Res 2607 Fourth Amendment to Maricopa County Human Services Department IGA for CAP Services 06 10 25

RESOLUTION NO. 2607 
 
A RESOLUTION OF THE MAYOR AND COUNCIL OF THE CITY OF TOLLESON, 
ARIZONA, 
APPROVING 
THE 
FOURTH 
AMENDMENT 
TO 
THE 
INTERGOVERNMENTAL AGREEMENT FOR FISCAL YEAR 2026, CONTRACT NO. C-
22-22-120-X-04, BETWEEN THE CITY OF TOLLESON AND MARICOPA COUNTY, 
ADMINISTERED BY ITS HUMAN SERVICES DEPARTMENT, FOR CASH 
REIMBURSEMENT TO THE CITY IN THE AMOUNT OF $165,000 COMMUNITY 
ACTION PROGRAM (CAP) SERVICES TO INCLUDE CRISIS CASE MANAGEMENT, 
COORDINATION OF SERVICES TO ASSIST LOW-INCOME HOUSEHOLDS IN CRISIS 
SITUATIONS, AND ASSISTANCE TO MOVE CLOSER TO ECONOMIC SELF-
SUFFICIENCY IN TOLLESON. 
 
WHEREAS, the City of Tolleson (the “City”) entered into an Intergovernmental Agreement 
(“Agreement”) with the Maricopa County Human Services Department (“MCHSD”) for the City to 
provide Community Action Program (“CAP”) services, including assisting low-income households 
in crisis situations and supporting efforts to achieve economic self-sufficiency, with funding 
provided by MCHSD; and 
 
WHEREAS, the City and MCHSD desire to enter into this Fourth Amendment to extend 
the term of the Agreement from July 1, 2025, through June 30, 2026, and revise certain 
provisions, including providing additional reimbursement in the amount of $165,000 for Fiscal 
Year 2026; and 
 
WHEREAS, CAP services under this Agreement include crisis case management, 
navigation, referrals, and delivery of financial assistance to stabilize households experiencing 
emergencies such as eviction, utility shutoff, food insecurity, or unemployment. 
 
NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND COUNCIL OF THE CITY OF 
TOLLESON, ARIZONA, as follows:  
 
Section 1. The recitals above are hereby incorporated as if fully set forth herein. 
 
Section 2. The Agreement between the City and MCHSD pertaining to CAP services is 
hereby approved in substantially the form attached hereto as Exhibit A and incorporated herein 
by reference. 
 
Section 3. The Mayor, City Manager, City Clerk and City Attorney are hereby authorized 
and directed to take all steps necessary to cause the execution and delivery of this Agreement 
and to take all steps necessary to carry out the purpose and intent of this Resolution. 
 
 
[SIGNATURES ON FOLLOWING PAGE]

CITY OF TOLLESON RESOLUTION NO. 2607 
JUNE 10, 2025 
PAGE 2 
 
 
 
 
 
PASSED AND ADOPTED by the Mayor and Council of the City of Tolleson, Arizona, on this 
10th day of June, 2025. 
 
____________________________________ 
Juan F. Rodriguez, Mayor 
 
 
                                                   ATTEST: ____________________________________ 
 
Crystal Zamora, City Clerk 
 
 
       APPROVED AS TO FORM: ____________________________________ 
 
Justin Pierce, City Attorney

CITY OF TOLLESON RESOLUTION NO. 2607 
JUNE 10, 2025 
PAGE 3 
 
 
 
 
 
EXHIBIT A 
TO 
RESOLUTION NO. 2607 
 
[Fourth Amendment to Intergovernmental Agreement] 
 
See following pages.

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 1 of 16 
AMENDMENT NO. 4 TO THE 
INTERGOVERNMENTAL AGREEMENT 
BETWEEN 
MARICOPA COUNTY 
ADMINISTERED BY ITS 
HUMAN SERVICES DEPARTMENT 
AND 
CITY OF TOLLESON 
 
I. 
Maricopa County (“County”), administered by its Human Services Department, and the 
City of Tolleson, (“Contractor”) entered into a financial Intergovernmental Agreement 
(“Agreement”), on or about June 22, 2022. The purpose of the Agreement is for the 
Contractor to provide Community Action Program (CAP) services to include crisis case 
management, coordination of services to assist low-income households in crisis situations, 
and assistance to move closer to economic self-sufficiency in Tolleson. The County and 
the Contractor collectively are referred to as the “Parties.”  
 
The Parties entered into Amendment No. 1 on or about June 28, 2023. The Amendment 
extended the Agreement through June 30, 2024. Section 3 (Work Statement) was 
replaced in its entirety. The Operating Budget in Section 4 (Budget and Compensation), 
Paragraph 1.5 (Operating Budget) was replaced in its entirety with a not to exceed amount 
of $165,000 for Fiscal Year 2024. 
 
The Parties entered into Amendment No. 2 on or about March 5, 2024. The Amendment 
added the Uyghur Forced Labor Prevention Act. Section 4 (Budget and Compensation), 
Paragraph 1.0 (Budget), Subparagraph 1.2.4 was revised by adding Assistance Listing 
Number (ALN) 21.027 American Rescue Plan Act (ARPA) as a source of funding. The 
ARPA ALN was an existing source of funding and the overall Agreement budget was not 
impacted. 
 
The Parties entered into Amendment No. 3 on or about June 26, 2024. The Amendment 
extended the Agreement through June 30, 2025, and updated County point of contact. 
Revised Section 1 (General Provisions), Paragraph 57.0 (UFLPA), Subparagraph 57.1 to 
correct the reference from Subrecipient to Contractor. Revised and replaced Section 3 
(Work Statement). Revised and replaced Section 4 (Budget and Compensation), 
Paragraph 1.5 (Operating Budget) with new Operating Budget. The County provided the 
Contractor with $165,000 for Fiscal Year 2025. The period of funding availability is July 1, 
2024, through June 30, 2025. 
 
II. 
The Parties agree to enter into this Amendment No. 4 to amend the Agreement as follows: 
 
A. 
Extend the Agreement term from July 1, 2025, through June 30, 2026. 
 
B. 
Retroactive to July 1, 2024, Fiscal Year 2025, as amended, in accordance with 2 
C.F.R. 200.331(a), the City of Tolleson shall be identified as “Subrecipient” for the 
purpose of carrying out the activities identified in the Work Statement in Section 3.

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 2 of 16 
C. 
Revise the Agreement funding by an amount not to exceed $165,000 for Fiscal 
Year 2026. The funding period of availability will be July 1, 2025, through June 30, 
2026. The funding sources for this Amendment may include but are not limited to 
the following: 
 
93.569 Community Services Block Grant (CSBG) 
93.568 Low Income Home Energy Assistance Program (LIHEAP) 
21.027 Coronavirus State and Local fiscal Recovery Funds (SLFRF) 
 
D. 
Revise the Maricopa County Representative name and contact information and 
replace it with the following: 
 
Maricopa County Representative 
Human Services Department 
Community Resilience Division 
Siman Qassim, Assistant Director 
234 N. Central Avenue, 3rd Floor 
Phoenix, AZ 85004 
602-506-4841 
Siman.Qaasim@maricopa.gov 
 
E. 
Revise Section 1 (General Provisions) to address the following: 
 
1. 
Revise and replace Paragraph 6.0 (Administrative Change Order) in 
its entirety with the following: 
 
6.0 
ADMINISTRATIVE CHANGE ORDERS 
6.1 
The Chairman of the Board of Supervisors is authorized, 
upon the recommendation of the Human Services 
Department Director and Legal Counsel, to review and 
execute administrative changes to the Agreement on behalf 
of the County through Administrative Change Orders. 
Administrative Change Orders will be effective upon 
execution by both the Parties. Administrative Change 
Orders shall address any of the following changes: 
6.1.1 Modifications to the project timeline if the last day of 
the project timeline is within the Agreement term; 
6.1.2 Modifications to Budget line items if the Agreement 
Amount remains unchanged; 
6.1.3 Modifications required by federal, state, or County 
regulations, ordinances, or policies; and/or 
6.1.4 Modifications to Administrative requirements such 
as changes in reporting periods, frequency of 
reports, or report formats required by the federal, 
state or local regulations, policies, or requirements. 
 
2. 
Add paragraph 58.0 Acronyms and Definitions to the Agreement: 
 
58.0 
ACRONYMS AND DEFINITIONS 
Acronyms and Definitions found under 2 C.F.R. §§ 200.0 & 200.1 are 
hereby incorporated by reference.

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 3 of 16 
F. 
Revise Section 2 (Special Provisions) Paragraph 4.0 (System for Award 
Management) to add the following subparagraph: 
 
4.4 
The Subrecipient shall have a valid Unique Entity Identifier (UEI) number 
and an active profile in the federal System for Award Management, or 
SAM.gov. Documentation of the UEI Number must be included in all project 
files. The Subrecipient must remain current with their registration 
throughout the term of the Agreement. Subrecipients and subcontractors 
will not receive a subaward until that entity has provided its UEI number. 2 
C.F.R. § 25.300; Appendix A to 2 C.F.R. § 25. 
 
G. 
Revise Section 3 (Work Statement), by removing in its entirety and replacing it with 
the following: 
 
1.0 
PROGRAM GOALS 
Maricopa County is a designated Community Action Agency, authorized 
under the federal Community Services Block Grant (CSBG) Act to address 
the causes and conditions of poverty in local areas. The Maricopa County 
Human 
Services 
Department/Community 
Resilience 
Division 
(MCHSD/CRD) administers the Community Action Program activities, the 
primary purpose of the CRD is to provide a range of programs or services 
that are intended to: 
• 
pursue the reduction of poverty, 
• 
the revitalization of low-income communities; and 
• 
the empowerment of low-income families and individuals to 
become fully self-supportive. 
Through partnerships with local municipalities or private, non-profit 
organizations, community action programs and services are provided to 
residents in the local area. 
 
2.0 
SCOPE OF WORK 
Community Action Program Services shall include the delivery of crisis 
services, internal/ external program navigation, and program referrals 
intended to assist in the stabilization of immediate/ emergent needs for 
families that are facing eviction, disruption in utilities, experiencing 
insufficient food and/or nutrition, and/or are unemployed/ underemployed.  
Services shall be delivered in a wrap around, comprehensive manner to 
address the needs of the household and to move families closer to 
economic stability. 
 
2.1 
MCHSD Crisis Financial Assistance Services  
Eligibility for financial assistance is determined and benefit 
payments made on behalf of program participants, these include 
but are not limited to, temporary emergency shelter, emergency 
rent, move-in assistance, utility payments or deposits, and 
emergency utility payments. 
2.1.1 MCHSD Crisis Financial Assistance Services shall be 
coordinated with other local or grant financial assistance 
services to maximize benefits to the household.  
2.1.2 Eligibility criteria for financial assistance funds is defined in 
the MCHSD/CRD Policy and Procedure Program Manual.

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 4 of 16 
2.1.3 Financial assistance funds are managed and allocated by 
MCHSD. Funds will be made available to the Subrecipient 
through HSD Dynamics. 
2.1.4 MCHSD/CRD will make payment directly to vendors upon 
authorization by County. 
2.1.5 Available Financial Assistance Services shall include the 
following: 
2.1.5.1 Utility Assistance 
2.1.5.1.1 Utility payments and deposits for heating 
and cooling; 
2.1.5.1.2 Rental assistance where utility payment 
is included in rent. 
2.1.5.2 Rental Assistance  
2.1.5.2.1 Rental assistance to prevent eviction; 
and 
2.1.5.2.2 Move in assistance to include rental 
deposits and first month rent. 
 
2.1.6 MCHSD Crisis Financial Assistance Service Requirements  
2.1.6.1 Subrecipient shall conduct application intake for 
MCHSD Crisis Financial Assistance Services to 
clients that apply in person with a paper application 
or needing assistance applying online. 
2.1.6.2 On-site application process shall include the 
following: 
2.1.6.2.1 Provide paper applications, or assist 
clients 
with 
completing 
the 
online 
application process; 
2.1.6.2.2 Collect client eligibility documents for 
identified services, as required in the 
MCHSD/CRD Policy and Procedure 
Program Manual;  
2.1.6.2.3 Information from the paper application 
shall be entered into HSD Dynamics 
within 24 hours of receipt;  
2.1.6.2.4 Upload a copy of the paper application in 
HSD Dynamics; 
2.1.6.2.5 Create an application in HSD Dynamics, 
as well as the program application (s) the 
client is eligible for; 
2.1.6.2.6 Upload eligibility documents in HSD 
Dynamics; 
2.1.6.2.7 Research each household member to 
determine if they have received previous 
assistance; and  
2.1.6.2.8 Research and enter vendor/provider 
information in Dynamics.  
2.1.6.3 The Subrecipient will also process applications 
submitted through the HSD Dynamics portal per 
MCHSD/ CRD Policy and Procedure Manual, 
following the process outlined below:

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 5 of 16 
2.1.6.3.1 Subrecipient will assign and disposition  
program applications to Client Services 
Specialist; 
2.1.6.3.2 Upload eligibility documents in HSD 
Dynamics; and 
2.1.6.3.3 Research provider profile and submit 
vendor information related to the County 
vendor 
registration 
process, 
within 
twenty-four (24 hours), if applicable; 
2.1.6.3.4 Document all services provided and 
supported by County funds in HSD 
Dynamics, in addition to local/ grant 
financial assistance services; 
2.1.6.3.5 Manage and monitor application queue in 
HSD Dynamics based on application 
submission date;  
2.1.6.3.6 Document client’s program involvement 
and progress in the required case 
note/timeline section of HSD Dynamics; 
2.1.6.3.7 Conduct quality assurance review and 
ensure controls on all submitted service 
authorizations; 
2.1.6.3.8 Resolve rejected service authorizations 
and data entry errors within two (2) 
business days from the rejection date. 
 
2.2 
Navigation Services 
Navigation services are offered to clients following the completion 
of the HSD Dynamics application. This is a staff assisted function 
that includes the collection of eligibility documents and completion/ 
submission of program application for both Subrecipient’s internal 
program (non-County funded) along with external program 
services.  
2.2.1 Navigation to Low-Income Energy Assistance Program 
(LIHEAP) Services:  
2.2.1.1 Subrecipient shall provide application assistance 
which may include the following:  
2.2.1.1.1 Answering questions about program 
eligibility and the application process.  
2.2.1.1.2 Entering application data directly into the 
DES portal on behalf of the Client.   
2.2.1.1.3 Scanning 
and 
uploading 
required 
documents, if needed.   
2.2.1.1.4 Provide paper applications to clients, 
upon request, and enter information 
directly into the DES portal on Client’s 
behalf.  
2.2.1.1.5 Provide assistance in completing the 
ID.me identity verification process to 
include scanning required documents

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 6 of 16 
and uploading to the ID.me website 
(www.ID.me.com). 
2.2.1.1.6 Screen for crisis circumstances to ensure 
priority will be given to Life Threatening 
Crisis Assistance Applicants.  
2.2.1.1.7 Conduct initial screening and reporting of 
potential Welfare Fraud. 
 
2.2.1.2 Navigation to Internal Program Services 
2.2.1.2.1 Subrecipient shall identify a minimum of 
two (2) internal program based on the 
most recent MCHSD Community Needs 
Assessment. Subrecipient will submit a 
logic model (Exhibit 1) by July 31st ,of the 
current program year, to be approved by 
MCHSD. The logic model shall provide 
the 
following 
information 
for 
each 
program service: 
2.2.1.2.1.1 Community need; 
2.2.1.2.1.2 Anticipated 
program 
outcome(s); 
2.2.1.2.1.3 Description 
of 
program 
service; 
2.2.1.2.1.4 Projected 
number 
of 
individuals/ households to be 
served; and 
2.2.1.2.1.5 Projected 
number 
of 
individuals/ households who 
will 
achieve 
anticipated 
program outcome(s). 
2.2.1.2.1.6 Data collection methodology  
2.2.1.2.2 Subrecipient shall conduct follow up 
contact with clients to assess for 
additional needs and to track program 
outcomes as it relates to the outcomes 
identified in the Subrecipient’s logic 
model. 
2.2.1.2.2.1 Follow up contact shall be 
conducted at intervals of 3 
months, 6 months, and 9 
months following the receipt 
of program services. 
 
2.2.1.3 Navigation Service Requirements 
2.2.1.3.1 Clients 
shall 
have 
a 
completed 
application in HSD Dynamics prior to 
receiving navigation services to DES 
portal for LIHEAP services or internal 
program services.

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 7 of 16 
2.2.1.3.2 Subrecipient shall ensure that all income 
eligible clients will be navigated to the 
Arizona Department Economic Security 
(DES) portal for LIHEAP services. 
2.2.1.4 Subrecipient shall provide navigation 
services as it relates to internal program 
services to clients that have been 
dispositioned in the HSD Dynamic 
queue. 
2.2.1.5 Navigation services shall be provided 
and documented, in accordance with the 
MCHSD/CRD Policy and Procedure 
Manual. 
2.2.1.6 Navigation services shall be reported in 
MCHSD/CRD quarterly ROMA reports. 
2.2.1.7 Subrecipient shall use the MCHSD 
approved logic model template for 
internal program navigation. 
 
2.3 
Information and Referrals  
2.3.1 Subrecipient shall provide information and referrals to 
include but not limited to the following:  
2.3.1.1 Community Legal Services (CLS) for households 
who are facing immediate eviction for non-payment 
of rent or who receive assistance and have a 
judgement that is not satisfied. 
2.3.1.2 DES Child support enforcement services for clients 
who are custodial parents in single parent 
households. 
2.3.1.3 Assistance completing applications for SNAP, 
AHCCCS, and Unemployment Insurance. 
2.3.1.4 Food and nutrition services to counteract the 
impacts of starvation or malnutrition. 
 
2.3.2 Information and Referrals Service Requirements 
2.3.2.1 Clients shall have a completed program application 
in HSD Dynamics prior to the delivery of information 
and referral services.   
2.3.2.2 Subrecipient shall document all referrals in HSD 
Dynamics and follow referral procedures in 
accordance with the MCHSD/CRD Policy and 
Procedure Manual. 
2.3.2.3 Information regarding program referrals shall be 
reported in the MCHSD/CRD quarterly ROMA 
reports. 
 
2.4 
Facility Requirements 
2.4.1 Subrecipient shall ensure staff on-site are able to navigate 
to websites and provide generalized assistance to clients. 
Staff shall provide access to through self-maintaining or 
partnership agreements, a computer lab to include multiple

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 8 of 16 
computers with internet access, fax machines, copier, 
phones, and basic office supplies to allow individuals 
access to the following: 
2.4.1.1 AZDES LIHEAP Application Portal; 
2.4.1.2 HSD Client Portal; 
2.4.1.3 Online applications for AZDES Unemployment 
Insurance, 
Supplemental 
Nutrition 
Assistance 
Program (SNAP), and AHCCCS Health Insurance; 
2.4.1.4 Online job search and submission of application/ 
resume; and/or 
2.4.1.5 Information regarding scholarships and federal 
financial aid. 
2.4.2 Subrecipient shall ensure adequate space for the following: 
2.4.2.1 On-site workshops and training classes; 
2.4.2.2 Local job/career fairs; and 
2.4.2.3 Eligibility 
determination 
where 
confidential 
information cannot be overheard. 
 
2.5 
Reporting Requirements 
2.5.1 Subrecipient shall submit programmatic and financial 
reports to MCHSD as listed below: 
2.5.1.1 Results Oriented Management and Accountability 
(ROMA/ROMA Next Gen) data and/or reports no 
later than the 10th business day after the end of each 
quarter of the fiscal year. 
2.5.1.2 Monthly 
invoices/claims 
with 
supporting 
documentation no later than the 10th business day, 
following the end of the month. 
2.5.1.3 The County reserves the right to add, remove, or 
revise reporting requirements to meet program 
goals. 
2.5.1.4 Failure to submit required reports in the designated 
timeframe listed may result: 
2.5.1.4.1 in a forfeiture of payment, if not submitted 
by the forty-fifth (45th) calendar days 
following the end of a month. 
2.5.1.4.2 in a forfeiture of final payment, if final 
program and fiscal reports is not 
submitted within the designated time 
period, determined by MCHSD following 
the Contract term. 
 
2.6 
HSD Dynamics Access 
2.6.1 Access to HSD Dynamics will be provided by MCHSD/CRD 
upon request from Subrecipient.  
2.6.2 Subrecipient shall provide MCHSD/CRD information 
regarding staffs’ name, position title, contact information, 
and confirmation of successful completion of all required 
background checks, to include Fingerprint and Central 
Registry Submission/Clearances.

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 9 of 16 
2.6.3 MCHSD reserves the right to immediately remove access if 
it is determined Subrecipient’s personnel is a risk to the 
County operations for any of the following reasons but not 
limited to: 
2.6.3.1 Approving clients for services they are not eligible for; 
2.6.3.2 Denying eligible clients services; and 
Accessing the HSD Dynamics for any purpose other 
than areas of responsibility. 
2.6.4 MCHSD will provide Subrecipient programmatic ad hoc 
reports, as requested. 
 
2.7 
Staff Requirements 
2.7.1 Subrecipient shall: 
2.7.1.1 Ensure staff and/or volunteers do not provide direct 
services to clients until all appropriate Background 
Checks, Fingerprint and Central Registry clearances 
have been completed with satisfactory results and 
procedures are in place if results are unsatisfactory; 
2.7.1.2 Maintain documentation that key staff have received 
appropriate 
training 
or 
hold 
appropriate 
certification/licensure in accordance with roles, 
responsibilities and job descriptions; 
2.7.1.3 Ensure that staff and volunteers do not have any 
conflicts of interest in the provision of services and 
management of programs; 
2.7.1.4 Provide staff and volunteers with supervision, 
equipment, materials and supplies necessary to 
perform contracted services; 
2.7.1.5 Provide training to all new employees and 
volunteers providing services under this Agreement, 
to include but not limited to the following: 
2.7.1.5.1 An overview of the MCHSD/CRD Policy 
and Procedure Manual; and 
2.7.1.5.2 Requirements of ARS §46-140.01 and 
ARS §1-501 and ARS § 1-502 regarding 
eligibility for state and local benefits. 
2.7.1.6 Maintain 
documentation 
that 
verifies 
case 
management staff have received relevant training 
and provide documentation upon request to 
MCHSD; 
2.7.1.7 The Subrecipient shall be required to notify MCHSD 
of staff changes and vacant positions within two (2) 
business days of staff changes. The Subrecipient 
shall open the recruitment to fill case worker 
vacancies, no later than thirty (30) days after the 
vacancy occurs, to ensure service availability and 
clients are not turned away due to lack of staff.  
 
2.7.2 Code of Conduct: 
2.7.2.1 The Subrecipient shall avoid any action that might 
create or result in the appearance of:

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 10 of 16 
2.7.2.1.1 Inappropriate 
use 
or 
divulging 
of 
information 
gathered 
or 
discovered 
pursuant to the performance of its duties 
under the Contract. 
2.7.2.1.2 Actions on behalf of the County without 
appropriate authorization. 
2.7.2.1.3 Providing 
favorable 
or 
unfavorable 
treatment to anyone. 
2.7.2.1.4 Making a decision on behalf of the 
County that exceeds their authority, 
displaying 
preferential 
treatment 
or 
actions that would have unfavorable 
consequences for the County. 
2.7.2.1.5 Misrepresenting or otherwise imped the 
efficiency, authority, actions, policies, or 
adversely affect the confidence of the 
public or integrity of the County. 
2.7.2.1.6 Loss of impartiality when advising the 
County. 
 
2.8 
Community Action Program Meetings 
2.8.1 MCHSD will facilitate quarterly meetings with CAP 
Subrecipients to communicate new developments, discuss 
problems, address barriers to services, share ideas for 
improvements, and to address other identified topic areas. 
2.8.2 Subrecipient shall ensure that a designated staff member 
participates in CAP meetings, as scheduled. 
 
2.9 
Cooperation in Strategic Planning and Community Needs 
Assessment: 
2.9.1 Subrecipient shall participate in strategic planning initiatives 
which lead to the development of the five (5) year strategic 
plan and the annual Community Action Plan and provide 
information regarding the causes/condition of poverty within 
the designated geographic service area. 
 
2.10 
Training and Technical Assistance 
2.10.1 To ensure successful program service delivery, MCHSD will 
provide/conduct training and technical assistance, if 
applicable, on the following: 
2.10.1.1 
MCHSD/CRD Policy and Procedure Program 
Manual; 
2.10.1.2 
MCHSD funded financial assistance services; 
2.10.1.3 
Use of HSD Dynamics; 
2.10.1.4 
Reports and forms, as required; 
2.10.1.5 
Results 
Oriented 
Management 
and 
Accountability (ROMA)/ROMA Next Gen; 
2.10.1.6 
Review of all applicable federal, state, and 
county regulations, laws, and rules related to 
specific funding sources used; 
2.10.1.7 
Review of program monitoring findings; and

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 11 of 16 
2.10.1.8 
Other training and technical assistance as 
needed/required. 
 
2.11 
Limited English Proficiency 
2.11.1 The Subrecipient shall ensure that all services provided are 
culturally relevant and linguistically appropriate to the 
population to be served. 
2.11.2 Applicable Program Rules and Regulations: 
2.11.2.1 
Subrecipient shall comply with all applicable 
federal, state, and county regulations, laws, and 
rules as amended, including but not limited to the 
following: 
2.11.2.2 
COATS Human Services Reauthorization Act of 
1998; 
2.11.2.3 
2 
CFR 
200 
Uniform 
Administrative 
Requirements; 
2.11.2.4 
Personal Responsibilities and Work Opportunity 
Reconciliation Act of 1996; 
2.11.2.5 
Stewart B. McKinney Homeless Assistance Act; 
2.11.2.6 
ARS §46-241-State Short Term Crisis Services; 
2.11.2.7 
ARS §46-731–Utility Assistance; 
2.11.2.8 
ARS §46-741–Neighbors Helping Neighbors; 
2.11.2.9 
ARS §46-140.01-Verification of identity and 
citizenship and/or immigration status; and 
2.11.2.10 ARS§§1-501-1-502, regarding eligibility for 
federal, state, or local public benefits. 
2.11.2.11 The requirements related to reporting to a peace 
officer or child protective services incidents of 
crimes against children as specified in A.R.S. 
§13-3620 as may be amended. 
2.11.2.12 P.L. 101-121, Section 319 (31 U.S.C. section 
1352) as may be amended, and 29 C.F.R. Part 
93 as may be amended which prohibit the use of 
federal funds for lobbying and which state, in 
part: Except with the express authorization of 
Congress, the Subrecipient, its employees or 
agents, shall not utilize any federal funds under 
the terms of this contract to solicit or influence, 
or to attempt to solicit or influence, directly or 
indirectly, any member of Congress regarding 
pending or prospective legislation. Indian tribes, 
tribal organizations and any other Indian 
organizations are exempt from these lobbying 
restrictions with respect to expenditures that are 
specifically permitted by other federal law. 
2.11.2.13 A.R.S. § 23-722.01 as may be amended relating 
to new hire reporting, 
2.11.2.14 A.R.S. § 23-722.02 as may be amended relating 
to wage assignment orders to provide child 
support, and A.R.S. § 25-535 as may be

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 12 of 16 
amended relating to administrative or court-
ordered health insurance coverage for children. 
2.11.3 Administrative Simplification rules in Title II of the Health 
Insurance Portability and Accountability Act of 1996 (Public 
Law 104-191) and all Federal regulations that are applicable 
to the operations of the Subrecipient by the dates required 
by the implementing Federal regulations as well as all 
subsequent requirements and regulations as published. 
 
2.12 
Grievance Procedures 
2.12.1 Subrecipient shall establish a process to review and 
address client grievances. Subrecipient shall submit 
grievance process to MCHSD/CRD, as requested.  
2.12.2 Subrecipient shall advise all applicants   of their right to 
present to the Subrecipient  any grievances arising from 
the delivery of contract services, including, but not limited 
to, ineligibility determination, reduction of services, 
suspension or termination of services, or quality of services. 
2.12.3 Subrecipient shall address grievances for individuals 
seeking/receiving County funded assistance who feel that 
they have not been treated fairly..  
2.12.4 Subrecipient shall act as first reviewer of grievances for their 
respective site following their prescribed written process . All 
grievances are documented in HSD Dynamics. MCHSD 
acts as second review for all escalated CAP grievances. 
Follow 
grievance 
procedures 
as 
outlined 
in 
the 
MCHSD/CRD Policy and Procedure Program Manual.  
 
2.13 
Community Action Tripartite Board Recruitment  
2.13.1 Subrecipient shall recruit local community members to 
serve in the role of the Public Official or Consumer 
Representative sectors for the MCHSD Community Action 
Commission, as requested by MCHSD.  Subrecipients shall 
perform the following outreach activities: 
2.13.1.1 
Post flyers at location(s) and community 
events; 
2.13.1.2 
Share information and distribute flyers to 
clients; 
2.13.1.3 
Direct community members to the following 
MCHSD 
website 
page 
to 
obtain 
additional 
information 
and 
Commission 
application: 
CACCommission@maricopa.gov; 
2.13.1.4 
Assist clients or with the Democratic 
Selection Process; 
2.13.1.5 
Coordinate outreach efforts to city council 
members.  
 
2.14 
Pandemic Award Performance 
2.14.1 The Subrecipient shall establish a written plan that 
illustrates how the services and contract performance

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 13 of 16 
standards will be met in the event of a pandemic 
occurrence. 
2.14.2 The pandemic performance plan shall include: 
2.14.2.1 
Key succession and performance planning if a 
sudden significant decrease in Subrecipient’s 
workforce should occur. 
2.14.2.2 
Alternative methods to ensure services are 
available. 
2.14.2.3 
An up-to-date list of Subrecipient contacts and 
organizational chart. 
2.14.2.4 
In the event of a pandemic, as declared by the 
Governor of Arizona, U.S. Government, or the 
World 
Health 
Organization, 
which makes 
performance of any term under this Award 
impossible or impracticable, the MCHSD shall 
have the following rights: 
2.14.2.5 
After the official declaration of a pandemic, 
MCHSD may temporarily void the Award in 
whole or specific sections if the Awardee cannot 
perform to the standards agreed upon in the 
initial terms. 
2.14.2.6 
MCHSD shall not incur any liability if a pandemic 
is declared, and emergency procurements are 
authorized by the Director of the Arizona 
Department of Administration per A.R.S. § 41-
2537 as may be amended by the Arizona 
Procurement Code. 
2.14.2.7 
Once the pandemic is officially declared over 
and/or the Subrecipient can demonstrate the 
ability to perform, MCHSD, at its sole discretion 
may reinstate the temporarily voided Award. 
 
H. 
Incorporate Federal Award Identification Number (FAIN), and Award Date into the 
Agreement by adding the following to Section 4 (Budget and Compensation), 
Paragraph 1.2 (Funding), Subparagraph 1.2.4. 
 
FAIN / AWARD DATE: 21.027: SLFRP0146 awarded 5/18/2021 
 
I. 
Revise Section 4 (Budget and Compensation), Paragraph 1.5 (Operating Budget) 
and replace the Operating Budget. The County shall provide the Subrecipient with 
a not to exceed amount of $165,000 for the period of July 1, 2025), through June 
30, 2026 (Fiscal Year 2026). Unexpended funds from Fiscal Year 2025 shall not 
be available for expenditures in Fiscal Year 2026. 
 
J. 
In accordance with 2 CFR 200.332(b)(1)(xii), the County shall provide the 
Subrecipient with the FY2026 final expenditure dollar amounts made available 
under each federal award program (according to Assistance Listing Number (ALN) 
within 60 days after June 30, 2026 (https://www.ecfr.gov/current/title-2/part-
200/subpart-D#p-200.332(b)(1)(xii)).

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 14 of 16 
III. 
Section II above contains all the changes to the Agreement made by this Amendment 
No. 4. The Agreement is amended to incorporate the changes contained in this 
Amendment No. 4. All other terms and conditions of the Agreement remain in full force 
and effect as executed by the Parties. This Amendment No. 4 is subject to and 
incorporates the provisions of A.R.S. §38-511. 
 
IV. 
The Parties have authorized the undersigned to execute this Amendment No. 4, and it 
shall be effective upon approval and signature by both Parties. 
 
 
[Signatures contained on following page]

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 15 of 16 
IN WITNESS, the Parties have approved and signed this Amendment No. 4: 
 
APPROVED BY: 
CITY OF TOLLESON 
 
APPROVED BY:  
MARICOPA COUNTY 
 
 
 
___________________________________ 
Juan F. Rodriguez, Mayor                    Date     
 
 
 
 
____________________________________ 
Thomas Galvin, Chairman                       Date 
Board of Supervisors              
Attested To: 
 
 
 
___________________________________ 
Crystal Zamora,                                    Date 
City Clerk                                             
 
Attested To: 
 
 
 
____________________________________ 
Juanita Garza,                                         Date 
Clerk of the Board 
IN ACCORDANCE WITH A.R.S. §§ 9-240, 9-
500.11, 11-952, AND 46-241, ET SEQ., THIS 
AMENDMENT NO. 4 HAS BEEN REVIEWED 
BY THE UNDERSIGNED ATTORNEY WHO 
HAS DETERMINED IT IS PROPER IN FORM 
AND 
WITHIN 
THE 
POWERS 
AND 
AUTHORITY GRANTED TO THE CITY OF 
TOLLESON UNDER THE LAWS OF THE 
STATE OF ARIZONA. 
 
APPROVED AS TO FORM: 
 
 
BY: ________________________________ 
Attorney for the City                       Date 
 
IN ACCORDANCE WITH A.R.S. §§ 11-201, 
11-251, AND 11-952, THIS AMENDMENT 
NO. 4 HAS BEEN REVIEWED BY THE 
UNDERSIGNED ATTORNEY WHO HAS 
DETERMINED IT IS PROPER IN FORM AND 
WITHIN THE POWERS AND AUTHORITY 
GRANTED TO MARICOPA COUNTY UNDER 
THE LAWS OF THE STATE OF ARIZONA. 
 
APPROVED AS TO FORM: 
 
 
BY: _________________________________ 
Deputy County Attorney                    Date

Contract No. C-22-22-120-X-04 
 
Amendment No. 4 
City of Tolleson 
 
Page 16 of 16 
 
Fiscal Year 2026 Operating Budget* 
 
 
*Budget modifications among line-item expenditure categories totaling less than 25 percent of the 
total budget amount can be authorized through prior written approval by the program manager. 
 
Contract Period
July 1st, 2025, through June 30th, 2026
Funding
County Funds
$165,000
Cash Match Contributions
$256,911
$421,911
Budget Category
Direct Cost
Administration Cost
Total Cost
Total Expenses
$400,223
$21,688
$421,911
City of Tolleson Operating Budget – CAP Services