Contract_Amendment_4.pdf

PDF 147 KB Posted

Attached to
Master Agreement AZ|CTR071424
Contract number
CTR071424
Issued by
Arizona

About this file

This document is a Contract Amendment issued by the Arizona Department of Child Safety's Office of Procurement, located in Phoenix, Arizona. The amendment is for Contract #CTR071424, specifically Amendment #4, which pertains to a statewide contract for group home residential services.

The amendment modifies the contracted capacity by removing the Enoch facility, which previously served Group Home Residential Teen Parents for ages zero to seventeen. The revised contract now includes two facilities: Enoch New Beginnings II (specializing in Teen Parent Infant Ward and Infant Non Ward services) with 5 beds for ages 0-17, and Fawn House (a GH Residential facility) with 5 beds for ages 13-17. The total contracted capacity is now ten beds, effective January 23, 2025. All other terms and conditions of the original contract remain unchanged.

View the file

Other files

File Type Posted
Amended.LicEnoch_NB_Effective_10-31-2024_Redacted.pdf PDF
Congregate_Care_Services_SOW_Amendment_3.pdf PDF
Contract_Amendment_1.pdf PDF
Contract_Amendment_Special_Terms.pdf PDF
Enoch_II_Amended_Op.Cert._New_Facility_7-22-2024_Redacted.pdf PDF
Exhibit I - DCS 06-01 Limited English Proficiency.pdf PDF
Exhibit II - Personalized Service Plan.pdf PDF
Exhibit XV Discharge Summary.pdf PDF
Exhibit XVI Facility Modification Request.pdf PDF
Exhibit XX ADJC-5002 ADJC Service Providers Protocol ADJC.doc DOC document
HITECH_Act.pdf PDF
2-Attachment_3-D_Redacted.pdf PDF
2-Attachment_3-E_Redacted.pdf PDF
Contract_Amendment_3.pdf PDF
Contract_Amendment_5.pdf PDF
Enoch_Amended_Lic._Effective_7-22-2024-_Redacted.pdf PDF
Exhibit V - Blood Sugar Log.pdf PDF
Exhibit XI One on One Supervision.pdf PDF
Amended.Op.Cert.ENB.FawnHouse_Redacted.pdf PDF
Congregate_Care_Services_SOW_2024.pdf PDF
ENOCH_NEW_BEGINNINGS__LLC_-_UPDATED_2025-2026_CERTIFICATE_OF_INSURANCE_-_ARIZONA_SUPREME_COURT_Redacted.pdf PDF
Exhibit IV - Medication Error Report.pdf PDF
Exhibit IX Clothing and Property Inventory.pdf PDF
Exhibit VIII Personal Allowance Ledger.pdf PDF
Exhibit XII Bed Hold.pdf PDF
Exhibit XIV Provider Census Report 2024.xlsm XLSM spreadsheet
Exhibit XIX ADJC Census Report.doc DOC document
Exhibit XVIII ADJC Monthly Attendance Report.doc DOC document
Exhibit XXII ADJC Residential Services Invoice.docx DOCX document
Congregate_Care_Services_Amendment.pdf PDF
Congregate_Care_Services_Amendment_8.pdf PDF
Congregate_Care_Services_SOW_Amendment_1.pdf PDF
Congregate_Care_Services_SOW_Amendment_2.pdf PDF
Contract_Extension.pdf PDF
Directions_to_Procurement_File.docx DOCX document
ENOCH_NEW_BEGINNINGS__LLC_-_UPDATED_2024-2025_CERTIFICATE_OF_INSURANCE_Redacted.pdf PDF
Exhibit CS0-1015A.pdf PDF
Exhibit III - Medication Log.pdf PDF
Exhibit VI Fees Log.pdf PDF
Exhibit VII Clothing Allowance Ledger.pdf PDF
Exhibit X Returned Allowances Form.xlsx XLSX spreadsheet
Exhibit XVII Quarterly Report.xlsm XLSM spreadsheet
Offer_and_Acceptance_Redacted.pdf PDF
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Text version

Contract Amendment State of Arizona Department of Child Safety

Office of Procurement 3003 N. Central St, 20th Fl.

Phoenix, AZ 85012

Contract #: CTR071424

Amendment #: 4

ALL OTHER REQUIREMENTS, SPECIFICATIONS, TERMS AND CONDITIONS REMAIN UNCHANGED

This amendment shall be fully executed upon the approval electronically in the state approved e-procurement system by an authorized representative of the Contractor and applied to the contract within the e-procurement system by the Procurement Officer or delegate.

The purpose of this amendment is to remove a facility and decrease capacity to the above referenced contract.

Pursuant to the Uniform Terms and Conditions, Section 5, Contract Changes, Paragraph 5.1, Amendments, and the Special Terms and Conditions, Section 9, Amendments, the facility named Enoch, serving Group Home Residential Teen Parents, ages zero (0) to seventeen (17) has been removed from the contract.

Total contracted capacity is sixteen (10) beds.

All other terms and conditions of the contract will remain the same. Below is the revised structure of the contracted capacity:

Facility Chart Specialty Ages Gender Beds

Enoch New Beginnings II

GH Residential Teen Parent Infant Ward and Infant Non Ward

0-17 M/F 5

Fawn House

GH Residential

13-17 M 5

The effective date of this modification is January 23, 2025.

File details come from the government source that posted it. Updated .