16-05-ED_FE_Amendment11.pdf
PDF 543 KB Posted
- Attached to
- Master Agreement AZ|CTR043817
- Contract number
- CTR043817
- Issued by
- Arizona
About this file
This document is an Amendment (No. 11) to an existing Interagency Service Agreement between the Arizona Department of Education and Northern Arizona University (NAU), located in Flagstaff, Arizona. The amendment is for Agreement No. 16-05-ED and pertains to the Evidence Based Practice (EBP) Conference program, with the Arizona Department of Education serving as the primary contracting agency.
The amendment extends the agreement for the period from October 1, 2024 to September 30, 2025, with a total budget of $50,000. The budget breakdown includes $24,996 for non-instructional salaries, $19,000 for purchased services/consultant fees, $2,050 for supplies and materials, $250 for printing and reproduction, and includes an 8% indirect cost rate of $3,704. The purpose of the amendment is to update the budget and renew the agreement for co-sponsoring the annual Evidence Based Practice Conference with NAU. The document is signed by the Assistant Director of Pre-Award Research Administration for NAU and is set to take effect upon execution.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 16-05-ED_FE_Amendment_4.pdf | ||
| FE_16-05-ED_Amendment_8.pdf | ||
| FE_16-05-ED_Amendment_10.pdf | ||
| 16-05-ED_Amendment_6_FE.pdf | ||
| 16-05-ED_FE_Amendment_9.pdf | ||
| 16-05-ED_Fully_Executed.pdf | ||
| FE_16-05-ED_Amendment_12.pdf | ||
| FE_16-05-ED_Amendment_7.pdf | ||
| 16-05-ED_AMD_5_FE.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ARIZONA DEPARTMENT OF EDUCATION
Procurement Section
1535 West Jefferson Street, Bin #37 Phoenix, Arizona 85007-3209
CONTRACT/AGREEMENT ATTACHMENT B
10. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT/AGREEMENT
NOT HERETOFORE CHANGED AND/OR AMENDED REMAIN UNCHANGED AND IN FULL EFFECT.
IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT.
CONTRACTOR
(SIGNATURE OF AUTHORIZED INDIVIDUAL)
NAME (Typed/Printed):
(SIGNATURE)
NAME: Steven Paulson
TITLE: TITLE: Chief Procurement Officer
DATE: DATE:
1. AGREEMENT NO.:
16-05-ED
2. AMENDMENT NO.:
3. EFFECTIVE DATE:
Upon Execution
4. PROGRAM:
EBP Conference
5. CONTRACTOR NAME:
Northern Arizona University P.O. Box 4130 Flagstaff, AZ 86011-4130
6. AUTHORITY FOR AMENDMENT: Paragraph 7, “Changes”, Paragraph 3 “Renewal of Agreement”
7. PURPOSE OF AMENDMENT: Updated Budget
8. DESCRIPTION OF THE SERVICE: Co-Sponsor Annual Evidence Based Practice Conference with NAU
9. THE ABOVE REFERENCED AGREEMENT IS HEREBY AMENDED AS FOLLOWS:
a. In accordance with paragraph 7, Changes, the budget is hereby replaced by Attachment B:
b. Pursuant to the Agreement, Paragraph 3 “Renewal of Agreement”, I hereby extend the agreement for the periods of October 1, 2024 to September 30, 2025.
Nicky Jurgens
Assistant Director, Pre-Award Research Administration
ABOR for and on behalf of Northern Arizona University
08/21/2024
ARIZONA DEPARTMENT OF EDUCATION INTERAGENCY
SERVICE/INTERGOVERNMENTAL AGREEMENT BUDGET/
ESTIMATED NEEDS PAYMENT SCHEDULE FOR
INSTITUTIONS OF HIGHER EDUCATION, STATE AGENCIES
AND OTHER AGENCIES
INSTRUCTIONS
Submit original to ADE Contracts Management Unit as part of proposed Agreement/amendment. Final Agreement will contain instructions for submission of periodic/completion reports
A. AGREEMENT IDENTIFICATION FOR THE BUDGET PERIOD FROM : 10/1/2024 TO: 9/30/2025
1. Applicant Agency:
IHD/NAU
2. Contact Person: Adi Schaeffer
Phone No: 602-728-9534
3. Agreement No.: 16-05-ED
Index No.: 4. Funding Source (Chapter 1, etc.)
ADE
5. Date submitted 6/26/2024
6. Proposal Name (if any):
7. Check ONE ☐ New ☒ Renewal Application
☐ Completion Report ☐ Amendment ☐ADE Revision
B. AGREEMENT BUDGET
*EXPENDITURE CATEGORIES
BUDGET
(1)
REQUEST
CHANGES
(2)
AMENDED
BUDGET
(3)
EXPENDITURE
TO DATE
(4)
BUDGET
BALANCE
(5)
8. Salaries – Instructional
9. Salaries – Non-Instructional $24,996
10. Employee Benefits
11. Travel
12. Supplies and Materials $2,050
13. Purch Services/Consultant Fees $19,000
14. Tuition
15. Printing and Reproduction $250
16. Utilities and Communications
17. Other:
18. SUBTOTAL $46,296
19. Indirect Cost (8% of Line 18) $3,704
20. Capital Outlay
21. TOTAL $50,000
22. Administrative Costs
23. Cash Balance (For Completion Purposes)
*SEE INSTRUCTIONS ON REVERSE SIDE
C. COMPLETION REPORT SIGNATURE (Blue Ink Only)
I hereby certify that this is a reasonable statement of total expenditures for this contract.
Applicant Authorized Agent Date
D. SUMMARY OF AVAILABLE FUNDS INCLUDED IN BUDGET ABOVE
Prior FY C/O + FY State C/O + FY (New)+ Other = TOTAL FY
08/21/2024
E. ESTIMATED NEEDS PAYMENT SCHEDULE ☐Original ☐Revised Date:
FY_____ State C/O FY______ FY_______ Jul: Jan: Jul: Jan: Jul: Jan:
Aug: Feb: Aug: Feb: Aug: Feb:
Sep: Mar: Sep: Mar: Sep: Mar:
Oct: Apr: Oct: Apr: Oct: Apr:
Nov: May: Nov: May: Nov: May:
Dec: Jun: Dec: Jun: Dec: Jun:
TOTAL TOTAL TOTAL
| 2024-08-22T15:04:31-0700 | |
| Steven Paulson |
File details come from the government source that posted it. Updated .