EXHIBIT A - OFFER AND ACCEPTANCE.PDF

Exhibit A 
 
 
 
 
 
  
    Katie Hobbs                                                             State of Arizona                                                             Tonya Hamilton 
      Governor                                        Governor’s Office of Youth, Faith and Family                                           Director 
 
OFFER AND ACCEPTANCE FORM (SPO FORM 203) 
 
TO THE GOVERNOR’S OFFICE OF YOUTH, FAITH AND FAMILY: 
The Undersigned hereby agrees, if awarded a grant, to all terms, conditions, requirements, and amendments in this Request for Grant 
Application (“RFGA”) solicitation and any written exceptions, as accepted by the Governor’s Office of Youth, Faith and Family, in the 
Application. 
 
Arizona Transaction (Sales) Privilege Tax License No.: 
 
____________N/A___________________________ 
 
Federal Employer Identification No.: 
 
_____86-6000472  __________  __________ 
 
Name of Point of Contact Concerning this Application: 
 
Name: _____Jared Beard________________________ 
 
Phone: _____602-372-7564___  Fax: _______________ 
 
E-Mail:__Jared.Beard@Maricopa.gov________________ 
By signature in this Offer section, the Applicant certifies:
1. The submission of the Application did not involve collusion or other anti-competitive practices.
2. The Applicant  shall not discriminate against any employee or Applicant for employment in violation of Federal Executive Order 
11246, State Executive Order 2009-9 or A.R.S. §§ 41-1461 through 1465.
3. The Applicant has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, 
gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer.  Failure to 
provide a valid signature affirming the stipulations required by this clause shall result in rejection of the offer.  Signing the offer with 
a false statement shall void the offer, any resulting contract and may be subject to legal remedies provided by law.
 
CERTIFICATION
 
 
 
 
Maricopa County Human Services Department  
 
 
Name of Applicant Organization 
 
234 N Central Ave, 3rd Floor 
 
Signature of Person Authorized to Sign Offer 
 
Clint Hickman 
Address 
 
Phoenix                                             AZ                 85004
 
 
 
Printed Name 
 
Chairman Maricopa County Board of Supervisors 
City                                  State                  Zip 
 
Title 
ACCEPTANCE OF APPLICATION
The Application is hereby accepted. 
The Applicant is now bound to perform as stated in the attached grant Application, and based upon the RFGA Solicitation Documents, 
including all terms, conditions, requirements, amendments, etc., and the Applicant’s grant Application as accepted by the State. 
This grant shall henceforth be referred to as Grant No. ________________________________________________________.   
The effective date of the contract is _______________________________________________________________________. 
The Applicant has been cautioned not to commence any billable work or to provide any material or service under this contract until 
Applicant receives a purchase order, contract release document, or written notice to proceed. 
 
State of Arizona 
Awarded this
 
  
day of
 
 
 
20
 
 
 
 
Shane Richardson, Procurement Manager