PE SAFEWAY ALBERTSONS AMENDMENT 2.PDF

Maricopa County — Formal (2023-08-09)

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CONTRACT NO: 200234

AMENDMENT NO: 2

AMENDMENT TO
CONTRACT
Between
MARICOPA COUNTY
By and Through
DEPARTMENT OF PUBLIC HEALTH
and
ALBERTSONS COMPANIES, INC.

I.
The above-named contract is hereby amended as specified below:

A. Contract Expiration date shall be updated to August 18, 2025.

B. Compensation shall be updated as follows:

i. Contractor shall only be reimbursed for the Administration fee for vaccines
provided by MCDPH. MCDPH will not reimburse for vaccines purchased by the
Contractor.

ii. Contractor shall submit a detailed monthly invoice within 30 days following the
event. The invoice must have a Task Order Number associated with it. Failure to
submit invoices within 30 days of the completed event or without a Task Order
Number associated with it may result in reimbursements being denied.

C. Scope of Work, shall be updated as follows:

i. This Contract is for events outside the Contractor’s normal clinic operations
unless prior approval is received in writing by MCDPH. If Contractor would like to
host an event at their facility, Contractor must seek prior authorization from
MCDPH, and the event must be open to the general public in order to seek
reimbursement.

ii. The Contractor must provide an End-of-Event report within 7 days of the event.
The report can be found at https://phvts.maricopa.gov and is attached as shown
beginning on page 3 of this Amendment.

iii. The Contractor must complete a Task Order request form for any new events
they plan on seeking reimbursement for. If the Contractor plans to extend the
event date past the final date in the previously submitted Task Order form, a new
Task Order form must be submitted. The form can be found at MCDPH Event
Task Order Form and is attached as beginning on page 5 of this Amendment.

D. Term and Conditions shall be updated to include:

i. WRITTEN CERTIFICATION PURSUANT to A.R.S. § 35-393.01:

If Contractor engages in for-profit activity and has 10 or more employees, and if
this agreement has a value of $100,000 or more, Contractor certifies it is not
currently engaged in, and agrees for the duration of this agreement to not engage
in, a boycott of goods or services from Israel. This certification does not apply to
a boycott prohibited by 50 U.S.C. § 4842 or a regulation issued pursuant to 50
U.S.C. § 4842.

DocuSign Envelope ID: FD8EA199-B445-4BBA-AD5E-4CC74AB97C11
C-86-22-238-X-00

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ii. WRITTEN CERTIFICATION PURSUANT to A.R.S. § 35-394:

Contractor warrants and certifies that it does not currently, and agrees for the
duration of the Agreement, that it will not use:

1. the forced labor of ethnic Uyghurs in the People's Republic of China,
2. any goods or services produced by the forced labor of ethnic Uyghurs
in the People's Republic of China,
3. any contractors, subcontractors or suppliers that use the forced labor
or any goods or services produced by the forced labor of ethnic
Uyghurs in the People's Republic of China. If Contractor becomes
aware during the term of this Agreement that the Contractor is not in
compliance with this paragraph, Contractor shall notify the County
within
five
business
days
after
becoming
aware
of
the
noncompliance. If the Contractor fails to provide a written certification
to the County that the Contractor has remedied the noncompliance
within 180 days after notifying the County of its noncompliance, then
the agreement terminates, except that if the agreement termination
date occurs before the end of the 180-day period, the agreement
terminates on the agreement termination date.

II.
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
MARICOPA COUNTY

FOR AND ON BEHALF OF
ALBERTSONS COMPANIES, INC.

By:

Chairman, Board of Supervisors

Joe Lask, PharmD, Senior Director,
Managed Care

Date

Date
ATTEST

Clerk of the Board

Date

APPROVED AS TO FORM

Attorney for Maricopa County

Date

DocuSign Envelope ID: FD8EA199-B445-4BBA-AD5E-4CC74AB97C11
05-19-2023 | 13:28:38 PDT

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