DES IGA AMENDMENT 3 RE COMMUNITY ACTION SERVICES PROGRAM.PDF

County No._____________________________ 
Board Approved Date:_____________________________ 
INTERGOVERNMENTAL 
AGREEMENT AMENDMENT 
ARIZONA DEPARTMENT OF 
ECONOMIC SECURITY 
1789 W. Jefferson Street, 
Mail Drop 1541 
Phoenix, Arizona 85007 
(602) 364-0170
10/13/2023Intergovernmental AgreementPage 1 of 1 
CONTRACTOR (Name and Address): 
Services Description: 
Community Action Services Program 
Maricopa County Administered by its 
Human Services Department 
234 N. Central Ave. Suite #300 
Phoenix, Az 85004 
Agreement Number: 
DI25-002428 
Amendment Number: 
Three (3) 
PURSUANT TO THE INTERGOVERNMENTAL AGREEMENT (IGA), UNIFORM TERMS AND CONDITIONS, 
SECTION 5.1 AMENDMENTS, THE PARTIES HEREBY AGREE TO AMEND THE AGREEMENT AS FOLLOWS: 
    The Scope of Work, Section 9.2, General Reporting Requirements are being revised to add the following:          
  9.2.2.2      Submit monthly financial backup documentation sufficient to verify that all costs billed under this contract 
are allowable, allocable, reasonable, and incurred within the approved period of performance. 
Documentation must clearly identify costs charged to this contract and reconcile to the corresponding 
invoice amounts, by budget category and totaled by funding lines LIHEAP A16, Intake, Neighbors 
Helping Neighbors, Navigator, SSBG, TANF, CSBG, CSBG Discretionary, Eviction Prevention, LIHEAP 
Voucher, SSBG Transport, Homeless Youth Outreach and in accordance with the ISB. 
9.2.2.3     Ensure that all financial backup documentation submitted pursuant to this Section is free of Personally 
Identifiable Information (PII) or any other confidential client data prior to submission. 
9.2.2.4 
  ADES may request additional source documentation at any time to substantiate costs billed under this 
contract. 
EXCEPT AS PROVIDED HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT SHALL REMAIN UNCHANGED AND 
IN FULL FORCE AND EFFECTS.  THE AMENDMENT SHALL BECOME EFFECTIVE ON THE DATE OF LAST SIGNATURE UNLESS 
OTHERWISE SPECIFIED HEREIN.  BY SIGNING THIS AMENDMENT ON BEHALF OF THE CONTRACTOR, THE SIGNATORY CERTIFIES 
HE/SHE HAS THE AUTHORITY TO BIND THE CONTRACTOR TO THIS CONTRACT. 
AGENCY NAME 
NAME OF CONTRACTOR 
Arizona Department of Economic Security 
Maricopa County 
Authorized Signature 
Authorized Signatory 
Type Name 
Type Name 
Title 
Title 
Date 
Date 
IN ACCORDANCE WITH ARS §11-952 THIS CONTRACT AMENDMENT HAS BEEN REVIEWED BY THE UNDERSIGNED WHO HAVE 
DETERMINED THAT THIS CONTRACT AMENDMENT IS IN APPROPRIATE FORM AND WITHIN THE POWERS AND AUTHORITY 
GRANTED TO EACH RESPECTIVE PUBLIC BODY. 
ARIZONA ATTORNEY GENERAL'S OFFICE 
PUBLIC AGENCY LEGAL COUNSEL 
ASSISTANT ATTORNEY GENERAL 
Date 
Date 
CLERK OF THE BOARD SIGNATURE AND NAME 
Date