PE WEST VALLEY OBGYN AMEND 2.PDF
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CONTRACT NO: C-86-24-004-X-00 / PH RFP 220294 AMENDMENT NO: 2 AMENDMENT TO CONTRACT Between MARICOPA COUNTY by and through DEPARTMENT OF PUBLIC HEALTH and West Vailey OB-GYN I The above-named contract is hereby amended as specified below: A. Section 1.0 CONTRACT TERM shail be updated to reflect a new expiration date of June 30, 2025. B. Exhibit A, PRICING ~ TOTAL REQUESTED shall be updated to $434,973. The increase of $144,991 are for services beginning in the new budget period starting July 1, 2024, and is shown on page 2 of this amendment. Il. All other terms and conditions of the original contract shall remain in full force and effect. IN WITNESS WHEREOF, the parties agree to the changes indicated herein: FOR AND ON BEHALF OF FOR AND ON BEHALF OF MARICOPA COUNTY WEST VALLEY OB-GYN By oy poe . Chairman, Board of Supervisors West Valley OB-GYN 4-$- 74 Date Date ATTEST Clerk of the Board Date APPROVED AS TO FORM Attorney for Maricopa County Date Page 1 of 2 CONTRACT NO: C-86-24-004-X-00 / PH RFP 220294 Exhibit A: Pricing Updated Budget AMENDME: July 1, 2024 — June 30, 2025 NT NO: 2 Fringe Benefits Line Item % of staff person budgeted Category Description Staff Last Name & Title to contract Requested amount Personnel Staff 1 ‘Community Health Worker 50%! $ 22,400.00 Personnel Staff 2 Physicians Assistant 50%! $ 62,500.00 Personnel [Staff 3 Medical Assistant 50%] $ 26,000.00 $ Total er FTE:| 1.5) 110,900.00 Line item Category Description Types of fringe (FiCA, Medical, etc.) % budgeted to contract _| Requested budget amount | Personnel Fringe Benefits _|FICA+Medicare+Health Ins+Workers Comp 12%| $ 2,688.00 Personnel Fringe Benefits 12%] $ 7,500.00 Personnel Fringe Benefits 12%] $ 3,120.00 Total Fringe Benefits:| $ 13,308.00 Other Operating Costs Line Item Category Description Description Requested budget amount Professional/Outside (Outreach Campain Deliverables @$2i/day = 21x362 days= = $7,602 annually. Services $ 7,602.00. Total Operating / Infrastructure Costs:| $ 7,602.00 [ Total Amount Requested Before Indirect Applied: | $ 131,810.00 ] Indirect Costs Indirect Costs I | 10% of Indirect costs requested $ 13,181.00 Total Budget Requested:| $ 144,991.00 Page 2 of 2