Amendment_9_-_Extend_to_10-15-2022_-_signed.pdf
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- Attached to
- Master Agreement AZ|CTR043946
- Contract number
- CTR043946
- Issued by
- Arizona
About this file
This document is a Contract Amendment (#9) issued by the Arizona Health Care Cost Containment System (AHCCCS) for contract #YH19-0025 with Sandata Technologies, a company located in Hicksville, New York. The amendment involves the DHCM (Department of Health Care Management) program and is specifically focused on extending an existing contract.
The amendment extends the original contract's duration from October 1, 2022, through October 15, 2022, a short 15-day period. All other terms and conditions of the original contract remain unchanged and in full effect. The document was electronically signed by Akshay Bhandari (CFO of Sandata) and Tracey Thomas (Procurement Manager for AHCCCS) on September 30, 2022, with the effective date being the date of the last signature. No specific details about the goods or services are provided in this amendment, which appears to be solely a brief contract time extension.
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Text version
CONTRACT AMENDMENT
1. AMENDMENT #:
2. CONTRACT #:
YH19-0025
3. EFFECTIVE DATE OF AMENDMENT:
Date of Last Signature
4. PROGRAM:
DHCM
5. CONTRACTOR/PROVIDER NAME AND ADDRESS:
Sandata Technologies 270 Duffy Avenue, Unit 266A
Hicksville, NY 11801
6. PURPOSE:
To extend the contract from October 1, 2022, through October 15, 2022
7. THE ABOVE REFERENCED CONTRACT IS HEREBY AMENDED AS FOLLOWS:
Pursuant to the terms and conditions, this contract is extended from October 1, 2022, through October 15, 2022.
8. EXCEPT AS PROVIDED FOR HEREIN, ALL TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT NOT HERETOFORE CHANGED AND/OR
AMENDED REMAIN UNCHANGED AND IN FULL EFFECT.
IN WITNESS WHEREOF THE PARTIES HERETO SIGN THEIR NAMES IN AGREEMENT.
9. NAME OF CONTRACTOR/PROVIDER:
Sandata
10. ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
SIGNATURE OF AUTHORIZED INDIVIDUAL:
SIGNATURE:
TYPED NAME:
Akshay Bhandari
TYPED NAME:
Tracey Thomas
TITLE:
CFO
TITLE:
Procurement Manager
DATE: DATE:
Tracey Thomas (Sep 30, 2022 08:48 PDT)Akshay Bhandari (Sep 30, 2022 15:21 EDT)
Amendment 9 - Extend to 10-15-2022 Final Audit Report 2022-09-30
Created: 2022-09-29
By: Lisa Monreal (Lisa.Monreal@azahcccs.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAzhT8qNc2TK-68pyHtGEyVOViowMaSPkD
"Amendment 9 - Extend to 10-15-2022" History Document created by Lisa Monreal (Lisa.Monreal@azahcccs.gov)
2022-09-29 - 10:42:20 PM GMT
Document emailed to Tracey Thomas (tracey.thomas@azahcccs.gov) for signature
2022-09-29 - 10:43:20 PM GMT
Email viewed by Tracey Thomas (tracey.thomas@azahcccs.gov)
2022-09-30 - 3:48:13 PM GMT
Document e-signed by Tracey Thomas (tracey.thomas@azahcccs.gov) Signature Date: 2022-09-30 - 3:48:32 PM GMT - Time Source: server
Document emailed to Akshay Bhandari (abhandari@sandata.com) for signature
2022-09-30 - 3:48:34 PM GMT
Email viewed by Akshay Bhandari (abhandari@sandata.com)
2022-09-30 - 3:50:14 PM GMT
Document e-signed by Akshay Bhandari (abhandari@sandata.com) Signature Date: 2022-09-30 - 7:21:56 PM GMT - Time Source: server
Agreement completed.
2022-09-30 - 7:21:56 PM GMT
| CONTRACT AMENDMENT |
| 7. THE ABOVE REFERENCED CONTRACT IS HEREBY AMENDED AS FOLLOWS: |
| 2022-09-30T12:21:58-0700 | |
| Agreement certified by Adobe Acrobat Sign |
File details come from the government source that posted it. Updated .