopa County  
By and through its Department of Public Health 
Contractor Name:  
Authorized Signature 
4041 North Central 
Address: 
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
       2021. 
Print Name 
Procurement Officer 
Contract No.: CTR040486, 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 
C-86-19-027-3-05
Jack Sellers
Chairman, Board of Supervisors
Anne Longo, Attorney for County
ATTEST:__________________________________
County office of the Clerk of the Board              Date

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT 
OF HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
Agreement No.: CTR040486 
IGA Amendment No.: 4 
Procurement Officer 
Karla Varela 
 
Page 2 of 2 
 
PRICE SHEET 
Effective through December 31, 2021 
 
 
COST REIMBURSEMENT LINE ITEMS 
BUDGETED 
AMOUNT 
Personnel Services & ERE 
$524,637.00 
Professional & Outside Services  
$0.00 
Travel 
$0.00 
Other Operating 
$3,117.00 
Occupancy Expense 
$0.00 
Capital Outlay Expenses 
$0.00 
Other 
$0.00 
Indirect 
$122,189.00 
ANNUAL TOTAL (Not to exceed) 
$649,943.00 
 
 
• The contractor shall receive a 25% budget increase in 2021.  The additional funds will be 
allocated for personnel services and other operating expenses.