CTR055260 AMENDMENT 5 DRAFT COUNTY SIGNATURE_CORRECTED.PDF

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
AMENDMENT  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
CONTRACT NO.:  CTR055260 
IGA AMENDMENT NO:  5 
PROCUREMENT OFFICER 
Ryan Garcia 
 
Page 1 of 2 
 
Title V Maternal and Child Health Healthy Arizona Families 
 
It is mutually agreed that the Intergovernmental Agreement (IGA) referenced in this Amendment Five (5) is amended as 
follows: 
 
1. Pursuant to the Terms and Conditions, Provision Six (6), Contract Changes, Section 6.1, Amendments, Purchase 
Orders and Change Orders, the Agreement is amended as follows: 
 
1.1.  The Price Sheet is revised and replaced. 
 
 
ALL CHANGES ARE IDENTIFIED BELOW IN RED  
 
ALL OTHER PROVISIONS OF THIS AGREEMENT REMAIN UNCHANGED 
 
 
Maricopa County 
 
 
Contractor Name:  
 
Authorized Signature 
4041 N. Central Ave 
 
 
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                                  2024. 
 
 
Print Name 
 
Procurement Officer 
 
 
Contract No.: CTR055260, 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

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
AMENDMENT  
 
ARIZONA DEPARTMENT OF 
HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
CONTRACT NO.:  CTR055260 
IGA AMENDMENT NO:  5 
PROCUREMENT OFFICER 
Ryan Garcia 
 
Page 2 of 2 
 
                                                                                   PRICE SHEET 
 
Program: MCH Healthy Arizona Families 
Federal Funding: Title V Maternal and Child Health Services Block Grant 
 
ACCOUNT CLASSIFICATION 
AMOUNT 
Personnel 
$211,408.00 
ERE 
$83,712.00  
Professional & Outside Services 
$64,456.00  
Travel  
$708.00 
Occupancy 
$3,450.00 
Other Operating 
$11,503.00 
Capital Outlay  
$0.00 
Indirect (if authorized) 
$58,724.00 
TOTAL (annual amount not to exceed) 
$433,961.00  
 
Program: Public Health Improvement (PHI) Program 
Federal Funding: Preventive Health and Health Services Block Grant 
 
ACCOUNT CLASSIFICATION 
AMOUNT 
Personnel 
$186,204.00 
ERE 
$71,867.00 
Professional & Outside Services 
$10,703.00 
Travel  
$13,969.00 
Occupancy 
$5,175.00  
Other Operating 
$12,336.00 
Capital Outlay  
$0.00 
Indirect (if authorized) 
$30,026.00 
TOTAL (annual amount not to exceed) 
$330,280.00  
 
The County is authorized to transfer up to a maximum of twenty-five percent (25%) of the total 
budget amount between line items. Transfers exceeding twenty-five percent (25%) or to a non-
funded line item shall require an amendment.