CTR056454 - A2.PDF

Maricopa County — Formal (2023-08-09)

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INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT 
OF HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
 
Contract No.: 
CTR056454 
IGA Amendment Two (2) 
Arizona Procurement Portal Amendment Two (2) 
Procurement Officer 
Michelle Fink 
 
1 
 
 STD Program Congenital Syphilis Intervention Project 
 
Effective upon signature by both parties, it is mutually agreed that the Intergovernmental Agreement referenced in this 
Amendment Two (2) is hereby amended as follows: 
 
1. Pursuant to the Terms and Conditions, Provision Four (4), Contract Administration and Operation, 4.2. Contract 
Renewal, the Contract is extended through August 1, 2024, the third (3rd) year of the Contract. 
 
2. Pursuant to Terms and Conditions, Provision Six (6), Contract Changes, 6.1. Amendments, Purchase Orders and 
Change Orders, the Exhibit A - CFR 200.332 Form is revised and replaced. 
 
ALL CHANGES ARE REFLECTED IN RED. 
 
 
All other provisions of this agreement remain unchanged. 
 
 
 
Contractor Name: Maricopa County Department of Public Health 
 
Authorized Signature 
 
4041 North Central Avenue, Suite #1400 
 
 
Address:  
 
Print Name 
Phoenix 
AZ 
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                                  2023. 
 
 
Print Name 
 
Procurement Officer: Michelle Fink, CPPB, Procurement 
Supervisor 
 
 
Contract No.: CTR056454, 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.: 
CTR056454 
IGA Amendment Two (2) 
Arizona Procurement Portal Amendment Two (2) 
Procurement Officer 
Michelle Fink 
 
2 
 
Exhibit A - 2 CFR 200.332 
§ 200.332 
Requirements for pass-through entities. 
All pass-through entities must: 
 
(a) Ensure that every subaward is clearly identified to the subrecipient as a subaward and includes the following 
information at the time of the subaward and if any of these data elements change, include the changes in 
subsequent subaward modification. When some of this information is not available, the pass-through entity must 
provide the best information available to describe the Federal award and subaward. 
Prime Awardee:  
Arizona Department of Health Services 
UEI # 
QMWUG1AMYF65 
Federal Award Identification (Grant Number): 
5 NU50CK000511-04-00 
Subrecipient name (which must match the name associated 
with its unique entity identifier): 
Maricopa County Department of Public Health, STD 
Program Congenital Syphilis Intervention Project 
(CCSP) 
Subrecipient's unique entity identifier (UEI #): 
M85MG1513K5 
Federal Award Identification Number (FAIN, sometimes it’s 
the same as the Grant Number): 
NU50CK000511 
Federal Award Date (see the definition of Federal award 
date in § 200.1 of this part) of award to the recipient by the 
Federal agency; 
7/11/2022 
Subaward Period of Performance Start and End Date; 
8/1/19 - 7/31/24 
Subaward Budget Period Start and End Date: 
8/1/2023 - 7/31/2024 
Amount of Federal Funds Obligated by this action by the 
pass-through entity to the subrecipient (this is normally the 
contract amount): 
$ 300,000.00 
Total Amount of Federal Funds Obligated to the 
subrecipient by the pass-through entity including the current 
financial obligation (how much is available for contracts): 
$ 300,000.00 
Total Amount of the Federal Award committed to the 
subrecipient by the pass-through entity 
$ 300,000.00

INTERGOVERNMENTAL AGREEMENT (IGA) 
 
Amendment  
 
ARIZONA DEPARTMENT 
OF HEALTH SERVICES 
150 18th Ave Suite 530 
Phoenix, Arizona 85007 
 
Contract No.: 
CTR056454 
IGA Amendment Two (2) 
Arizona Procurement Portal Amendment Two (2) 
Procurement Officer 
Michelle Fink 
 
3 
 
Federal award project description, as required to be 
responsive to the Federal Funding Accountability and 
Transparency Act (FFATA) 
93.323 
Name of Federal awarding agency, pass-through entity, 
and contact information for awarding official of the Pass-
through entity 
Centers for Disease Control and Prevention 
Assistance Listings number and Title; the pass-through 
entity must identify the dollar amount made available under 
each Federal award and the Assistance Listings Number at 
time of disbursement: 
93.323 Epidemiology and Laboratory Capacity for 
Infectious Diseases (ELC) 
Identification of whether the award is R&D 
NOT R&D 
Indirect cost rate for the Federal award (including if the de 
minimis rate is charged) per § 200.414 
 15.65%